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1.
Nieves Martell-Claros Alberto Galgo Nafría María Abad-Cardiel Beatriz Álvarez-Álvarez José Antonio García Donaire Emilio Márquez-Contreras Ángel Molino-González 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(7):406-413
Introduction
To know the opinion/evaluation of the primary care physicians (PCPH) of the received information about patients that were attended in specialized care (SC).Design
Cross-sectional study.Location
Performed nationwide in primary care centers.Participants
Researchers from the primary care network.Methods
We used the SEH-LELHA derivation criteria guidelines, plus an ad hoc survey that included demographic and anthropometric data, blood pressure levels, and the main reason for derivation to SC at the baseline and final (post-derivation) visit. In addition, time deployed for the study of every patient, changes in diagnosis and treatment, type of follow-up, issues throughout the derivation process and assessment of the medical referred to the PCPH were evaluated.Results
With participation of 578 researchers from primary, the study included 1715 patients aged 60.7 ± 13.3 years, 62.7% male. Patients were taking 2.3 ± 1.2 (range 0-10) antihypertensive drugs pre-referral and 2.5 ± 1.2 (0-9) after derivation. Blood pressure levels changed from 166 ± 21.6 / 97.7 ± 12.6 mmHg to 143 ± 14.4 / 85.5 ± 10.5 mmHg. The number of controlled patients (BP < 140 and < 90 mmHg) increased from 5.8% to 32.2%. Time between pre- and post-derivation visit was 72 ± 64 days (median 57 days, IQ 26-99). The PCPH received a medical report in 80.3% of cases, 76.9% with an explanation of the results of the complementary tests, 75.8% with additional information or a reasoning of treatment and in 71% of cases information about the patient future management. 63% of PCPH were fully agreed with the management of the specialist, 29% agree and 2% strongly disagree. The derivation was evaluated as effective or very effective in 86% of patients and no effective in 9%.Conclusions
Communication between AE and SC in HTA is valued satisfactorily by MAP. However there is still room for improvement in the process. 相似文献2.
Mariano de la Figuera Sergio Cinza Nuria Marín Isabel Egocheaga Miguel Angel Prieto 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(6):359-367
Objective
To analyse the clinical characteristics and management of patients with non-valvular atrial fibrillation (NVAF) treated with direct oral anticoagulants (DOAC).Design
Observational, cross-sectional and multicentre study.Location
Autonomous Communities in which the general practitioner can prescribe DOAC (n = 9).Participants
The study included a total of 790 patients on chronic treatment with anticoagulants, and on whom therapy was changed, as well as being currently on treatment with DOAC for at least for 3 months.Main measures
A record was made of the sociodemographic and clinical management date.Results
Mean age was 78.6 ± 8.4 years, and 50.5% of patients were men. Mean CHADS2 score was 2.6 ± 1.2, mean CHA2DS2-VASc score was 4.3 ± 1.6, and the mean HAS-BLED score was 2.3 ± 1.0. Mean duration of treatment with DOAC was 15.8 ± 12.5 months. Rivaroxaban was the DOAC most frequently prescribed (57.8%), followed by dabigatran (23.7%), and apixaban (18.5%). Of the patients receiving rivaroxaban, 70.2% were taking the dose of 20 mg/daily. Of the patients receiving dabigatran, 41.7% were taking the dose of 150 mg twice daily, and in the case of apixaban, 56.2% were taking the dose of 5 mg twice daily. Satisfaction (ACTS Burdens scale 52.0 ± 7.2 and ACTS Benefits scale 12.1 ± 2.2), and therapeutic adherence (97.8% of patients took their medication regularly) with DOAC were high.Conclusions
Patients treated with DOAC in Spain have a high thromboembolic risk. A significant proportion of patients receive a lower dose of DOAC than that recommended according to their clinical profile. Satisfaction and medication adherence are high. 相似文献3.
Gloria Aranda Auserón M. Rosario Elcuaz Viscarret Carmen Fuertes Goñi Victoria Güeto Rubio Pablo Pascual Pascual Enrique Sainz de Murieta García de Galdeano 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(3):141-150
Objective
To evaluate the effectiveness of a Mindfulness and Self-Compassion Program on the levels of stress and burnout in Primary Care health professionals.Design
Randomised, controlled clinical trial.Participants and setting
Training in Mindfulness was offered to 1,281 health professionals in Navarra (Spain) Primary Care, and 48 of them accepted. The participants were randomly assigned to groups: 25 to the intervention group, and the remaining 23 to the control group.Intervention
The Mindfulness and Self-Compassion training program consisted of sessions of 2.5chours/week for 8 weeks. The participants had to attend at least 75% of the sessions and perform a daily practical of 45 minutes.Main measurements
The levels of mindfulness, self-compassion, perceived stress, and burnout were measured using four questionnaires before and after the intervention.Results
After the intervention, the scores of the intervention group improved significantly in mindfulness (P < .001); perceived stress (P < .001); self-compassion: self-kindness P < .001, shared humanity P = .004, mindfulness P = .001; and burnout: emotional fatigue (P = .046). The comparison with the control group showed significant differences in mindfulness (P < .001), perceived stress (P < .001), self-kindness (P < .001) and emotional fatigue (P = .032).Conclusions
This work suggests that it may be beneficial to encourage mindfulness and self-compassion practices in the health environment. 相似文献4.
Cristina Vedia Urgell Mireia Massot Mesquida Roser Valles Fernandez Juan Antonio Garcia Vicente Alicia Franzi Siso Laura Muñoz Ortiz Laia Vilaró Jaques Maite Bosch Peligero 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(1):6-15
Objective
Quantitative study: To assess the prevalence of inadequacy of treatment for osteoporosis in primary prevention (OPP) in women aged 60-74 years. Qualitative study: To evaluate the diagnostic and treatment criteria of the OPP and it's variability in primary care physicians (PC) and specialists.Material and methods
Quantitative study: observational, cross-sectional and retrospective study. Population: women aged 60-74 years with active treatment for OPP (n = 424) in May 2012. Inadequacy if they had ≤ 2 risk factors with a DXA or DXA T-score ≥ ?2.4. Qualitative study: Delphi technique (15 items) and two rounds of consultation. Period: March-April 2014. Population: PC physicians, rheumatologists and orthopaedic surgeons (n = 251). Random sampling.Results
Quantitative study: degree of inadequacy is 63.4%. In 43.2% isn’t mention a diagnosis of osteoporosis. In 82.3% there isn’t mention of risk factors. Treatment: bisphosphonate 40.3% and calcium + vitamin D 47.9%. Qualitative study: 23% respond to the first round, and of these 67% the second round. Items with higher agreement were the important of the evaluation of risk factors for diagnosis and bisphosphonates for treatment. Items with fewer consensuses were using the FRAX and densitometry and treatment with only calcium + vitamin D.Conclusions
The percentage of inadequacy is high. The degree of registration in medical history is low. The Delphi method is useful for detecting discrepancies between recommendations of clinical practice guidelines and results. 相似文献5.
M.P. González Romero F.J. Cuevas-Fernández I. Marcelino-Rodríguez V.J. Covas M.C. Rodríguez Pérez A. Cabrera de León A. Aguirre-Jaime 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(7):414-421
Objective
To determine if the ETAP smoking scale, which measures accumulated exposure to tobacco, both actively and passively, is applicable and effective in the clinical practice of Primary Care for the prevention of acute myocardial infarction (AMI).Location Barranco Grande Health Centre in Tenerife, Spain.Design
A study of 61 cases (AMI) and 144 controls. Sampling with random start, without matching. COR-II curves were analysed, and effectiveness was estimated using sensitivity and negative predictive value (NPV). A questionnaire was provided to participating family physicians on the applicability of ETAP in the clinic.Results
The opinion of the participating physicians was unanimously favourable. ETAP was easy to use in the clinic, required less than 3 min per patient, and was useful to reinforce the preventive intervention. The ETAP COR-II curve showed that 20 years of exposure was the best cut-off point, with an area under the curve of 0.70 (95% CI: 0.62-0.78), and a combination of sensitivity (98%) and NPV (96%) for AMI. When stratifying age and gender, all groups achieved sensitivities and NPVs close to 100%, except for men aged ≥ 55 years, in whom the NPV fell to 75%.Conclusions
The results indicate that ETAP is a valid tool that can be applied and be effective in the clinical practice of Primary Care for the prevention of AMI related to smoking exposure. 相似文献6.
Javier C. Angulo María P. Calderín Yolanda Fernández Miriam González Esther Gómez Maria B. Herreros Purificación Peñasco Manuela Zapatero Juan F. Dorado 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(2):79-87
Objective
Determining the prevalence of symptoms suggestive of overactive bladder (OAB) in a Spanish population and evaluate the impact of these symptoms on well-being and labour productivity in this population.Design
Transversal study.Location
Primary health care, Madrid, Spain.Participants
Males and females > 30 years.Interventions
Classification by primary care physicians with the Overactive Bladder Awareness Tool abbreviated version (OAB-V3). Subjects with score ≥ 3 and a similarly balanced control population with score < 3 were clinically investigated.Principal measurements
History, physical examination, urinalysis, sonography, general well-being scale and the questionnaires PPBC, OAB-q y WPAI-SHP.Results
A total 923 subjects were screened, of which 209 (22.6%), 35% males and 65% females, had probable OAB. Age distribution increased from 11.1% in 4th decade to 44.4% in 9th decade. Kappa coefficient between suspected OAB and definite diagnosis was .83. The area under ROC curve for diagnosis based on OAB-V3 questionnaire and the presence of perceived bother and coping strategies was 92%. Subjects classified by score ≥ 3 had worse well-being, higher PPBC score and worse parameters on total OAB-q and transformed scores for each OAB-q subscale (P < .0001). In these subjects labour productivity was not affected (P = .14) but the capacity to perform regular activities was (P < .0001).Conclusions
OAB-V3 is a simple questionnaire to screen OAB with good predictive accuracy in a primary care setting and reveals important implications on health related quality of life issues. 相似文献7.
8.
Carles Llor Albert Boada Mariona Pons-Vigués Elisabet Grenzner Rosa Juvé Jesús Almeda 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(1):44-52
Introduction
The information available on antibiotic resistance patterns are generally based on specimens from hospitalised individuals. This study was aimed at evaluating the antibiotic resistance rate of nasal carriage strains of Staphylococcus aureus and Streptococcus pneumoniae in healthy individuals, in accordance with age and gender, attended in Primary Care Centres (PCC).Design
Cross-sectional study.Setting
Seven PCC in the Barcelona area.Participants
Healthy nasal carriers aged 4 years or more who did not present with any sign of infectious disease, and had not taken any antibiotic or had been hospitalised in the previous 3 months.Main measurements
A total of 3,969 nasal swabs valid for identification were collected between 2010 and 2011 and were sent to one central microbiological laboratory for isolation of both pathogens. Resistance to common antibiotics was determined on the basis of the current European Committee on Antimicrobial Susceptibility Testing guidelines on cut-off points.Results
The prevalence of methicillin-resistant S. aureus was 1.3% (95% CI: 0.5-2.1%), with resistance rates of 87.1% to phenoxymethylpenicillin and 11.6% to azithromycin, with no significant differences with age and gender. A total of 2.4% (95 CI%: 0.1-4.7%) of the pneumococcal strains were highly resistant to both phenoxymethylpenicillin and macrolides, whereas the highest resistance rates were to cefaclor (53.3%), followed by tetracycline (20%) and cefuroxime (12.1%).Conclusions
These pathogens have lower resistance rates in the community than in the hospital setting. Primary Care physicians must be more aware of the current antimicrobial resistance, in order to ensure prudent use of antibiotics. 相似文献9.
Daniela Dubois Marques Vicente Mora Llabata Julián Pacheco Arroyo Salvador Gasull Insertis Manuela Vicente Cañizares Ildefonso Roldán Torres 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(6):340-349
Objective
To determine whether antithrombotic treatment (ATT) in patients with non-valvular atrial fibrillation in a health area complies with the recommendations of current clinical guidelines.Design
Prospective observational study.Location
Primary Health Care Centres and Cardiology Department of a Health Department of the Valencian Community, Spain.Participants
A total of 505 patients with nonvalvular atrial fibrillation were included in the study.Main measurements
ATT was deemed to be inappropriate in patients with a CHA2DS2-VASc score ≥ 1 and who were not under oral anticoagulation, in patients treated with antivitamin K drugs, and poor control of oral anticoagulation, or with antiplatelet therapy inappropriately associated with anticoagulation, and in patients on ATT with a CHA2DS2-VASc score = 0.Results
The median age was 77.4 ± 10 years. The ATT was considered inadequate in 58% of cases. Factors independently associated with inadequate ATT were age (OR: 1.02 [1-1.04]; P = .029), hypothyroidism (OR: 1.98 [1.14-3.43]; P = .015), ischaemic heart disease (OR: 1.3 [1.15-2.59]; P = .008) and paroxysmal non-valvular AF (OR: 2.11 [1.41-3.17]; P < .0001).Conclusions
These data underline the high prevalence of inadequate ATT in daily practice, as well its different causes. 相似文献10.
Ingrid Solanes Ignasi Bolíbar Maria Antònia Llauger Meritxell Peiro Pepi Valverde Mar Fraga Casimira Medrano Teresa Bigorra Montserrat Freixas Iskra Ligüerre Maria Antònia Pou Leandra Domínguez Carles Valero Judit Solà Jordi Giner Vicente Plaza 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(3):184-196
Objective
To evaluate the effectiveness of two management programs on patients with chronic obstructive pulmonary disease (COPD).Design
A study with a quasi-experimental design was used to evaluate the effectiveness of two interventions (I1, I2) for the care of patients with COPD after a mean follow-up of 31.2 months.Setting
Primary Care Centres in two Barcelona Health Areas and their referral hospitals.Participants
Patients with COPD selected by simple random sampling using any disease code corresponding to COPD.Interventions
I1: Integrated management program that was optimised and coordinated the resources. Training was given, as well as quality control of spirometry. I2: Isolated interventions like a call-centre. Care circuits and computerised clinical notes were shared.Main measurements
Variables were recorded as regards lung function, severity, use of inhalers, lifestyles, quality of life, and exacerbations.Results
Of the 393 patients evaluated at the beginning, 120 and 104 (I1 and I2, respectively) received the final evaluation. With I1, there was a reduction in patients who smoked (P = .034). Lung function and quality of life did not change significantly in either group, but shortness of breath was slightly worse. There was an increase in the correct use of inhalers, although it only reached 48% and 61% with interventions I1 and I2, respectively. The percentage of patients with exacerbations decreased with I1 compared to that of I2 (P < .001), and there were less hospital admissions due to exacerbations with I2 compared to I1 (P < .003]).Conclusions
Both interventions achieved significant improvements, and no overall worsening of a chronic and progressive disease as is COPD. 相似文献11.
Olga Ochoa-Gondar Ángel Vila-Córcoles Cinta de Diego Eva Satué Angel Vila-Rovira María Aragón 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(9):553-559
Objectives
To know antipneumococcal vaccination coverages among Catalonian adults and evaluate the adequacy of vaccine use according to 3 distinct current vaccination guidelines.Design
Population-based cross-sectional study.Setting
Primary Health Care. Catalonia, Spain.Participants
A total of 2,033,465 individuals ≥ 50 years-old registered in the Catalonian Health Institute.Main measurements
Vaccination status for the 23-valent pneumococcal polysaccharide vaccine (PPV23) and/or the 13-valent pneumococcal conjugate vaccine (PCV13) was revised at 1/01/2015. Adequacy of vaccination status was determined according to 3 distinct vaccination recommendation guidelines: Spanish Ministry of Health (basically coinciding with Catalonian Health Institute's recommendations), Spanish Society of Family Physicians (semFYC) and Centers for Disease Control and Prevention (CDC).Results
Overall, 789,098 (38.8%) persons had received PPV23 and 5,031 (0.2%) had received PCV13. PPV23 coverage largely increased with increasing age (4.8% in 50-59 years, 35.5% in 60-69 years, 71.9% in 70-79 years and 79.5% in ≥ 80 years; P < .001), whereas PCV13 coverage was very small in all age groups. Considering the 3 analysed vaccine guidelines a 46.1% of the overall study population were adequacy vaccinated according to Spanish Ministry's recommendations, 19.3% according to semFYC's recommendations and 4.6% according to CDC's recommendations.Conclusion
PPV23 coverage among Catalonian adults may be considered as intermediate, but PCV13 coverage is very small. The institutional recommendations (Spanish Ministry) are more followed than corporative (semFYC) or less local (CDC) recommendations in clinical practice. 相似文献12.
13.
14.
Belén Muñoz Díaz Antonio P. Arenas de Larriva Guillermo Molina-Recio Rafael Moreno-Rojas Jorge Martínez de la Iglesia 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(2):88-95
Objective
To analyse the nutritional status of patients older than 65 years included in the home care program (PAD).Design
Croos-sectional study.Emplacement
3 urban health centers.Participants
218 patients in the PAD.Method
Mini Nutritional Assessment questionnaire (MNA) was applied. Sociodemographic, anthropometric, dependency, emotional and cognitive status and analytical parameters: 57 variables were collected. Possible associations were analysed by applying the chi square and variance analysis. The level of significance was considered to be P < .05 was considered.Results
The mean age was 83.9 years (SD = 7.4); 34.9% were institutionalized and 80.7% were women; 21.2% of patients were malnourished and 40.1% were at risk of it. A significant association was established between poorer nutritional status and older age, lower BMI, greater dependence on basic and instrumental activities of daily living and greater cognitive impairment. The lowest mean hemoglobin, albumin, and iron levels were also associated with malnutrition and risk of malnutrition.Conclusions
More than half of PAD patients are malnourished or at risk for it, and a high proportion of them some laboratory abnormality susceptible to be corrected. Most cognitive impairment and functional dependence are closely related to malnutrition; so patients with these characteristics should receive more attention from the nutritional point of view. 相似文献15.
Cristina Salvadó-Hernández Pilar Cosculluela-Torres Carmen Blanes-Monllor Neus Parellada-Esquius Carmen Méndez-Galeano Neus Maroto-Villanova Rosa Maria García-Cerdán M. Pilar Núñez-Manrique Carmen Barrio-Ruiz Betlem Salvador-González 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(4):213-221
Objective
To determine the attitudes, knowledge, and self-care practices in patients with heart failure (HF) in Primary Care, as well as to identify factors associated with better self-care.Design
Cross-sectional and multicentre study.Setting
Primary Care.Participants
Subjects over 18 years old with HF diagnosis, attended in 10 Primary Health Care Centres in the Metropolitan Area of Barcelona.Main measurements
Self-care was measured using the European Heart Failure Self-Care Behaviour Scale. Sociodemographic and clinical characteristics, tests on attitudes (Self-efficacy Managing Chronic Disease Scale), knowledge (Patient Knowledge Questionnaire), level of autonomy (Barthel), and anxiety and depression screening (Goldberg Test), were also gathered in an interview. A multivariate mixed model stratified by centre was used to analyse the adjusted association of covariates with self-care.Results
A total of 295 subjects (77.6%) agreed to participate, with a mean age of 75.6 years (SD: 11), 56.6% women, and 62% with no primary education. The mean self-care score was 28.65 (SD: 8.22), with 25% of patients scoring lower than 21 points. In the final stratified multivariate model (n = 282; R2 conditional = 0.3382), better self-care was associated with higher knowledge (coefficient, 95% confidence interval: ?1.37; ?1.85 to ?0.90), and coronary heart disease diagnosis (?2.41; ?4.36: ?0.46).Conclusion
Self-care was moderate. The correlation of better self-care with higher knowledge highlights the opportunity to implement strategies to improve self-care, which should consider the characteristics of heart failure patients attended in Primary Care. 相似文献16.
Laura Illamola Martin Juan José Rodríguez Cristobal Carlos Alonso-Villaverde Betlem Salvador-González Irene Moral Pelaez 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(6):325-331
Objectives
To determine whether the benefit on cardiovascular risk factors (CVRF) persists 5 years after an intensive intervention in lifestyle (LS) that lasted 2 years, in patients with hyperfibrinogenaemia and moderate or high cardiovascular risk.Design
multicentre prospective observational study.Location
13 Primary Care Centres in Barcelona and Baix Llobregat.Participants
A total of 300 patients who completed the EFAP study (146 intervention group, 154 control group).Interventions
The EFAP study, conducted on patients with normal cholesterol and elevated fibrinogen showed that lifestyle interventions are effective in reducing CVRF. After the EFAP study, the 2 groups followed the usual controls, and re-assessed after 5 years.Main measurements
Age, gender, cardiovascular diseases (CVD) (diabetes, dyslipidaemia, hypertension, obesity), laboratory parameters (fibrinogen, glucose, full blood count, cholesterol, triglycerides), blood pressure, weight, height, body mass index (BMI), tobacco and alcohol use, REGICOR.Results
At 5 years, the intervention group had a lower abdominal circumference (98 and 101 cm, respectively, P = .043), a lower weight (76.30 and 75.04 kg, respectively, P < .001), and BMI (29.5 and 30.97 kg/m2, P = .018). Fibrinogen level was lower in the intervention group (330.33 and 320.27 mg/dl respectively, P < .001), and REGICOR risk was also lower in the intervention group (5.65 and 5.59 respectively, P < .06).Conclusion
The benefit of an intensive intervention in LS for 2 years to reduce CVRF persists at 5 years, but decreases its intensity over time. It is recommended to repeat the interventions periodically to maintain the beneficial effect on LS. 相似文献17.
Francisco Javier Formigo Couceiro Marta Pena Seijo Antonio Pose Reino José Manuel Mayán Santos Francisco Javier Ayape Amigot Jesús Sueiro Justel 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2019,51(5)
Objective
To estimate the prevalence of orthostatic hypotension (OH) in patients 80 years old and over attending a primary care unit. To relate OH to the most prevalent pathologies and to the most used drugs.Design
Transversal observational study.Location
Primary care unit, Santiago de Compostela.Participants
Eighty one patients 80 years old or over representative of a primary care unit were recruited. Ten patients were excluded.Main measurements
Blood pressure was measured in decubitus and later in erect position first immediately after standing and then after 3 minutes. Diagnoses and active treatments were reviewed in the electronic clinical history and through an interview with the patient and caregiver.Results
In 26.76% of patients the systolic blood pressure fell by 20 mmHg or more and/or the diastolic blood pressure fell by 10 mmHg in the instant following the postural shift. In 16.90% of patients the drop persisted after 3 minutes of standing from decubitus position. None of the patients was diagnosed with OH. The highest prevalence ratio was observed for diabetes mellitus (1.6; P = .412), not existing differences for arterial hypertension (P = .881). OH related in a statistically meaningful way to the use of renin angiotensin aldosterone system inhibitors (OR: 8.174, CI95%: 1.182-56.536); P = .033] and benzodiazepines (OR: 5.938, CI95%: 1.242-28.397; P = .026)].Conclusion
OH had a prevalence of 16.90% among the elderly patients who had a consultation. Its connection with some drugs (renin angiotensin aldosterone system inhibitors and benzodiazepines) must be considered. 相似文献18.
Cristina Blánquez Moreno Cristina Colungo Francia M. Carme Alvira Balada Belchin Kostov Luis González-de Paz Antoni Sisó-Almirall 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(9):539-546
Aim
To determine the impact of an educational program to improve the management of chronic obstructive pulmonary disease (COPD) that contributes to an increase of the quality of life, exercise capacity, level of dyspnoea, and clinical risk.Design
Intervention study without controls.Location
Primary Healthcare Centre.Participants
193 patients with COPD were invited, 73 accepted and 55 participated in the educational program.Interventions
Respiratory rehabilitation educational program with basic concepts of pulmonary and respiratory pathophysiology, respiratory physiotherapy exercises, practical workshop on the use of the most frequent inhalation devices, understanding of chronic disease and self-care measures in case of exacerbation.Main measurements
The quality of life (the COPD assessment test), exercise tolerance (the Six-Minute Walk Test), rating of perceived exertion (Borg Dyspnoea Score) and clinical risk (BODE index) were assessed by means of validated questionnaires in Spanish.Results
A total of 43 (78.2%) participants completed the program. An improvement in the quality of life by a mean of 3.3 points was observed (95%CI; 1.76-4.84). Just over half (53.5%) of the participants obtained a clinically relevant improvement. Participants also improved their physical exercise capacity at post-intervention by increasing the distance that they walked in 6 min by a mean of 20.76 m (95%CI; 2.57-38.95). Improvements in the level of dyspnoea and clinical risk were also observed.Conclusions
The educational program shows a statistically significant and clinically relevant improvement in the quality of life, fatigue, symptomatology, exercise capacity, level of dyspnoea, and clinical risk. The program is adaptable to the health care routine of healthcare centres. 相似文献19.