scholarly journals Characteristics of citizens and their use of teleconsultation in Primary Care in the Catalan public health system before and during COVID: Retrospective Descriptive Cross-Sectional Study (Preprint)

Author(s):  
Oscar Solans ◽  
Josep Vidal-Alaball ◽  
Pasqual Roig Cabo ◽  
Núria Mora ◽  
Ermengol Coma ◽  
...  
2020 ◽  
Vol 11 ◽  
Author(s):  
Tânia Regina Ferreira ◽  
Luciane Cruz Lopes ◽  
Cristiane de Càssia Bergamaschi

Background: There is lack of national studies that assess the risks associated with the drugs provided under the Brazilian public health system for treating Alzheimer’s disease. Then, this study determined the prevalence and severity of self-reported adverse drug reactions (ADRs) prescribed to patients with Alzheimer’s disease in the Brazilian public health system.Methods: A cross-sectional study was carried out based on public data from the MEDEX system (information on dispensing data, known as exceptional dispensing medications) and interviews with patients and/or caregivers who get access to Alzheimer’s drugs at a public pharmacy in a large Brazilian city, between July and September 2017, inquiring about ADRs and serious adverse events (SAEs).Results: The subjects were asked about ADRs and SAEs related to the use of donepezil, galantamine, rivastigmine and memantine. Out of 285 patients enrolled on the database, 250 participated in the study (87.7%). Among the participants, approximately 63.0% were female, 70.3% aged ≥75 years and 70.3% had comorbidities. Overall, 209 patients (83.6%) reported at least one ADR (total 1,149 ADRs) and rivastigmine was associated with the largest number of ADRs per patient (7.9 ADRs/patient). The predominant adverse effects were psychiatric disorders with common frequency (57.1%) and mild severity (89.0%). Six patients (2.4%) had SAEs that required hospitalization. The use of antipsychotics was the variable associated with ADR (OR = 4.95; 95% CI: 1.45–16.93; p = 0.011).Conclusion: There was a large number of reported ADRs and most of them were of common frequency and mild severity, being mainly related to psychiatric disorders. Considering the fragility of these patients, it is important to improve safety-related care in the use of drugs for treating this disease.


2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Luciana Bahia ◽  
Evandro Silva Freire Coutinho ◽  
Laura Augusta Barufaldi ◽  
Gabriela de Azevedo Abreu ◽  
Thainá Alves Malhão ◽  
...  

PLoS ONE ◽  
2013 ◽  
Vol 8 (12) ◽  
pp. e83822 ◽  
Author(s):  
Miaomiao Tian ◽  
Da Feng ◽  
Xi Chen ◽  
Yingchun Chen ◽  
Xi Sun ◽  
...  

2021 ◽  
Author(s):  
Oscar Solans ◽  
Josep Vidal-Alaball ◽  
Pasqual Roig Cabo ◽  
Núria Mora ◽  
Ermengol Coma ◽  
...  

BACKGROUND eConsulta (asynchronous and two-way teleconsultation in Primary Care) is one of the most important telemedicine developments in the Catalan public health system, a service that has been heavily boosted by the outbreak of the pandemic. It is vitally important to know the characteristics of its users in order to be able to meet their needs and have an idea of who is being covered (and who is not) through this service in a context where there is less accessibility to the health system. OBJECTIVE Undertake a descriptive analysis of the profile of the citizens who use the tool and the type of use they make of it to gain an understanding of the elements that characterize their decision to use it, making a distinction between those who used it before and those who have used it since the outbreak of the COVID-19 pandemic METHODS Descriptive observational study based on administrative data. The study differentiates between the pre and during COVID periods, taking as the cut-off point the day the state of emergency was declared in Spain (13 March 2020), and between users who send messages and those who only receive them. The main study variable is the use of the eConsulta service. RESULTS The pandemic has resulted in almost triple the number of unique users in just the first three months observed (220,043/76,598, 2.87). Since the start of the COVID outbreak, although users have continued to be predominantly female, they are systematically younger than before, more actively employed and with less complex pathologies for the two user profiles analysed. There is also a relative decrease in the number of conversations initiated by higher-income urban citizens and an increase in users in rural areas. CONCLUSIONS This study identifies a change in the profile of citizens who use the eConsulta tool, which as a result of the COVID-19 pandemic now has a profile similar to that of the average citizen: actively employed, with low complexity of pathology and who receives more messages proactively from the health professionals through eConsulta. The pandemic has helped to generalize the use of telemedicine as a tool to compensate to some extent for the decline in face-to-face visits, especially in younger citizen profiles.


Author(s):  
Desirée Mena-Tudela ◽  
Susana Iglesias-Casás ◽  
Víctor Manuel González-Chordá ◽  
María Jesús Valero-Chillerón ◽  
Laura Andreu-Pejó ◽  
...  

Background: Obstetric violence is a worldwide public health problem, which seems greater in Spain. As no studies were found that identify the most representative healthcare professionals, times, and areas involved in obstetric violence, the objective of this work was to study at what time of maternity, with which professionals, and in what areas women identified obstetric violence. Methods: This descriptive, retrospective, and cross-sectional study was performed from January 2018 to June 2019. The main variables were the area (hospital, primary care, both), the time (pregnancy, birth, puerperium), and the professionals attending to women. Results: Our sample comprised 17,541 participants. The area identified with the most obstetric violence for the different studied variables was hospitals. Women identified more obstetric violence at time of birth. Findings such as lack of information and informed consent (74.2%), and criticism of infantile behavior and treatment (87.6%), stood out. The main identified healthcare professionals were midwives and gynecologists, and “other” professionals repeatedly appeared. Conclusions: Having identified the professionals, times, and areas of most obstetric violence in Spain, it seems necessary to reflect on not only the Spanish National Health System’s structure and management but also on healthcare professionals’ training.


Author(s):  
Clea Adas Saliba Garbin ◽  
Bruno Wakayama ◽  
Tânia Adas Saliba ◽  
Orlando Adas Saliba Junior ◽  
Artênio José Ísper Garbin

2010 ◽  
Vol 13 (1) ◽  
pp. 118-125 ◽  
Author(s):  
Aline Mendes Silva ◽  
Andréa Maria Duarte Vargas ◽  
Efigênia Ferreira e Ferreira ◽  
Mauro Henrique Nogueira Guimarães de Abreu

OBJECTIVE: The aim of the present study was to investigate the prevalence of periodontitis among individuals with diabetes who use the public health system in the city of Belo Horizonte-Minas Gerais, Brazil, and the association of this condition with socioeconomic, behavioral and clinical variables. METHODS: A cross-sectional study was carried out on a calculated sample of 300 individuals with diabetes. Periodontitis was defined as clinical attachment loss (CAL) > 3 mm in two or more non-adjacent teeth or those that exhibited CAL > 5 mm in 30.0% of teeth. All subjects were over 30 years of age and underwent a periodontal examination. Socioeconomic and behavioral characteristics as well as medical history and dental history were obtained from a structured interview. Multivariate analysis was conducted using Poisson regression. RESULTS: Among the individuals with diabetes, 6.7% exhibited good periodontal health, 68.0% exhibited gingivitis and 25.3% exhibited periodontitis. The following variables were associated with periodontitis after adjustment: male (PR 1.67 95% CI 1.12, 2.49), individuals with diabetes for more than eight years (PR 1.63 95% CI 1.63, 2.38), smokers (PR 1.71 95% CI 1.10, 2.65); individuals with more than 12 missing teeth (PR 2.67 95% CI 1.73, 4.15) CONCLUSIONS: Multiple determinants are associated with the prevalence of periodontitis among patients with diabetes.


2018 ◽  
Vol 64 (9) ◽  
pp. 814-818 ◽  
Author(s):  
Daniel I.G. Cubero ◽  
Cláudia Vaz de Melo Sette ◽  
Beatriz de Camargo Preto Piscopo ◽  
Camila Ribeiro de Arruda Monteiro ◽  
Jean Henri Maselli Schoueri ◽  
...  

SUMMARY INTRODUCTION Structural disparities between different Brazilian regions in public health system cause patients to migrate in search of better conditions to treat their diseases. Besides patient’s discomfort, there is a concentration of care in large centres, causing overload to current capacity. OBJECTIVE To evaluate migratory flow and associated factors in a reference service in oncology. METHODS Cross-sectional study conducted at a referral oncology service in Great ABC region of São Paulo. Patients were interviewed, and clinical and demographic data collected. RESULTS Between March-July 2016, 217 patients were included. Analysis showed a divergence between the postal code registered in the medical record and that recorded during the interview in approximately 10% of cases. Of these, 42.9% were residents of other states. Search for treatment motivated most patients to seek service outside their city. CONCLUSION Results reflect the informal search for medical care outside the home area. Besides the direct impact on patients’ quality of life, migratory flow has an economic-social impact because these patients place a burden and impose costs on services of cities where they do not perform their responsibilities as citizens. Confirmation of the existence of a significant migratory flow demonstrates the need to discuss restructuring public health policies.


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