Evaluación durante 6 años de la dislipidemia en un centro de salud. Importancia de las acciones de mejora / A 6-year evaluation of dyslipidemia in a health center: Importance of improvement actions

Introducción. La dislipidemia, sobre todo el aumento del colesterol LDL, se ha demostrado como uno de los factores de riesgo más importantes en la génesis de la afectación coronaria. La prevalencia de las dislipidemias en España es alta. El objetivo del presente trabajo es valorar la evolución de los pacientes dislipidémicos de nuestro centro de salud durante 6 años y ver si se ha producido una mejora en el control de los mismos tras la presentación de la evaluación de los 3 primeros años y la actualización del protocolo de dislipidemias del centro de salud. Pacientes y método. Evaluación Periodo 1 (2006-2008): 267 pacientes dislipidémicos. Evaluación Periodo 2 (2009-2011): 222 pacientes, excluidos exitus y cambios de domicilio. Variables: edad, sexo, antecedentes personales de ECV, factores de riesgo vascular, lípidos, número de analíticas, tratamiento farmacológico, niveles de riesgo CV y porcentajes en objetivos de control. Resultados. Edad media 66,2 años (DE 13,4), mujeres 66,3%. Periodo 1-Periodo 2: colesterol total: 221,9-196,6 mg/dl (p = 0,000); colesterol LDL: 147,9-115,8 mg/dl (p = 0,000). En objetivos terapéuticos, pacientes riesgo alto: 14-50,5% (p = 0,024); riesgo medio: 35-68,1% (p = 0,038); riesgo bajo: 44-68,2% (p = NS). Tratamiento farmacológico 68-77% (p = 0,000). Modificación tratamiento: 30-43% (p = 0,001). Cumplimiento terapéutico: 75-86% (p = 0,003). Sin tratamiento riesgo alto: 15,4-16,3% (p = NS). Conclusiones. Se ha producido una mejoría significativa en el Periodo 2, sobre todo en los pacientes de riesgo alto, tras presentar los resultados de la evaluación del Periodo 1 y haber actualizado, en el centro de salud, el protocolo de dislipidemias. Hay pacientes con riesgo alto sin tratamiento hipolipidemiante que se deben detectar y revisar. (AU)

Introduction. Dyslipidemia, especially an increased LDL-cholesterol, has been shown to be one of the most important risk factors in the genesis of coronary involvement. The prevalence of dyslipidemias in Spain is high. The objective of this study is to assess the progress of dyslipidemic patients in our health center over a 6-year period, and see if there has been any improvement in its control after the presentation of the evaluation of the first 3 years, as well as an updated dyslipidemia protocol. Patients and methods. Assessment Period 1 (2006-2008): 267 patients with dyslipidemia. Assessment Period 2 (2009-2011): 222 patients, excluding exitus and address changes. Variables: age, sex, personal history of CVD, vascular risk factors, lipids, drug treatment, risk levels, and percentages of CV control objectives. Results. Mean age was 66.2 years (SD 13.4), 66.3% women. Period 1-Period 2: Total cholesterol: 221.9-196.6 mg/dl (P = .000); LDL-cholesterol: 147.9-115.8 mg/dl (P = .000). In high risk patients, therapeutic targets: 14-50.5% (P = .024); medium risk: 35-68.1% (P = .038); low risk: 44-68.2% (P = NS). Pharmacotherapy 68-77% (P = .000). Changing treatment: 30-43% (P = .001). Adherence: 75-86% (P = .003). Untreated high risk: 15.4-16.3% (P = NS). Conclusions. There was a significant improvement in Period 2, especially in high-risk patients, after presenting the results of the evaluation for Period 1 and with the updated dyslipidemia protocol. There are high risk patients without lipid-lowering treatment to be detected and reviewed (AU)

[A 6-year evaluation of dyslipidemia in a health center: Importance of improvement actions]. / Evaluación durante 6 años de la dislipidemia en un centro de salud. Importancia de las acciones de mejora.

INTRODUCTION: Dyslipidemia, especially an increased LDL-cholesterol, has been shown to be one of the most important risk factors in the genesis of coronary involvement. The prevalence of dyslipidemias in Spain is high. The objective of this study is to assess the progress of dyslipidemic patients in our health center over a 6-year period, and see if there has been any improvement in its control after the presentation of the evaluation of the first 3 years, as well as an updated dyslipidemia protocol. PATIENTS AND METHODS: Assessment Period 1 (2006-2008): 267 patients with dyslipidemia. Assessment Period 2 (2009-2011): 222 patients, excluding exitus and address changes. VARIABLES: age, sex, personal history of CVD, vascular risk factors, lipids, drug treatment, risk levels, and percentages of CV control objectives. RESULTS: Mean age was 66.2 years (SD 13.4), 66.3% women. Period 1-Period 2: Total cholesterol: 221.9-196.6 mg/dl (P=.000); LDL-cholesterol: 147.9-115.8 mg/dl (P=.000). In high risk patients, therapeutic targets: 14-50.5% (P=.024); medium risk: 35-68.1% (P=.038); low risk: 44-68.2% (P=NS). Pharmacotherapy 68-77% (P=.000). Changing treatment: 30-43% (P=.001). Adherence: 75-86% (P=.003). Untreated high risk: 15.4-16.3% (P=NS). CONCLUSIONS: There was a significant improvement in Period 2, especially in high-risk patients, after presenting the results of the evaluation for Period 1 and with the updated dyslipidemia protocol. There are high risk patients without lipid-lowering treatment to be detected and reviewed.