Conocimientos, percepciones y actitudes que intervienen en la adherencia al tratamiento en pacientes ancianos polimedicados desde una perspectiva cualitativa / Knowledge, perceptions and attitudes involved in adherence to treatment elderly patients polymedicated from qualitative perspective

Objetivos. Evaluar los conocimientos, percepciones y actitudes de grupos de informantes clave sobre la adherencia al tratamiento de pacientes mayores de 65 años polimedicados que recibieron el alta hospitalaria desde el Servicio de Medicina Interna. Material y métodos. Investigación cualitativa mediante la realización de grupos focales y entrevistas semiestructuradas. La población diana fueron pacientes con prescripción anterior al ingreso de 4 o más fármacos, sin deterioro cognitivo y con autonomía propia. Ejes temáticos valorados: ingreso hospitalario, alta domiciliaria, problemas cognitivos, creencias que disminuyen el cumplimiento y características de los medicamentos. Resultados. Durante la hospitalización se detecta una falta de información sobre la enfermedad que originó el ingreso, los tratamientos suministrados durante la hospitalización y los prescritos tras el alta. En el domicilio la polimedicación, la acumulación de fármacos, la confusión con los genéricos, la complejidad de la pauta, la duplicidad terapéutica y la falta de coordinación entre hospital, primaria y farmacias junto a los problemas cognitivos, las creencias negativas y determinadas características de los medicamentos disminuyen la adherencia al tratamiento. Conclusiones. A la vista de los resultados, sería oportuno aumentar los conocimientos que los pacientes tienen sobre su enfermedad de ingreso, los tratamientos suministrados durante la hospitalización y los prescritos tras el alta. En relación con las actitudes, los profesionales deben mejorar las explicaciones sobre el tratamiento y adaptar los informes del alta hospitalaria. En cuanto a las percepciones, se deben disminuir las creencias negativas y preocupaciones que los pacientes o cuidadores tengan sobre un fármaco ya que pueden dificultar la adherencia al tratamiento(AU)

Aims. To assess the knowledge, perceptions and attitudes of groups of key informants on adherence to treatment by polymedicated patients aged over 65 years following hospital discharge (internal medicine service). Material and methods. Qualitative research study, based on focus groups and semi-structured interviews. The target population were patients prescribed 4 or more drugs prior to admission, self-sufficient and suffering no cognitive impairment. Key areas assessed: hospital admission, hospital discharge, cognitive problems, attitudes that reduce adherence to treatment, and medication characteristics. Results. During their hospitalization, patients lacked information on the condition that caused the admission, the treatment provided during hospitalization, and that prescribed following hospital discharge. At home, polymedication, drug accumulation, confusion about generic drugs, the complexity of the treatment regimen, treatment duplication, and a lack of coordination between hospital, primary healthcare and pharmacies, together with cognitive problems, negative attitudes and certain characteristics of the drugs prescribed, all decrease adherence to treatment. Conclusions. In view of the results obtained, it would be appropriate to increase patient knowledge about their condition on admission to hospital, as well as the treatment provided during hospitalization, and that prescribed after discharge. Regarding attitudes, healthcare staff should better explain the treatment offered and adapt hospital discharge forms for these patients. In terms of perceptions, steps should be taken to reduce negative attitudes and concerns that patients or caregivers may have about a drug, as these views could hinder adherence to treatment(AU)

[Knowledge, perceptions and attitudes involved in adherence to treatment elderly patients polymedicated from qualitative perspective]. / Conocimientos, percepciones y actitudes que intervienen en la adherencia al tratamiento en pacientes ancianos polimedicados desde una perspectiva cualitativa.

AIMS: To assess the knowledge, perceptions and attitudes of groups of key informants on adherence to treatment by polymedicated patients aged over 65 years following hospital discharge (internal medicine service). MATERIAL AND METHODS: Qualitative research study, based on focus groups and semi-structured interviews. The target population were patients prescribed 4 or more drugs prior to admission, self-sufficient and suffering no cognitive impairment. Key areas assessed: hospital admission, hospital discharge, cognitive problems, attitudes that reduce adherence to treatment, and medication characteristics. RESULTS: During their hospitalization, patients lacked information on the condition that caused the admission, the treatment provided during hospitalization, and that prescribed following hospital discharge. At home, polymedication, drug accumulation, confusion about generic drugs, the complexity of the treatment regimen, treatment duplication, and a lack of coordination between hospital, primary healthcare and pharmacies, together with cognitive problems, negative attitudes and certain characteristics of the drugs prescribed, all decrease adherence to treatment. CONCLUSIONS: In view of the results obtained, it would be appropriate to increase patient knowledge about their condition on admission to hospital, as well as the treatment provided during hospitalization, and that prescribed after discharge. Regarding attitudes, healthcare staff should better explain the treatment offered and adapt hospital discharge forms for these patients. In terms of perceptions, steps should be taken to reduce negative attitudes and concerns that patients or caregivers may have about a drug, as these views could hinder adherence to treatment.

Evaluación y aprendizaje del 27 Congreso de la Sociedad Española de Calidad Asistencial / Assessment and learning from the 27th Conference of the Spanish Society for quality in healthcare

Objetivo. Analizar los resultados del 27 Congreso de la Sociedad Española de Calidad Asistencial (SECA) celebrado en Sevilla (octubre de 2009). Material y método. Estudio descriptivo, retrospectivo, utilizando como fuente de información la base de datos de los comités del congreso. Población. Todas las comunicaciones recibidas (1.231). Evaluación de las comunicaciones por 36 parejas de evaluadores mediante criterios explícitos puntuables y asignación como experiencias o comunicaciones electrónicas. La satisfacción de los participantes en el congreso y en los talleres fue evaluada mediante un cuestionario anónimo. Resultados. Se aceptaron 1.213 comunicaciones. La puntuación media del total de comunicaciones aceptadas fue de 6,38±0,95 puntos. Las experiencias tienen una puntuación media de 7,55±0,41 puntos, mientras que las comunicaciones electrónicas tienen una puntuación media de 6,26±0,9 puntos. En cifras absolutas son Andalucía y Cataluña las comunidades autónomas que más comunicaciones presentaron (557 y 140, respectivamente) aunque, tras el cálculo de la tasa por millón de habitantes, la Región de Murcia (76,43) y Andalucía (67,91) obtuvieron las cifras más elevadas. Conclusiones. La evaluación de comunicaciones y la organización de un congreso de ámbito nacional son un proceso metodológicamente complejo. La rendición de cuentas de las acciones y decisiones realizadas por los Comités Organizador y Científico son un requisito ético de transparencia(AU)

Objective. To analyse the results of the 27th Conference of the Spanish Society for Quality in Health Care (SECA) held in Seville (October 2009). Material and methods. A retrospective descriptive study was conducted using the conference databases. Population. All abstracts received (1231). 36 pairs of reviewers using explicit criteria evaluated abstracts and assignment as Experiences or Electronic Communications. Participant satisfaction in the Conference and Workshops was evaluated by an anonymous questionnaire. Results. A total of 1213 communications were accepted. The average score of accepted abstracts was 6.38±0.95 points. Experiences had an average score of 7.55±0.41 points, while Electronic Abstracts had an average score of 6.26±0.9 points. Andalusia (557) and Catalonia (140) had the highest amount of abstracts in the Conference, but Murcia and Andalusia obtained the highest rates per million inhabitants. Conclusions. The assessment of abstracts and organising a national conference are methodologically complex processes. Accountability for actions and decisions made by the Organising and Scientific Committees are an ethical requirement of transparency(AU)

[Assessment and learning from the 27th Conference of the Spanish Society for quality in healthcare]. / Evaluación y aprendizaje del 27 Congreso de la Sociedad Española de Calidad Asistencial.

OBJECTIVE: To analyse the results of the 27th Conference of the Spanish Society for Quality in Health Care (SECA) held in Seville (October 2009). MATERIAL AND METHODS: A retrospective descriptive study was conducted using the conference databases. POPULATION: All abstracts received (1231). 36 pairs of reviewers using explicit criteria evaluated abstracts and assignment as Experiences or Electronic Communications. Participant satisfaction in the Conference and Workshops was evaluated by an anonymous questionnaire. RESULTS: A total of 1213 communications were accepted. The average score of accepted abstracts was 6.38 ± 0.95 points. Experiences had an average score of 7.55 ± 0.41 points, while Electronic Abstracts had an average score of 6.26 ± 0.9 points. Andalusia (557) and Catalonia (140) had the highest amount of abstracts in the Conference, but Murcia and Andalusia obtained the highest rates per million inhabitants. CONCLUSIONS: The assessment of abstracts and organising a national conference are methodologically complex processes. Accountability for actions and decisions made by the Organising and Scientific Committees are an ethical requirement of transparency.