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Biomedical subjects

P Solanas Saura

Publications and source records attributed to P Solanas Saura.

9 recordsLinked to original sources
PubMed2005

[Costs of spirometry as a screening test for chronic obstructive pulmonary disease in primary care].

OBJECTIVE: To calculate the costs of COPD screening by simple spirometry, conducted in primary care, in smokers and ex-smokers over 40 years old. DESIGN: Descriptive study. Cost analysis. SETTING: Semi-rural health district covering some 6000 inhabitants. PARTICIPANTS: Randomised sample of 350 smokers and ex-smokers over 40 allocated to the centre. 73 were excluded on SEFAR criteria. INTERVENTIONS AND MEASUREMENTS: Simple spirometry was conducted with an automatic, portable, dry spirometer. Costs were calculated from the time needed, the material, human resources and the number of valid spirometer readings. RESULTS: 85% of 277 had a spirometry test. 18% of the spirometry readings were not valid. 3 spirometries an hour could be done: at least 1 was pathological and a bronchodilator test was needed. The cost of a spirometry, if a professional devotes 2 hours a day for 5 years, was 10.57 euros or 8.54 euros, for doctor or nurse, respectively. Modifying the number of spirometries per year or the number of professionals trained for such a technique causes only minor changes in cost. CONCLUSIONS: Optimal cost: 9000 spirometries a year by a single nurse. However, this would entail one nurse's almost exclusive dedication. Two trained professionals raises the cost slightly and distributes the work load better, enabling more hours to be covered. Before advising any COPD screening, its costs and its real possibility of affecting active smokers (the sole preventive possibility) should be carefully assessed.

Adult↗
PubMed2004

[Management of osteoporosis at a primary care center].

OBJECTIVES: To find how suitable a semFYC guide is for the indication of bone densitometry in menopausal women; and how appropriate their Osteoporosis treatment is. DESIGN: Cross-sectional study.Setting. Girona-3 Health District. PARTICIPANTS: Women between 50 and 80 allocated to the Girona-3 Health District. Suffering a grave psychiatric disorder or a terminal illness were considered criteria for exclusion. 409 out of the 420 women envisaged were included, to achieve a 5% accuracy and a 0.05% alpha error. MAIN MEASUREMENTS: Whether bone densitometry took place or otherwise, other diagnostic tests, risk factors for osteoporosis recorded and drug treatment prescribed. RESULTS: Of the 125 women with risk factors for osteoporosis, 12 (9.6%) had had a bone densitometry. 20% of all bone densitometries done showed pathology. Only in 3 cases (0.7%) of the pathological cases was any recommendation on life-style recorded. 19.8% of the women took drug treatment. In 8% this was justified. The most common treatment prescribed was calcium, on its own or linked to vitamin D. 20% of cases had a bone densitometry to monitor them after 2 years. CONCLUSIONS: The indication for bone densitometry is low and its use could be improved. In those cases in which bone densitometry is requested, a pharmacological intervention is more common than a life-style one.

Aged↗
PubMed2001

[Tackling mental health problems from primary care: relationship with specialized support services].

OBJECTIVES: To find the relationship between primary care (PC) and mental health (MH) by evaluating: 1) perception of MH problems in PC: training of professionals and doctor-patient relationship, and 2) relationship between PC and specialist support services: coordination meetings and reasons for referrals. DESIGN: Descriptive study. SETTING: Seven PC centres that share the same mental health centre in the Girona Health Region. PARTICIPANTS: All the PC doctors from the 7 centres (n = 66). MEASUREMENTS AND MAIN RESULTS: Specific, anonymous and self-administered survey, with 71 Likert-type items, distributed in 14 fields. 51 replies (77.2%). 60.4% valued positively their MH training. 100% thought that a good doctor-patient relationship improves adherence to treatment, and 76.5% saw this hindered by lack of time. Aggressive and manipulative patients caused a higher level of tension (70.6% and 66.7%). The point most highly valued of their relationship with the MH centre was its support in patient follow-up (69.6%) and the agreement to share responsibilities for treatment of mental disorders (71.1%). The forms of support most valued were: inter-clinical meetings (80.4%) and inter-clinic telephone consultations (78.4%). The factors most conditioning referral to the MH centre were ideas of suicide (96.1%) and the seriousness of the symptoms (94%). CONCLUSIONS: Greater MH training should be offered to PC doctors. PC doctors think they have little time available to devote to their psychiatric patients. Availability of a specialist PC support team is essential.

Adult↗
PubMed2000

[Prevalence of Helicobacter pylori infection in primary health care].

OBJECTIVES: To find the prevalence of Helicobacter pylori (Hp) infection in the population as a whole. To assess its relationship with the associated factors described in other studies. DESIGN: Transversal study of an urban population of 20,000. PARTICIPANTS: Between 14 and 80 years old. Randomised sampling of the computerised records (640 clinical histories). Necessary sample n = 384 (alpha = 0.05, prior prevalence = 50%, precision 0.05). MEASUREMENTS: Breath test with urea marked (13C), age, sex, alcohol and tobacco consumption, social class and dyspepsia and/or gastro-duodenal pathology. RESULTS: 123 exclusions. 122 losses (23%). 397 people screened, 43.6% male. Average age: 42.6. 41.6% consumed alcohol. 30.5% smoked. Prevalence of dyspepsia, gastritis, gastric ulcer and duodenal ulcer, 14%, 2.8%, 2.8% and 2.0%, respectively. Hp prevalence: 56.1% (95% CI, 51.2-60.1). There were no significant differences between prevalence of Hp+ and sex, dyspepsia, peptic ulcer history, gastritis, alcohol consumption and tobacco consumption. Greatest prevalence of Hp+ in over-70s (73%). Significant linear tendency between presence of Hp+ and age (p < 0.05) and low social class (p < 0.05). The logistic regression analysis found a statistically significant relationship only between the presence of H. pylori and age and social class. CONCLUSIONS: Prevalence was similar to that in other studies. The relationship between low social class and age and greater Hp prevalence was confirmed. Dyspepsia is not a justification for empirical treatment of Hp. Patients with and without the infection must be followed to evaluate morbidity longitudinally.

Adolescent↗
PubMed1998

[User satisfaction in primary care].

OBJECTIVES: To find user satisfaction and assess the usefulness of an analogue scale in measuring satisfaction. DESIGN: Multi-centre, descriptive and crossover study. SETTING: Four primary care centres in Girona. PARTICIPANTS: All those users who happened to attend on a certain day (n = 1349). MEASUREMENTS AND MAIN RESULTS: A multi-dimensional, self-administered and anonymous 33-item questionnaire on satisfaction, which had already been validated in primary care, was used. An analogue scale, running from 0 to 10, on overall satisfaction was added. The mean age was 48.5; 33% were men, 62% women. 84.2% replied; 37.3% needed help to reply. Mean satisfaction on the questionnaire was 85%, with lower ratings given to organisational questions, and the highest to personal treatment. The analogue scale achieved 7.34 average. The correlation between the two was r = 0.63 (p < 0.001). CONCLUSIONS: The satisfaction level was similar to that found in other studies. The analogue scale correlated closely with the questionnaire, but was quicker and more simple. As such, it could be used to monitor user satisfaction along with open questions for a supplementary qualitative evaluation.

Adolescent↗
PubMed1998

[Overattendance at primary care: a study of psychosocial factors].

OBJECTIVE: To determine the effect of various psychological and social factors--family function, social support, psychological malaise and social class--on frequency of attendance. DESIGN: Study with cases and controls. SETTING: Health Districts Girona-3 and La Bisbal. PARTICIPANTS: Criteria for inclusion: being older than 14, being on a list as a user, and having been seen at least once during the study period. The person over-attending is defined as someone attending 7 or more times in a year. The normal attender attends less than 7 times. The sample was 441 patients (209 cases and 232 controls). MEASUREMENTS AND MAIN RESULTS: The Smilkestein family Apgar and the DUKE-UNC social support questionnaires, and the Goldberg anxiety and depression scale, were administered. Social class was defined according to the job of the head of the family. Statistical analysis was undertaken in two steps: firstly, bivariate analysis; and second, multivariate. The social support and age variables were related to frequency of attendance: they explained 8.1% of it (through multiple regression). Depression increased by between 1.21 and 2.58 the risk of over-attending and explained 10.53% of the variability of over-attendance, in line with the logistical regression analysis. CONCLUSIONS: The psychological and social variables studied fail to explain most of the variability. We should demystify the importance of psychological and social factors in the use of health resources.

Adolescent↗