Que hacen y que deben hacer los pacientes diabeticos para evitar errores con el tratamiento ? / What do diabetic patients and what should they do to avoid errors in the course of treatment?

RESUMEN

Objetivo: Describir que hacen los pacientes diabeticos para evitar errores con el tratamiento y presentar consejos para incrementar la seguridad. Metodos Estudio descriptivo de conductas de pacientes diabeticos tratados con insulina para minimizar errores y de consejos de los profesionales para mejorar la seguridad. Se reclutaron aleatoriamente 99 pacientes de 3 centros de salud y 2 hospitales. Adicionalmente, se conto con una muestra de oportunidad de 33 medicos y enfermeros. Resultados Informar de todas las prescripciones (p=0,005), revisar dudas antes de la consulta (p=0,009) y el cumplimiento de la dieta (p=0,02) fueron las unicas precauciones informadas por los pacientes que se relacionaron con un menor numero de errores de los propios pacientes. Las mujeres siguen mejor en casa las indicaciones sobre los controles de glucemia (odds ratio 0,07, intervalo de confianza [IC] del 95% 0,1-0,6) y recurren a pastilleros para evitar errores (odds ratio 0,23; IC 95% 0,1-0,6) con mas frecuencia que los hombres. La informacion de alergias es mas frecuente entre varones (odds ratio 5,03; IC 95% 1,4-17,5). Los pacientes con un curso mas prolongado tienden a no proporcionar informacion a su medico sobre otros (..) (AU)

ABSTRACT

Objective: To report the precautions taken by diabetic patients to avoid treatment errors and to provide advice to increase their safety. Methods: A descriptive study of patients' behaviors to minimize errors and tips by professionals to improve safety. Ninety-nine insulin-treated patients were randomly recruited from 3 primary healthcare centers and 2 hospitals. An opportunity sample of 33 doctors and nurses was also surveyed. Results: Information of all prescriptions (p = 0.005),review of doubts before the visit(p = 0,009),and diet adherence (p = 0.02) were the only precautions reported by patients that related to a lower number of patient errors. Female patients better follow at home instructions for blood glucose monitoring (odds ratio 0.07; 95% confidence interval (CI) 0.1-0.6) and use pillboxes to avoid errors (odds ratio 0.23; 95% CI 0.1-0.6) more frequently than male patients. Male patients more commonly carry with them a card with information about allergies (odds ratio 5.03; 95%CI 1.4-17.5). Patients with a longer course of disease tend to withhold information about other treatments from their doctors ( -15.8; 95% CI -23.2-8.4). For healthcare professionals, safety may increase if patients play a more active role in their treatment (91%), and inform their doctors about their different treatments (88%).Conclusions: Promotion of patient autonomy, improved communication to patients, and systematic information about the most common medication errors may contribute to patient safety (AU)