[The prescription of nonsteroidal anti-inflammatory and stomach-protector agents. Its adaptation to quality criteria in primary care]. / Prescripción de antiinflamatorios no esteroides y gastroprotectores. Adecuación a criterios de calidad en atención primaria.

OBJECTIVE: To find the attitude of doctors working in General Medicine and out-patient Traumatology to the prescription of non-steroidal anti-inflammatory drugs (NSAID) and if these attitudes fit quality criteria. DESIGN: Crossover, descriptive study. SETTING: General medicine and out-patient traumatology in the inland area of Vizcaya. PARTICIPANTS: A questionnaire was sent to all doctors working in general medicine (146) and out-patient traumatology (19) in the inland area. MEASUREMENTS AND RESULTS: There was a 78.2% final reply rate. The questionnaire had 14 questions and collected the demographic variables and those which referred to the use of NSAIDs and stomach protectors. The prescription criteria for NSAIDs and stomach protectors were taken from a review of the literature before beginning this study. The most frequent risk factors were a previous history of ulcers (83%) and age > 65 (51.2%). CONCLUSIONS: Although a great many doctors attached great importance to the erosive effects of NSAIDs on the stomach, they still use the most damaging drugs on at-risk patients and prescribe stomach protectors whose efficacy is very doubtful. Age is not thought of enough as a risk factor (only half the doctors considered it); the NSAID which were less damaging to the stomach were little used.

[Validity of the attendance pressure indicator in a primary care area]. / Validez del indicador presión asistencial en un área de atención primaria.

OBJECTIVE: To measure the validity of the attendance pressure indicator in the Primary Care clinics at a Health Centre. DESIGN: An observational, crossover study. SETTING: Primary Care Area 3, Madrid. PATIENTS AND OTHER PARTICIPANTS: Stratified sampling by professional group and systematic sampling out of a total of 296 Primary Care team professionals in the area were performed. The size of the sample was 100: 40 general practitioners, 15 paediatricians and 45 nurses. Information on the attendance pressure indicator was gathered directly from the Health Centres and compared with that sent to Area 3's Information System (3-IS) by the professionals themselves. MEASUREMENTS AND MAIN RESULTS: The attendance pressure indicator showed the following ICC for Area 3: 0.86 (LL > or = 0.79) in general medicine, 0.79 (LL > or = 0.69) in paediatrics and 0.95 (LL > or = 0.93) in nursing. The over-notification found was: 1.35 users per day (p < 0.05) in general medicine, 1.47 (p < 0.05) in paediatrics and 0.47 in nursing. CONCLUSIONS: The measurement method of the attendance pressure indicator in Madrid's Primary Care Area 3 is valid for general medicine, paediatrics and nursing. A light, but statistically significant, over-notification to 3-IS was observed in general medicine and paediatrics, but this does not affect the validity of the indicator.