¿Quieres dormir sin pastillas? Desmedicalización de benzodiacepinas mediante un abordaje comunitario y de educación para la salud / Would you like to sleep without pills? Demedicalization of benzodiazepines with a community and group health education approach

Objetivo: Reducir el consumo de benzodiacepinas en los pacientes asignados al Centro de Salud Daroca (Madrid) mediante un abordaje multidisciplinar, comunitario y de educación para la salud grupal.Métodos. El programa constaba de tres sesiones de educación para la salud informativas y prácticas para retirar las benzodiacepinas con seguimiento telefónico y en las oficinas de farmacia. Se realizó una difusión activa con carteles, folletos, prensa y radio locales con ayuda de los diferentes activos de la zona. Resultados. Se hicieron cinco ediciones con 94 participantes. El 68,6% abandonó el tratamiento con benzodiacepinas, el 13,2% redujo la dosis y el 51,9% no reportó efectos secundarios a los 6 meses de la intervención. Las prescripciones del centro de salud disminuyeron un 2,65% en 2 años (825 pacientes).Discusión. El abordaje comunitario y de educación para la salud puede ser efectivo para promover el buen uso de medicamentos, aunque son necesarios más estudios que avalen estas estrategias. (AU)

Objective: The aim of this project is to reduce the consumption of benzodiazepines in patients treated inDaroca Healthcare Centre (Madrid). This reduction isachieved by means of a multidisciplinary, communityand educational approach for the common health.Methods. The programme consisted of three maineducational sessions regarding informative and practical education. Within these sessions, patients weretaught how to withdraw the chronic use of benzodiazepines. This process was monitored by a physician through telephonic monitoring, as well as by localpharmacies. Thus, an active diffusion based on posters,brochures, press and even local radio stations was carried out.Results. 94 patients were enrolled into five differentrounds: 68.6% withdrew the benzodiazepine treatment, 13.2% reduced the dose and 51.9% did not report adverse effects 6 month after intervention. Medical benzodiazepine prescription decreased 2.65% in atwo-year period (825 patients).Discussion. Our approach based on community andeducational health can be effective in terms of promoting a safe and effective use of medicines. However,additional studies supporting our strategy would benecessary. (AU)

Inicio del curso escolar durante la segunda ola de la COVID 19: una oportunidad para la salud comunitaria en las zonas básicas de salud de La Elipa y Daroca (Madrid) / Start of the academic year during the second wave of COVID-19: an opportunity for community health in the basic health areas of La Elipa and Daroca (Madrid)

Introducción y objetivos: El comienzo del curso escolar durante la epidemia por COVID-19 hizo necesaria la comunicación entre el Centro de Salud Daroca (Madrid) y los centros educativos de su zona. Métodos: Se realizó un mapeo de los centros educativos estableciendo contacto telefónico y ofreciendo un correo electrónico para compartir incidencias. Se recogieron datos sobre las medidas adoptadas ante la epidemia y se celebraron sesiones informativas en los centros que lo solicitaron, evaluadas mediante cuestionarios. Resultados: Se contactó con 14 centros educativos de la zona (3.635 alumnos y 412 profesionales) y se intercambiaron 103 correos electrónicos. Todos los centros tomaron medidas especiales ante la epidemia. Se impartieron 13 sesiones informativas en 3 centros: 92,5% solicitaron más sesiones y la puntuación media fue de 8,1. Conclusiones: El contacto del centro de salud con los centros educativos tuvo muy buena acogida y supuso un punto de partida para establecer un vínculo comunicativo. (AU)

Introduction and objectives: The onset of the school year during the COVID-19 epidemic made communication between Daroca Health Centre (Madrid) and the schools in its area of influence of paramount importance. Methods. Schools were mapped after establishing contact by phone. Data were collected regarding the interventions made to tackle the epidemic. An e-mail for sharing incidences was provided. Informative sessions were held in the schools when requested; these were evaluated using ad hoc questionnaires. Results. Fourteen schools were contacted (3635 students and 412 school workers) and 103 e-mails were exchanged. All schools took special measures to tackle the epidemic and 13 briefing sessions were held in three centres. A total of 92.5% requested further sessions addressing health issues and their mean satisfaction score was 8.1 Conclusions. Contact between health centres and schools appears to be satisfactory and serves as a starting point for establishing a communication link. (AU)

Economic Migrants and Clinical Course of SARS-CoV-2 Infection: A Follow-Up Study.

Objective: To analyze whether social deprivation and economic migrant (EM) status influence the risk of being hospitalized with COVID-19. Methods: This was a retrospective follow-up study including all patients older than 18 years attending the Daroca Health Center in Madrid, Spain, diagnosed with COVID-19 during September 2020. Data on EM status and other sociodemographic, lifestyle and comorbidities that could affect the clinical course of the infection were obtained from electronic medical records. Results: Of the 796 patients positive for COVID-19, 44 (5.53%) were hospitalized. No significant differences were observed between those who were hospitalized and those who were not in the mean of social deprivation index or socioeconomic status, but EM status was associated with the risk of being hospitalized (p = 0.028). Logistic regression models showed that years of age (OR = 1.07; 95% CI: 1.04-1.10), EM status (OR = 5.72; 95% CI: 2.56-12.63) and hypertension (OR = 2.22; 95% CI: 1.01-4.85) were the only predictors of hospitalization. Conclusion: Our data support that EM status, rather than economic deprivation, is the socioeconomic factor associated with the probability of hospital admission for COVID-19 in Madrid, Spain.

Sistemas personalizados de dosificación en atención primaria: un estudio multidisciplinar / Dose dispensing service in a prymary health care area: A multidisciplinary study

Introducción: los sistemas personalizados de dosificación (SPD) preparados en farmacias son una opción para mejorar la adherencia terapéutica. Objetivo: describir las características y grado de implantación de los SPD bajo la perspectiva de profesionales sanitarios de un centro de salud, farmacéuticos comunitarios y pacientes adscritos a ese centro. Método: estudio descriptivo transversal en la zona de influencia del centro de salud Daroca (Madrid). Participaron 64 profesionales del centro de salud, 37 farmacéuticos comunitarios y 29 usuarios de SPD. Se utilizaron cuestionarios para cada una de las categorías con preguntas sobre conocimientos y opiniones de los SPD, gestión, preparación y satisfacción con el servicio. Resultado: conocen los SPD el 61,4 % de los profesionales del centro de salud y el 94 % creen que son útiles. Trece farmacias ofrecen los SPD: el 55,6 % considera que hay que contactar con el médico, el 41,7 % pone precio al servicio y el 92,3 % lo hace manualmente. Cinco farmacias preparan SPD a 18 pacientes de la zona. Criterios de inclusión más utilizados: edad, polimedicación y sospecha de mal cumplimiento. Perfil de paciente usuario de SPD: mujer octogenaria con estudios primarios polimedicada que vive sola. El 66,7 % de los pacientes encuestados tomaba los medicamentos directamente de la caja y al 88,9 % de ellos les recomendó el SPD el farmacéutico. El cien por cien de los usuarios de SPD está muy satisfecho con el servicio. Conclusión: aunque todos los colectivos estudiados creen que los SPD son útiles para mejorar la adherencia, existe una baja implantación de los SPD en nuestra zona

Introduction: Dose Dispensing Service (SPD) prepared in pharmacies are an option to improve therapeutic adherence. Objective: to describe the characteristics and implantation of SPD from the perspective of professionals of a health center, community pharmacists and patients attached to that center. Methods: Descriptive cross-sectional study in the area of influence of Daroca health center (Madrid). 64 health center professionals, 37 community pharmacists and 29 SPD users participated. Questionnaires were used for each of the categories with questions about knowledge and opinions of SPDs, management, preparation and satisfaction with the service. Results: 61.4% of health center professionals know SPD and 94% believe they are useful. 13 pharmacies offer SPD: 55.6% consider that they should contact the doctor, 41.7% charge for the service and 92.3% do so manually. 5 pharmacies prepare SPD for 18 patients in our local zone. Most used inclusion criteria: age, polymedication and suspicion of poor compliance. Patient profile using SPD: octogenarian woman polymedicated with primary studies living alone. 66.7% of the patients took the medications directly from the box. Pharmacists recommended SPD to 88.9% of patients. 100% of SPD users are very satisfied with the service. Conclusion: Although all the groups studied believe that SPDs are useful for improving adherence, SPDs have a low implementation in our area

7 años de DarocaFarmacias: programa de coordinación entre el Centro de Salud Daroca y los Farmacéuticos Comunitarios de su Zona Básica de Salud / 7 years of DarocaFarmacias: coordination program between Daroca Primary Health Center and Community Pharmaceuticals in a Basic Health Area

OBJETIVO: Evaluar el funcionamiento y el grado de satisfacción de los profesionales implicados en un programa de colaboración entre el Centro de Salud Daroca y las Farmacias Comunitarias de su zona de influencia (DarocaFarmacias) en Madrid, España. MÉTODOS: Participan 36 oficinas de farmacia y 81 profesionales sanitarios del centro de salud Daroca en un área urbana con 53.600 pacientes. Existe un correo electrónico y un teléfono directo en el centro de salud para facilitar la comunicación con las farmacias. Se realizan conjuntamente trabajos de investigación, sesiones de formación y actividades de educación para la salud. Se preguntó sobre los diferentes aspectos del proyecto (comunicación, relación interprofesional, sesiones de formación y satisfacción) mediante una encuesta anónima a los integrantes de DarocaFarmacias. RESULTADOS: Contestaron 67 profesionales (32 farmacéuticos, 21 médicos y 13 enfermeros). El 95,5% cree que ha mejorado la relación entre profesionales y el 82% que ha favorecido la comunicación. Para el 43,7% de los farmacéuticos la mejor vía de comunicación es el teléfono (92% de llamadas resolutivas), para el 31,2% el correo electrónico y el 53,1% ha acudido alguna vez al centro para resolver el problema. Acude a las sesiones de formación el 82% y resultan muy útiles para el 92,5%. El 91% de los profesionales está bastante o muy satisfecho con DarocaFarmacias. CONCLUSIÓN: DarocaFarmacias es un ejemplo de colaboración entre centros de salud y oficinas de farmacia en aras de una mejor atención a los pacientes

OBJECTIVE: To assess the performance and degree of satisfaction of the healthcare professionals involved in a cooperation programme between Daroca Health Centre and Community Pharmaceuticals in a Basic Health Area (DarocaFarmacias) in Madrid, Spain. METHODS: Thirty-six community pharmacies and 81 health care professionals of the Daroca Health Centre took part in this study, affecting an urban area of 53600 patients. Communications between Health Centre and Community Pharmacies were done by email and direct phone. Researching, clinical sessions and educational activities were collaboratively carried out. Different aspects of the project were analysed, such as communication, interprofessional relationship, training sessions and global satisfaction. With this aim, a blinded survey was submitted to the DarocaFarmacias members. RESULTS: Sixty-seven health professionals took part (32 community pharmacists, 21 physicians and 12 nurses) in the study. Among them, 95.5% are of the opinion that professional relationship improved and 82% agreed for a better-quality communication between health professionals. Most of the community pharmacists (43.7%) considered telephone as the preferred channel of communication (92% problem solving), followed by e-mail (31.2%), although half of them (53.1%) visited the Health Centre to solve a relevant question. Eighty-two out of 100 attended to the clinical sessions and educational activities, being considered as beneficial by 92.5% of them. Over nine out of ten (91%) of the health professionals were quite or very satisfied with DarocaFarmacias project. CONCLUSION: DarocaFarmacias is a positive experience of collaboration between Health Centre and community pharmacies in pursuit of a better attendance of the patients