[Cardiovascular preventive activities in primary care].
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Biomedical subjects
Publications and source records attributed to J Navarro Pérez.
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OBJECTIVE: To typify the episodes of early detection of cardiovascular risk factors (CRF) and to calculate their frequency by age and sex groups. DESIGN: An observational, prospective and multi-centred study. SETTING: Twenty health centres distributed in the three provinces of the Community of Valencia. PATIENTS: Episodes of prevention of CRF in users of both sexes aged between 18 and 64 who, in the three years prior to the study, had undergone no CRF early diagnosis protocol. They were included by means of consecutive proposal with informed consent. MEASUREMENTS AND RESULTS: The diagnostic protocol of the Plan for Prevention of Cardiovascular Diseases (PPCVD) was applied. The variables analysed were: age, sex, number and duration of consultations, CRF diagnosed previously, and CRF diagnosed at the intervention. 632 episodes were analysed, with a mean 1.44 (CI: 1.39-1.49) consultations per episode and a mean duration of 10 minutes 53 seconds. At the start of the study 60.3% of the population did not have CRF, but after the intervention only 17.2% had no CRF diagnosed. CRF frequency after the intervention was: diabetes 4.5% (CI: 3.2-12.2), alcohol consumption 5.5% (CI: 2.2-13.1), hypertension 14.9% (CI: 7.7-22.2), obesity 30.8% (CI: 24.3-37.3), tobacco habit 33.2% (CI: 26.8-39.6), lipaemia 42.5% (CI: 36.6-48.5), and sedentary life-style 54.9% (CI: 49.6-60.2). CONCLUSIONS: CRF diagnosed most often after the intervention were: sedentary life-style, tobacco habit and obesity; and the least commonly diagnosed was alcohol consumption. The application of the PPCVD protocol was most effective in the youngest age-groups and women. The "episode" as a unit of analysis is a useful and feasible instrument for investigating the procedures and results of primary care preventive activities.
OBJECTIVE: To find the control degree of a population of hypertension patients. To evaluate the cost effectiveness of health services. SETTING: EAP Salvador Pau. Valencia (Spain). PATIENTS: 200 patients diagnosed of hypertension included in the health center file. MEASUREMENTS AND RESULTS: Items studied were age, sex, diagnosis and program inclusion year, number of visits, other explorations and its cost, TAS and TAD, drugs and its cost, personnel cost. We established different well control levels and we obtained the cost of each of them. Twenty six point five per cent of patients had TA values below 140/90 mmHg; Sixty four point five per cent had values below 160/90 mmHg. And sixty six point nine had values below 90 mmHg. Monthly medium cost per patient was 3242 pts. Monthly medium cost per patient well controlled was 12234 pts. CONCLUSIONS: Only a third of our patients are well controlled according the current standards. Efficiency decreases noteworthy when control levels are lower.
OBJECTIVES: To find the effectiveness of short-term eradication treatment of Helicobacter pylori in the duodenal ulcer. DESIGN: Intervention study, open controlled, randomised with parallel groups. SETTING: Three Health Centres in the city of Valencia. PATIENTS: Patients with a duodenal ulcer diagnosis and a Helicobacter pylori infection who attended the Primary Care physician. INTERVENTION: The study group (48 patients) was treated for six days with the triple therapy: Amoxycillin, Clarithromycin and Omeprazole. The control group (40 patients) was treated with Omeprazole for six weeks. MEASUREMENTS AND MAIN RESULTS: The observance period lasted a year, after which the Elisa test was conducted. Eradication was successful for 65% of those treated with the triple therapy, but for only 30% of those treated with monotherapy. The consumption of medication for the ulcer during the year of observance was almost three times greater in the group treated with monotherapy than in the triple-therapy group. CONCLUSIONS: Eradicative triple therapy was shown to be more effective and efficient than monotherapy. It is feasible to use it in Primary Care. Eradicative triple therapy is not advisable within six days: a longer treatment period should be employed with this recommendable therapy.