RESUMO
No disponible
Assuntos
Humanos , Atenção Primária à Saúde , Infecções por HIV , Síndrome da Imunodeficiência AdquiridaAssuntos
Hemorragia Gastrointestinal/diagnóstico , Úlcera Péptica/diagnóstico , Idoso , Serviço Hospitalar de Emergência/estatística & dados numéricos , Medicina de Família e Comunidade/estatística & dados numéricos , Feminino , Humanos , Masculino , Medicina/estatística & dados numéricos , Pessoa de Meia-Idade , Espanha , EspecializaçãoRESUMO
OBJECTIVE: To find out how many patients older than 64 years of age seen in a primary health care (PHC) centre receive antiplatelet drugs for secondary prevention of coronary heart disease (CHD), as well as by whom they are prescribed, which drug is chosen, and what are its contraindications, unwanted effects and motives for ending therapy. DESIGN: Description of all cases of CHD among patients older than 64, identified through the audit of clinical records. SETTING: Urban health care centre with 23,702 inhabitants, with 2,742 over 64, 2,660 of whom have clinical records. SUBJECTS: Patients over 64 with CHD, seen in the health centre within 1993. MEASUREMENTS AND INTERVENTIONS: Age, sex, type of CHD, therapy with a platelet aggregation inhibitor, drug used, dose, prescriptor, adverse events, contraindications. RESULTS: We identified 179 cases of CHD, a prevalence of 6.7%, of which 60.9% were male. 94 patients received an antiplatelet drug: aspirin (88.3%), dypiridamol and triflusal (5.3% each) and ticlopidine (1 case). 111 patients were adequately treated, including 84 given aspirin or ticlopidine, 12 patients in which therapy was ended due to adverse events, and 15 patients in which use of antiaggregant drugs was contraindicated. All prescriptions originating from general practitioners were for aspirin, while specialists prescribed other drugs in 11% of cases. CONCLUSION: Two-thirds of patients with CHD were correctly treated. Aspirin is the antiaggregant drug most frequently used, particularly among PHC physicians. Even low doses of aspirin were associated with interruptions of therapy due to adverse events.
Assuntos
Prescrições de Medicamentos , Isquemia Miocárdica/prevenção & controle , Inibidores da Agregação Plaquetária/uso terapêutico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Aspirina/uso terapêutico , Dipiridamol/uso terapêutico , Medicina de Família e Comunidade , Feminino , Humanos , Masculino , Auditoria Médica , Medicina , Isquemia Miocárdica/epidemiologia , Prevalência , Atenção Primária à Saúde , Salicilatos/uso terapêutico , Espanha/epidemiologia , Especialização , Ticlopidina/uso terapêutico , População UrbanaRESUMO
A questionnaire was sent out to the interns in Family and Community Medicine throughout the country in the last month of training. The objective was to find out the degree of fulfillment and the evaluation of the Official Program of the Specialty as far as courses, rotations and duty periods were concerned. We received 170 questionnaires (response rate: 49.8%). The obligatory courses are overwhelmingly attended, but not so the optional ones. What stands out especially is the incorrect length of rotation among Internal Medicine, Pediatrics, and Primary Health Care. The specializations which draw the most interest due to their eventual use are Internal Medicine, Pediatrics, and Primary Health Care, and the least interesting are Gynaecology, Otorhinolaryngology and Ophthalmics. Roughly half have not had any duty watches in Surgery and Primary Care. With these results in hand, we recommend some changes be made in the specialization programs.
