[Who monitors patients treated with psychotropic drugs in primary care?]. / 'Quién controla a los enfermos tratados con fármacos psicotropos en atención primaria?

OBJECTIVE: To analyse the degree of monitoring by doctors, nurses, and other health professionals of patients taking psychotropic medication. DESIGN. Retrospective, observational study of patients of both sexes and over 15 years old, who took psychotropic medication and had attended a minimum of ten times the same doctor-nurse primary care unit (PCU). Their monitoring during 2 year-long periods was studied: a first period (the first year after diagnosis) and a second period from October 2001 to October 2002. SETTING: Primary care in the Raval Sud District, Barcelona, Spain. PARTICIPANTS: A total of 730 clinical histories were reviewed, of which 200 (27%) met inclusion criteria. RESULTS: The most common diagnosis was anxiety-depression disorder (58%), and 14.5% of patients had no recorded diagnosis. 35.5% were patients taking more than one medicine. The most common drug group was the benzodiazepines (60.4%). Significant differences in the number of controls were found between the 2 periods and between different PCUs. The mean difference between periods was -0.5, with 95% CI at -1.0: clearly the degree of monitoring drops over time. CONCLUSIONS: These patients' follow-up was not monitored well, which poses the need to create clear aims and protocols for the doctor-nurse team, to thus assist the treatment of patients with mental health problems.

¿Quién controla a los enfermos tratados con fármacos psicotropos en atención primaria? / Who monitors patients treated with psychotropic drugs in primary care?

Objetivo. Analizar el grado de seguimiento realizado por médicos, enfermeras y otros profesionales de la salud sobre los enfermos consumidores de fármacos psicotropos. Diseño. Estudio observacional retrospectivo en el que se seleccionó a pacientes de ambos sexos mayores de 15 años, con consumo de fármacos psicotropos y visitados un mínimo de 10 veces por la misma unidad básica de atención médico-enfermera (UBA). Se estudió su seguimiento durante 2 períodos de un año: el primer año después del diagnóstico y el período octubre de 2001-octubre de 2002. Emplazamiento. Atención primaria en el Área Básica de Salud (ABS) Raval Sud, Barcelona. Participantes. Se revisaron 730 historiales de pacientes, de los cuales 200 (27%) cumplieron criterios de inclusión. Resultados. El diagnóstico más frecuente fue el trastorno de ansiedad-depresión (58%), y destacaba que un 14,5% de los pacientes no tenían un diagnóstico registrado. El 35,5% correspondió a pacientes que recibieron más de un fármaco y el grupo farmacológico más frecuente fue el de las benzodiacepinas (60,4%). Se detectaron diferencias significativas en el número de controles entre los 2 períodos, y entre las diferentes UBA. La mediana de la diferencia de períodos fue ­0,5 y su intervalo de confianza del 95%, ­1,0; se evidencia que el grado de control disminuye con el tiempo. Conclusiones. En estos pacientes se observa poco control en su seguimiento, lo que indica la necesidad de crear unos objetivos y unos protocolos claros dirigidos al equipo médico-enfermera, para así facilitar el tratamiento del paciente con problemas de salud mental

Objective. To analyse the degree of monitoring by doctors, nurses, and other health professionals of patients taking psychotropic medication. Design. Retrospective, observational study of patients of both sexes and over 15 years old, who took psychotropic medication and had attended a minimum of ten times the same doctor-nurse primary care unit (PCU). Their monitoring during 2 year-long periods was studied: a first period (the first year after diagnosis) and a second period from October 2001 to October 2002. Setting. Primary care in the Raval Sud District, Barcelona, Spain. Participants. A total of 730 clinical histories were reviewed, of which 200 (27%) met inclusion criteria. Results. The most common diagnosis was anxiety-depression disorder (58%), and 14.5% of patients had no recorded diagnosis. 35.5% were patients taking more than one medicine. The most common drug group was the benzodiazepines (60.4%). Significant differences in the number of controls were found between the 2 periods and between different PCUs. The mean difference between periods was ­0.5, with 95% CI at ­1.0: clearly the degree of monitoring drops over time. Conclusions. These patients' follow-up was not monitored well, which poses the need to create clear aims and protocols for the doctor-nurse team, to thus assist the treatment of patients with mental health problems