Treatment Satisfaction Among Patients Taking Antidepressant Medication.

This study sought to assess treatment satisfaction among patients on antidepressants, ascertaining whether there might be an association with depressive symptomatology and other variables. Cross-sectional study conducted on 564 adult patients taking antidepressant medication. Satisfaction with antidepressant treatment was assessed using the Assessment of Satisfaction with Antidepressant Treatment Questionnaire (ESTA/Evaluación de la Satisfacción con el Tratamiento Antidepresivo). A moderate negative correlation was observed between satisfaction and intensity of depressive symptoms, as assessed with the Montgomery-Asberg scale. A weak negative correlation was observed between greater satisfaction and less favourable views about taking medication. Satisfaction scale scores were higher among those who took antidepressant medication for 1 year or more versus shorter periods. Most patients reported being satisfied with the antidepressant treatment but the level of satisfaction was higher among those who presented with less marked depressive symptoms, received longer-term treatment and viewed drug treatments favourably. Treatment satisfaction is one of the patient-reported outcome measures that can serve to complement clinical evaluation of depressive disorders.

[Validation of Questionnaire "ESTA": designed to assess the satisfaction with antidepressant treatment. Spain]. / Satisfacción con el tratamiento antidepresivo: validación del cuestionario "ESTA"

BACKGROUND: We have no questionnaires to assess satisfaction with antidepressant treatment, which affects the health related quality of life. The objective was to develop and validate a specific instrument to assess satisfaction with antidepressant treatment, determining convergent validity regarding clinical effectiveness, fulfillment of expectations, adherence and tolerability. METHODS: Longitudinal observational study where 168 patients started antidepressant treatment and were followed for one year. The variables included adverse effects, compliance and intensity of depressive symptoms. The questionnaire for the Evaluation of Antidepressant Treatment Satisfaction (ESTA) consists of 11 items answered using Likert scale. We evaluated its reliability, construct validity and concurrent validity with conceptually related measures with the construct assessed. RESULTS: The Cronbach's alpha statistic ranged between 0.936 and 0.951. In the factor analysis one factor accounted for 64.11% of the variance. The average score of the questionnaire ranged from 40.0 to 44.7 points, showing a negative correlation regarding the Hamilton scale (-0.321 / -0.601) and Montgomery-Asberg scale (-0.491 / -0.307). After a month, the antidepressant treatment satisfaction was 39.5 points in noncompliant patients and 44.3 in compliers. In those who had adverse effects was 39.2 versus 43.3 for those who had not. At the first visit (15 days) the score was 40.0, in a month 42.6, in 3 months 44.4 and in 6 months 44.5. These differences were statistically significant (p <0.05). In test-retest analysis, intraclass correlation coefficient was 0.908. CONCLUSIONS: The questionnaire, designed to assess satisfaction with antidepressant treatment, is valid and reliable, and provides a patient-centered instrument which is complementary to the clinical assessment of the effectiveness of antidepressant treatment.

[Adherence to recommendations to prevent falls in the elderly, Albacete, Spain, 2009]. / Adherencia a las recomendaciones para evitar caídas en personas mayores de 64 años Albacete, 2009.

BACKGROUND: There are recommendations to prevent falls. Our goal is to determine, in older people, the knowledge and adherence to these recommendations, and to analyze the demographic characteristics and associated morbidity. METHODS: Observational study of prevalence and crossed association. The target population are older people living in the community. The subjects were randomly selected (n = 919) and interviewed about their knowledge and level of adherence to existing recommendations to prevent falls in older people, we also gathered information about their health problems and their demographic characteristics. A descriptive analysis was performed and compared the "more compliant" subjects with the rest of the participants. Using a multivariate analysis the association of adhesion with possible factors was found. RESULTS: 50.8% were unaware that there are physical exercises recommended to prevent falls and 22.0% that taking care of your feet can contribute to this end. The recommendations with greater adherence are those related to the bathroom, where 62.2% used the shower for personal hygiene and 83.5% use non-slip floor mat in the shower or bathtub. Variables associated with increased compliance are: presence of 3 or more health problems (OR: 1.6), age over 80 years (OR: 1.4), higher level of schooling (OR: 1.5) and unmarried individuals, widowed or divorced (OR: 1.4).

Functional status in the elderly with insomnia.

BACKGROUND: Insomnia causes psychological distress in the elderly. Besides primary insomnia (PI), illness, medications and psychosocial factors contribute to development of sleep disorders. Although elderly insomniacs usually complain of poorer daytime functioning, it is unknown whether the disorder affects capacity to carry out activities. OBJECTIVE: To assess the relationship in the elderly between PI, level of physical functioning, depression and anxiety symptoms, state of psychological well-being and consumption of psychopharmaceuticals. DESIGN: Cross-sectional, observational study. SETTING: Populational. SUBJECTS: About 424 non-institutionalized elderly patients. METHODS: Subjects were interviewed at public Health Centres or at home. They were considered to have PI if DSM-IV criteria were met. The remaining variables measured were: depression and anxiety symptoms (The Goldberg's Depression and Anxiety Scale), cognitive state (Short Portable Mental Status Questionnaire), physical functioning (The Katz Index and the Instrumental Activities of Daily Living Scale), life satisfaction (The Philadelphia Geriatric Center Morale Scale), health problems, consumption of pharmaceuticals and sociodemographic variables. RESULTS: About 34.2% of the elderly admitted to having problems with sleep, but only 20.3% (CI: 95%: 16.5-24.1) fulfilled the criteria for PI. The existence of an anxiety disorder, a score below the 50th percentile on The Philadelphia Geriatric Center Morale Scale (lower life satisfaction) and consumption of psychopharmaceuticals were variables associated with insomnia. Amongst the most common illnesses reported, only diabetes appeared with significantly higher frequency in the elderly with insomnia (24.4% vs. 14.7%) (p < 0.05). No statistically significant association was found between insomnia and level of dependence in carrying out basic or instrumental activities. CONCLUSIONS: Approximately one fifth of the non-institutionalized elderly meet the criteria for PI. Those affected present a poorer state of psychological and social well-being, although level of autonomy for conducting basic and instrumental activities does not appear to be modified by the disorder. The existence of an anxiety disorder, low life satisfaction and consumption of psychopharmaceuticals constitute variables associated with PI in the population we studied.

Adherencia al tratamiento con antiinflamatorios no esteroideos / Therapeutic compliance with antiinflamatorys not steroids

Objetivo: Determinar la adherencia al tratamiento con AINEs prescritos para alivio del dolor en elámbito de Atención Primaria, estimar la probabilidad de abandono en los días siguientes a su prescripcióny reconocer factores pronósticos relacionados con el cumplimiento.Diseño del estudio: Estudio observacional de carácter longitudinal o de seguimiento durante 10 díastras el inicio del tratamiento.Emplazamiento: Atención Primaria. Área Sanitaria de Albacete.Sujetos: Se seleccionaron, mediante muestreo consecutivo, 125 pacientes de 14 o más años deedad, que, durante el periodo de estudio, iniciaron algún tratamiento con AINEs para procesos dolorososde cualquier etiología.Mediciones principales: Como variables dependientes fueron consideradas la duración en días deltratamiento con AINEs, desde la prescripción hasta la segunda observación al cabo de diez días, y elabandono de la medicación durante el periodo de seguimiento.Resultados: Entre los 115 pacientes en los que se pudo completar el seguimiento, 32 reconocieronhaber abandonado el tratamiento con AINEs (27,8%), siendo su edad media (47,59 años ± 2,6 DE)significativamente inferior (p=0,01) a la de los pacientes que cumplieron con la pauta prescrita (56,1 ±1,8 DE). Se observó una relación estadísticamente significativa entre el abandono de la medicación yla presencia de reumatismo no articular (42,4%). Del análisis de supervivencia se desprende que lostratamientos considerados presentan una mediana superior a 10 días de duración y que la probabilidadacumulada de supervivencia desciende hasta el 70% al cabo de 10 días.Conclusiones: El abandono del tratamiento con AINEs es inferior en pacientes ancianos. El riesgo deabandono es superior en los pacientes que reciben el tratamiento por reumatismo no articular y en losque no presentan mejoría con el tratamiento o ésta es de carácter leve

Objective: To know about treatment tracking with AINS prescribed in primary health level to relievepain, to estimate the probability of to stopping treatment the next days and to detect predictor factorsinvolved with the end means.Design: Observational and longitudinal study during 10 days after begining treatment.Setting: First level health centers in Albacete city.Subjects: Have been selected 125 patients 14 or older, by consecutive picking, who began AINSdrugs prescribed in order to relieve everyones pain.Main measurements: It was consider any dependent parameters like lengh in days of the teatmentfrom prescription until second observation in ten days, also stopping treatment during the follow upperiod.Results: It was not possible to complete the follow up in 115 patients; into this group, 32 have admitedthey left the treatment (27,8 %) and his average age (47,59 ± 2,6 SD) was clearly less (p = 0,01) thanpatients with a correct tracking treatment (56,1 ± 1,8 SD).There has been observed a relationship with statistical value between treatment stopping and presenceof non articular rheumatism (42,4 %). From survivance research it is possible to deduce that the life ofthe treatment presents a “median” > 10 days and the acumulative probability of survival, decreaces to70 % in 10 days.Conclusions: Living treatment with AINS is significantly less in elderly patients. Risk of stoppingtreatment is statistically higher in patients under treatment for non articular rheumatism who don’t showimprovement by the treatment