ABSTRACT
Loneliness and related constructs associated with isolation are public health problems with increasing prevalence. The aim of this umbrella was to collate and grade evidence analyzing actual and subjective loneliness as a health risk factor. Following prospective registration, a systematic search was conducted in Pubmed, Embase, Scopus, Web of Sciences, psycoINFO and Cochrane Library until August 2023. Systematic reviews assessing the association between actual and subjective loneliness with adverse health outcomes were selected. Risk of bias was evaluated using AMSTAR-2 tool. Data were tabulated and synthesis was narrative. A total of 13 systematic reviews was selected (four included meta-analysis). The methodological quality was critically low in 10 reviews (76.92%) and low in 3 (23.08%). Results showed that loneliness was related to poor well-being and increase the risk of negative mental and physical health. The available data suggested but did not allow the confirmation of a causal association. Most constructs of loneliness seem to be related to mental and physical health conditions. A preventive strategy ought to be recommended, especially for vulnerable populations.
ABSTRACT
Al menos uno de cada 3 adultos tiene múltiples enfermedades crónicas. La asistencia a estos pacientes es imprescindible, y constituye una de las labores principales en atención primaria. El abordaje de estos pacientes supone un reto, ya que existen barreras a múltiples niveles (sistema sanitario, trabajadores sanitarios, paciente). Además, la pandemia por COVID-19 no ha hecho sino empeorar aún más esta situación. En consecuencia, se hace necesario tomar medidas que intenten mejorar esta situación. Para ello, con el objetivo de definir soluciones/recomendaciones que ayuden a un mejor diagnóstico, tratamiento y seguimiento de los pacientes con enfermedades crónicas, un grupo de expertos de SEMERGEN ha tratado de identificar los problemas en la atención de estos pacientes, buscando posibles soluciones y áreas de mejora. En concreto, el presente documento se ha centrado en 4 de las enfermedades crónicas más prevalentes en atención primaria: dislipemia, hipertensión arterial, enfermedad venosa crónica y depresión (AU)
At least one in three adults has multiple chronic conditions. The assistance of patients with chronic conditions is mandatory. This is one of the main tasks of the primary care physicians. The approach in these patients is challenging, as there are many barriers at different levels (sanitary system, healthcare professionals and patients). In addition, COVID-19 pandemic has worsened this situation even more. Therefore, it is necessary to take actions that try to improve this state. For this purpose, with the aim to find solutions/recommendations that may be helpful to attain a better diagnosis, treatment and follow-up of patients with chronic diseases, a group of experts of SEMERGEN have tried to identify the problems in the attention to these patients, searching for potential solutions and areas of improvement. The present document has specifically focused on four prevalent chronic conditions in primary care: dyslipidemia, arterial hypertension, chronic venous disease and depression (AU)
Subject(s)
Humans , Adolescent , Young Adult , Adult , Middle Aged , Aged , Chronic Disease/therapy , Treatment Adherence and Compliance , Chronic Disease/classification , Diagnostic Techniques and Procedures , Primary Health CareABSTRACT
At least one in three adults has multiple chronic conditions. The assistance of patients with chronic conditions is mandatory. This is one of the main tasks of the primary care physicians. The approach in these patients is challenging, as there are many barriers at different levels (sanitary system, healthcare professionals and patients). In addition, COVID-19 pandemic has worsened this situation even more. Therefore, it is necessary to take actions that try to improve this state. For this purpose, with the aim to find solutions/recommendations that may be helpful to attain a better diagnosis, treatment and follow-up of patients with chronic diseases, a group of experts of SEMERGEN have tried to identify the problems in the attention to these patients, searching for potential solutions and areas of improvement. The present document has specifically focused on four prevalent chronic conditions in primary care: dyslipidemia, arterial hypertension, chronic venous disease and depression.
Subject(s)
COVID-19 , Hypertension , Humans , Pandemics , Chronic Disease , Health PersonnelABSTRACT
La diabetes mellitus (DM) incrementa el riesgo de presentar complicaciones tanto microvasculares como macrovasculares. Aunque reducir la glucemia hasta los objetivos recomendados reduce el riesgo de complicaciones microvasculares, el efecto de los antidiabéticos sobre las complicaciones macrovasculares y la muerte cardiovascular es motivo de preocupación. Es más, algunos antidiabéticos podrían ser hasta perjudiciales desde el punto de vista de seguridad cardiovascular. En este contexto, las diferentes agencias reguladoras han establecido la necesidad de realizar estudios específicamente diseñados acerca de la seguridad cardiovascular de los antidiabéticos. Recientemente se han publicado los resultados de 2 ensayos clínicos que aportan información relevante acerca de la seguridad cardiovascular de los inhibidores de la dipeptidil peptidasa-4 (DPP-4). El objetivo del presente artículo es revisar la evidencia científica disponible acerca de la seguridad cardiovascular de los diferentes antidiabéticos no insulínicos y realizar unas recomendaciones prácticas sobre su uso en este contexto (AU)
Diabetes increases the risk of both microvascular and macrovascular complications. Although reducing plasma glucose levels to recommended targets decreases the risk of microvascular outcomes, the effects of anti-diabetic drugs on macrovascular complications and cardiovascular death are of concern. In fact, it has been suggested that some anti-diabetic agents could even be harmful for cardiovascular outcomes. In this context, several health care regulatory agencies have established the need for performing clinical trials specifically designed to assess the cardiovascular safety of anti-diabetic drugs. The results of 2 clinical trials have recently been published that provide important information on the cardiovascular safety of dipeptidyl peptidase 4 (DPP-4) inhibitors. The aim of this document was to review the available evidence on the cardiovascular safety of non-insulin anti-diabetic drugs and provide practical recommendations on their use in this context (AU)
Subject(s)
Humans , Male , Female , Adverse Drug Reaction Reporting Systems/legislation & jurisprudence , Adverse Drug Reaction Reporting Systems/trends , Hypoglycemic Agents/analysis , Hypoglycemic Agents/metabolism , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/prevention & control , Evidence-Based Medicine/legislation & jurisprudence , Evidence-Based Medicine/methods , Evidence-Based Practice/methods , Safety-Based Drug Withdrawals/legislation & jurisprudence , Primary Health Care/methods , Primary Health Care , Sulfonylurea Compounds/therapeutic use , Biguanides/therapeutic use , alpha-Glucosidases/therapeutic useABSTRACT
Diabetes increases the risk of both microvascular and macrovascular complications. Although reducing plasma glucose levels to recommended targets decreases the risk of microvascular outcomes, the effects of anti-diabetic drugs on macrovascular complications and cardiovascular death are of concern. In fact, it has been suggested that some anti-diabetic agents could even be harmful for cardiovascular outcomes. In this context, several health care regulatory agencies have established the need for performing clinical trials specifically designed to assess the cardiovascular safety of anti-diabetic drugs. The results of 2 clinical trials have recently been published that provide important information on the cardiovascular safety of dipeptidyl peptidase 4 (DPP-4) inhibitors. The aim of this document was to review the available evidence on the cardiovascular safety of non-insulin anti-diabetic drugs and provide practical recommendations on their use in this context.
Subject(s)
Cardiovascular Diseases/chemically induced , Dipeptidyl-Peptidase IV Inhibitors/adverse effects , Hypoglycemic Agents/adverse effects , Blood Glucose/drug effects , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Dipeptidyl-Peptidase IV Inhibitors/therapeutic use , Humans , Hypoglycemic Agents/therapeutic useABSTRACT
No disponible
No disponible
Subject(s)
Humans , Male , Female , Somatoform Disorders/pathology , Somatoform Disorders/psychology , Primary Health Care/methods , Depression/psychology , Family Practice/methods , Mental Health/education , Stress, Psychological/psychology , Dysmenorrhea/genetics , Erectile Dysfunction/psychology , Body Dysmorphic Disorders/psychology , Somatoform Disorders/complications , Somatoform Disorders/diagnosis , Primary Health Care , Depression/metabolism , Family Practice/classification , Mental Health/classification , Stress, Psychological/metabolism , Dysmenorrhea/metabolism , Erectile Dysfunction/genetics , Body Dysmorphic Disorders/metabolismABSTRACT
No disponible
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Subject(s)
Humans , Male , Female , Personality Disorders/metabolism , Personality Disorders/psychology , Depression/psychology , Anxiety/psychology , Schizophrenia/genetics , Panic Disorder/psychology , Stress, Psychological/psychology , Personality Disorders/complications , Personality Disorders/genetics , Depression/metabolism , Anxiety/metabolism , Schizophrenia/complications , Panic Disorder/diagnosis , Stress, Psychological/complicationsABSTRACT
No disponible
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