Calidad de las espirometrías en Atención Primaria en Cantabria 10 años después. Estudio EspiroCan / Quality of spirometry in Primary Care in Cantabria 10 years later. EspiroCan Study

INTRODUCCIÓN: Estudiar la calidad de las espirometrías realizadas en el ámbito de Atención Primaria de la Comunidad de Cantabria y el grado de cumplimiento de la normativa de dicha técnica de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR). MATERIAL Y MÉTODOS: Estudio descriptivo transversal en la Comunidad de Cantabria mediante cuestionario original basado en la última normativa SEPAR. El cuestionario se distribuyó en 2018 por correo interno a los 42 Centros de Salud del Servicio Cántabro de Salud que disponen de espirómetro tras contacto personal o vía telefónica de los investigadores con los coordinadores de los Centros de Salud y responsables de enfermería. Se trata de una encuesta original, basada en las normativas de la SEPAR, con la que se evalúa la calidad del material empleado (modelo, años de funcionamiento, calibración, limpieza), así como la formación del personal que realiza las espirometrías. RESULTADOS: Se ha encuestado al personal sanitario responsable de realizar las espirometrías en los 42 Centros de Salud del Servicio Cántabro de Salud de todo el territorio cántabro, en el que se realiza una media de 564 espirometrías al mes. Un 13% de los espirómetros no se calibran nunca. Tan solo el 10,5% de los espirómetros son calibrados por el personal que realiza la prueba en el propio centro. El 53,7% de estos profesionales (N54) nunca han recibido formación específica para realizar espirometrías, y solo el 3,8% de ellos tienen experiencia en realizar la prueba, como recomienda la SEPAR. En cuanto a la limpieza de los aparatos un 30% de los técnicos no limpia el espirómetro ni el adaptador que lo une a la boquilla. CONCLUSIONES: Diez años después de nuestro estudio inicial seguimos observando un déficit de formación de nuestros profesionales de Atención Primaria, lo que podría poner en duda la validez de las espirometrías

INTRODUCTION: To study the quality of spirometry performed in Primary Care in Cantabria (Spain) and the level of compliance with the regulations of this technique of the Spanish Society of Chest Diseases and Thoracic Surgery (SEPAR). MATERIAL AND METHODS: Cross-sectional descriptive study in the Community of Cantabria using an original questionnaire based on the latest SEPAR regulations. The questionnaire was distributed in 2018 by internal mail to the 42 Primary Care Centres of the Cantabrian Health Service, with the coordinators of the PCC and the nurses responsible having been personally contacted by the researchers or by telephone. This is an original survey, based on the regulations of the SEPAR, which evaluates the quality of the material used (model, years of operation, calibration, cleanliness), as well as the training of personnel who perform spirometry. RESULTS: The health personnel responsible for performing spirometry were surveyed in the 42 Primary Care Centres of the Cantabrian Health Service throughout the Cantabrian area. A mean of 564 spirometries are performed per month. A significant number (13%) of spirometers are never calibrated, and only 10.5% of the spirometers are calibrated by the personnel who perform the test in the centre itself. More than half (54, 53.7%) of these professionals have never received specific training to perform spirometry, and only 3.8% of them have experience in performing the test as recommended by SEPAR. As for the cleaning of the devices, 30% of the technicians do not clean the spirometer or the adapter. CONCLUSIONS: 10 years after our initial study lack of training is still being observed in the professionals, and probably translates into invalid spirometry

[Quality of spirometry in Primary Care in Cantabria 10 years later. EspiroCan Study]. / Calidad de las espirometrías en Atención Primaria en Cantabria 10 años después. Estudio EspiroCan.

INTRODUCTION: To study the quality of spirometry performed in Primary Care in Cantabria (Spain) and the level of compliance with the regulations of this technique of the Spanish Society of Chest Diseases and Thoracic Surgery (SEPAR). MATERIAL AND METHODS: Cross-sectional descriptive study in the Community of Cantabria using an original questionnaire based on the latest SEPAR regulations. The questionnaire was distributed in 2018 by internal mail to the 42 Primary Care Centres of the Cantabrian Health Service, with the coordinators of the PCC and the nurses responsible having been personally contacted by the researchers or by telephone. This is an original survey, based on the regulations of the SEPAR, which evaluates the quality of the material used (model, years of operation, calibration, cleanliness), as well as the training of personnel who perform spirometry. RESULTS: The health personnel responsible for performing spirometry were surveyed in the 42 Primary Care Centres of the Cantabrian Health Service throughout the Cantabrian area. A mean of 564 spirometries are performed per month. A significant number (13%) of spirometers are never calibrated, and only 10.5% of the spirometers are calibrated by the personnel who perform the test in the centre itself. More than half (54, 53.7%) of these professionals have never received specific training to perform spirometry, and only 3.8% of them have experience in performing the test as recommended by SEPAR. As for the cleaning of the devices, 30% of the technicians do not clean the spirometer or the adapter. CONCLUSIONS: 10 years after our initial study lack of training is still being observed in the professionals, and probably translates into invalid spirometry.

Actualización de la terapia inhalada en la enfermedad pulmonar obstructiva crónica / Inhaled in chronic obstructive pulmonary disease therapy update

El conocimiento de la enfermedad pulmonar obstructiva crónica ha evolucionado de manera importante en los últimos años y hoy en día tenemos un concepto más global de la enfermedad. Así mismo, el desarrollo farmacológico actual permite disponer de un amplio abanico de opciones terapéuticas. La vía inhalada es de elección al permitir administrar fármacos que actúan directamente sobre el árbol bronquial. En los últimos meses se han desarrollado nuevas moléculas y dispositivos que aumentan nuestras opciones a la hora de tratar, pero también nuestras dudas al elegir unos u otros; por ello, consideramos relevante realizar una actualización de las medicaciones inhaladas más utilizadas en la enfermedad pulmonar obstructiva crónica. En este artículo pretendemos revisar los distintos tipos de inhaladores de los que disponemos actualmente y evaluar las ventajas e inconvenientes de cada uno de ellos, así como saber cuándo y cómo debemos elegirlos (AU)

Knowledge of chronic obstructive pulmonary disease has increased significantly in recent years, and today we have a more comprehensive concept of the disease. Additionally, drug development allows having a wide range of therapeutic options. The inhaled route is the choice, as it allows drugs to act directly on the bronchial tree. In the past few months, new molecules and devices have been developed that increases our options when treating, but also our doubts when choosing one or the other, so an update of inhaled medications for chronic obstructive pulmonary disease is necessary. he different types of inhalers currently available are reviewed in this article, as well as the advantages and disadvantages of each of them, in order to determine how to choose the right device (AU)

[Inhaled in chronic obstructive pulmonary disease therapy update]. / Actualización de la terapia inhalada en la enfermedad pulmonar obstructiva crónica.

Knowledge of chronic obstructive pulmonary disease has increased significantly in recent years, and today we have a more comprehensive concept of the disease. Additionally, drug development allows having a wide range of therapeutic options. The inhaled route is the choice, as it allows drugs to act directly on the bronchial tree. In the past few months, new molecules and devices have been developed that increases our options when treating, but also our doubts when choosing one or the other, so an update of inhaled medications for chronic obstructive pulmonary disease is necessary. The different types of inhalers currently available are reviewed in this article, as well as the advantages and disadvantages of each of them, in order to determine how to choose the right device.