Riesgo de caídas y consumo de fármacos en los pacientes mayores de 65 años. Estudio PYCAF

Cardiovascular Risk in Patients with Dyslipidemia and Their Degree of Control as Perceived by Primary Care Physicians in a Survey-TERESA-Opinion Study

OBJECTIVE

The aim of this study was to evaluate, through a survey, the opinion of primary care (PC) physicians on the magnitude of dyslipidemia and its degree of control in their clinical practice.

MATERIALS AND METHODS

An ecological study was carried out, in which the physicians were invited to participate by means of an online letter. Data were collected at a single timepoint and were based only on the experience, knowledge, and routine clinical practice of the participating physician.

RESULTS

A total of 300 physicians answered the questionnaire and estimated the prevalence of dyslipidemia between 2% and 80%. They estimated that 23.5% of their patients were high-risk, 18.2% were very high-risk, and 14.4% had recurrent events in the last 2 years. The PC physicians considered that 61.5% of their patients achieved the targets set. The participants fixed the presence of side-effects to statins at 14%. The statin that was considered safest with regard to side-effects was rosuvastatin (69%).

CONCLUSIONS

PC physicians in Spain perceive that the CVR of their patients is high. This, together with the overestimation of the degree of control of LDL-C, could justify the inertia in the treatment of lipids. Moreover, they perceive that one-sixth of the patients treated with statins have side-effects.

[Functional physical condition after a multi-component community intervention of active aging: Pragmatic clinical trial]

OBJECTIVE

The objective is to assess the effectiveness of a multicomponent program of active aging in the improvement of the functional physical condition of patients older than 65years old with social risk.

MATERIAL AND METHODS

Pragmatic clinical trial non-blinded.

SETTING

Community activity; primary care and public education center.

PARTICIPANTS

Patients older than 65years and diagnosed with social risk. The patients who attended at the health center and fulfilled the inclusion criteria were selected consecutively (n=102).

INTERVENTIONS

The patients were randomized into the intervention group or to the control group. The intervention included two weekly sessions of 1h of exercise during 4months, monthly health education sessions, and three days of social activities. The control group received the regular tips. The physical conditions were evaluated before and at the end the study.

RESULTS

Eighty of the patients completed the study. Their middle age was 71.5±5 years old, and 91.3% of them were women. There was no significant differences between both groups. After the intervention, all the test for physical qualities improved in the intervention group; in the 6-minutes walk test the patients improved their mark in a 98% from the baseline marks, with an average increase of 65±35m. Flexibility improved in the 60% of the patients (95%CI: 50-70); strength increased an 84% (95%CI: 76-92), and dynamic balance increased a 79% (95%CI: 70-88). In control group improve some test marks but it had no statistical significance.

CONCLUSIONS

The socio-motor intervention program coordinated between health services and educational centers improves the functional physical condition of the elderly with social risk.

[Mortality and use of healthcare resources in elderly patients in Seville: Differences between institutionalised patients and those included in a home care program]

OBJECTIVES

Society is ageing, and as a consequence, the population with increased frailty and comorbidity is growing. The aim is to analyse the mortality and its potential factors, as well as the use of healthcare resources in elderly patients, and to study the differences between institutionalised patients and those included in a home care program.

MATERIALS AND METHODS

An observational, longitudinal and prospective cohort study was conducted in Seville during 2016. The study subjects consisted of 1314 elderly patients (1061 institutionalised and 253 at home). The variables studied included mortality and its potential factors, and the use of healthcare resources.

RESULTS

No differences were found in mortality between institutionalised and home care program patients (RR=1.044; 95% CI; 0.74-1.46; P=.799). The leading cause of death was circulatory diseases followed by respiratory diseases. Among the factors explaining the mortality, it is important to highlight: age, dependency and admissions in the hospital or the emergency department. The patient's functional independence is associated with a higher survival rate. Differences were found between both groups in the number of calls to the Critical Care and Emergency Services (P=.022) or the primary care doctor (P<.001) and in the hospital admissions (P<.001), the first 2differences being higher in home care program patients, and the latter in institutionalised patients.

CONCLUSIONS

There are no differences between groups either in the mortality or in the cause of death. Age, functional dependency and admissions in the hospital are factors which explain the mortality. The use of healthcare resources is higher in patients at home.