ABSTRACT
OBJECTIVE: To find the chronic prescription of medication in older people, associated variables and its quality. DESIGN: Observation, descriptive-crossover study. SETTING: Urban health district. PATIENTS: Sample stratified in age and sex groups of 385 people of 65 and over registered at the health centre and not in institutions. MEASUREMENTS AND MAIN RESULTS: Social and demographic data, self-perception of health and functional capacity were obtained through interview; and pathology and medication records, from the clinical records and authorized medication cards. 349 people, average age 73 (SD +/- 6.5), were interviewed. There were 210 women and 139 men. 12% perceived their health as bad/very bad. Barthel's index and the Lawton scale were disturbed in 13.8% and 30.4%, respectively. 93% suffered some chronic pathology (average 2.7). 81.4% habitually took medication (average 3.1). The most commonly consumed drugs belonged to the cardiovascular (32%), nervous system (21%) and digestive apparatus and metabolism (17%) groups. For the first group, the main drugs were ACEIs and diuretics; for the second, analgesics and neuroleptics; for the third, antacid and antiulcer drugs. 86% had high intrinsic value, the most prescribed drugs of those with low intrinsic value belonged to the antivaricose, cerebral and peripheral vasotherapy, and urological drugs groups. Multiple medications was related significantly to having more than two chronic pathologies (OR = 7.89, 95% CI 4.40-14.15) and self-perception of worse health (OR = 2.51, 95% CI 1.13-5.59). CONCLUSION: The elderly persons with a greater number of pathologies and perception of worse health took more medication. We thought that our quality of prescription was acceptable, although we should review the indications for neuroleptics and reduce prescription for medication of low therapeutic value.
Subject(s)
Aged , Drug Prescriptions , Age Factors , Aged, 80 and over , Cross-Over Studies , Female , Health Services , Humans , Logistic Models , Male , Sex Factors , Socioeconomic Factors , Spain , Urban PopulationABSTRACT
Tuberculosis continues to be an important health problem. A tuberculosis prevention and control program was begun in 1989 in Ciutat Badia, introducing the inclusion of those who had been in close contact with infected subjects. In the two years of the study, a total of 1,548 tuberculin tests was performed, 518 of which were positive 33%). Prevalence of tubercular infection in the study population, was 13.95%. Ages ranged from 14 to 20 years. We detected 20 cases of pulmonary tuberculosis and were able to study 91% of those who had been in close contact with the subjects in question. Three of these were detected in the latter study, and two by contact with tubercular infection. We prescribed a total of 180 chemoprophylaxes (47 primary and 133 secondary) with compliance of 60% and 71% respectively. We believe that chemoprophylaxis plays an important role in the prevention and control of tuberculosis in primary care.
