Subject(s)
Evidence-Based Medicine , Practice Guidelines as Topic , Primary Health Care/standards , Humans , SpainABSTRACT
No disponible
Subject(s)
Humans , Evidence-Based Medicine , Practice Guidelines as Topic , Primary Health Care/standards , SpainABSTRACT
OBJECTIVE: To describe the aspects of continuing education in pharmacological therapeutics considered as most relevant by the primary health care physicians. DESIGN: Observational study.Setting. Physicians filled-up the questionnaires during 45 minutes at their primary health care centres. PARTICIPANTS: Primary health care physicians involved in the Fundation Institut Català de Farmacologia continuing education activities since 1997 were selected. MAIN MEASUREMENTS: A specific questionnaire was designed to collect the physicians' opinion on different topics regarding continuing education in pharmacological therapeutics. RESULTS: 180 physicians from 21 primary health care centres answered the questionnaire. 68% of the responding physicians considered that continuing education has to be useful to improve routine clinical practice. Regular seminars and methods stimulating active participation administered by primary health care professionels are preferred. Continuing education in pharmacological therapeutics should be focused to health problems rather than being drug-oriented. They referred being more interested in drug selection issues and in the role of new drug in comparison with the existing alternatives rather than in regulation and drug consumption issues. 66,3% of the responding physicians considered that continuing education in pharmacological therapeutics should be compulsory. Public health authorities and primary health care physicians should share the responsibility in setting-up continuing education in pharmacological therapeutics programs, according to the opinion of almost 70% of the physicians. CONCLUSIONS: Primary health care physicians are interested in continuing education in pharmacological therapeutics as far as it is practical and useful to solve problems of their routine clinical practice.
Subject(s)
Drug Therapy , Education, Medical, Continuing/statistics & numerical data , Family Practice/education , Physicians, Family/education , Primary Health Care/statistics & numerical data , Adult , Attitude of Health Personnel , Data Collection , Female , Humans , MaleABSTRACT
Objetivo. Describir qué aspectos de la formación en terapéutica farmacológica consideran los médicos de atención primaria como más necesarios. Diseño. Estudio observacional. Emplazamiento. Los médicos fueron citados en su centro para contestar las encuestas. Participantes. Participaron médicos de centros de atención primaria a los que habitualmente la Fundación Institut Catalá de Farmacología dirige su programa de formación. Mediciones principales. Se elaboró un cuestionario, diseñado específicamente para recoger la opinión de los médicos sobre la formación continuada en terapéutica farmacológica. Resultados. La encuesta fue realizada en 21 centros de atención primaria de Barcelona. Respondieron a la encuesta 180 médicos. El 68 por ciento de médicos considera que la formación continuada ha de ser útil para mejorar su práctica clínica habitual. Prefieren realizar seminarios periódicos, métodos docentes participativos y consideran que las personas que han de impartir habitualmente la formación han de ser cercanas a la atención primaria. Prefieren una formación dirigida al abordaje terapéutico de los problemas de salud. Con respecto a la información sobre medicamentos, están más interesados en la selección de los mismos y su lugar terapéutico que en temas de regulación o consumo farmacológico. El 66,3 por ciento de los encuestados considera que la formación continuada debería ser obligatoria. Casi un 70 por ciento considera que la responsabilidad en la elaboración de los programas de formación debería ser compartida por las instituciones sanitarias y los propios profesionales. Conclusiones. Los médicos de atención primaria están interesados en una formación continuada sobre terapéutica farmacológica de carácter práctico, que dé respuestas a las cuestiones que se le plantean en su actividad clínica habitual (AU)
Subject(s)
Adult , Male , Female , Humans , Drug Therapy , Physicians, Family , Primary Health Care , Attitude of Health Personnel , Data Collection , Education, Medical, Continuing , Family PracticeABSTRACT
BACKGROUND: In patients with heart failure, beta-adrenergic blocking agents reduce overall and cardiovascular mortality. This meta-analysis aimed at clarifying their effect on sudden death, the magnitude of their benefit according to the cause of heart failure, and whether there is any difference between vasodilating and nonvasodilating agents. METHODS: Randomized, clinical trials were included if they evaluated a beta-adrenergic blocking agent without intrinsic sympathomimetic activity, included a control group receiving placebo or standard treatment, evaluated mortality on an intention-to-treat basis, and lasted at least 8 weeks. RESULTS: Twenty-one trials with 5,849 patients (3,130 receiving beta-blockers) were included. Median length of treatment was 6 months. Most patients had mild or moderate heart failure and were treated with angiotensin-converting enzyme inhibitors, diuretics, and digitalis. The beta-blockers significantly reduced overall mortality, cardiovascular mortality, and mortality due to pump failure and sudden death by 34% to 39%. The decrease in overall mortality in patients with ischemic heart disease (IHD) (30%) was no different from that among patients with non-IHD (26%) (P = .08). The reduction in overall mortality was greater with vasodilating than with nonvasodilating agents (45% vs 27%; P = .007), particularly in patients without IHD (62%), compared with those with IHD (22%; P =.03). CONCLUSIONS: In patients with heart failure, beta-blockers reduce total and cardiovascular mortality at the expense of a decrease in mortality due to pump failure and sudden death. The magnitude of the benefit is similar in patients with IHD and in those with non-IHD. Vasodilating beta-blockers have a greater effect on overall mortality than nonvasodilating agents, particularly in patients with non-IHD.
Subject(s)
Adrenergic beta-Antagonists/therapeutic use , Death, Sudden, Cardiac/prevention & control , Heart Failure/drug therapy , Vasodilator Agents/therapeutic use , Cross-Over Studies , Death, Sudden, Cardiac/etiology , Heart Failure/etiology , Heart Failure/mortality , Hospitalization , Humans , Randomized Controlled Trials as Topic , Survival RateABSTRACT
In order to discover the present state of research into the use of medication (UM) in primary care, articles published in the "Original Articles" sections of Medicina Clínica (MC) (Clinical Medicine) and Atención Primaria (AP) (Primary Care) between 1983 and 1990, were studied. A total of 130 articles that meet the definition of the WHO for studies into the use of Medications (SUM) were identified. The instigator and organiser of the research, the drugs included, the kind of study, the source of the data, the main variables used and the qualitative analysis made, were all studied. In conclusion we were able to point out that the characteristics of UM were met in the majority of the studies; although they are the main objective of the study in only a minority of cases. The people who undertook most of the research were those who themselves prescribed the drugs or dealt with very common pathologies. In general, the studies are only descriptive and have a poor level of assessment of the results.
