Superando las barreras en el abordaje del paciente crónico(Pag.-e 101874)

  1. V. Gasull Molinera 1
  2. J.A. Divison Garrote 2
  3. A. Díaz Rodríguez 3
  4. M. Frías Vargas 4
  1. 1 Centro de Salud Torrent 2, Valencia, España
  2. 2 Centro de Salud Casas Ibañez, Albacete, España
  3. 3 Centro de Salud Bembibre, León, España
  4. 4 Centro de Salud Comillas, Madrid, España
Mostrar afiliaciones +
Revista:
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Año de publicación: 2023

Número: 2

Páginas: 5-5

Tipo: Artículo

DOI: 10.1016/J.SEMERG.2022.101874 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Semergen: revista española de medicina de familia

Resumen

Al menos uno de cada 3 adultos tiene múltiples enfermedades crónicas. La asistencia a estos pacientes es imprescindible, y constituye una de las labores principales en atención primaria. El abordaje de estos pacientes supone un reto, ya que existen barreras a múltiples niveles (sistema sanitario, trabajadores sanitarios, paciente). Además, la pandemia por COVID-19 no ha hecho sino empeorar aún más esta situación. En consecuencia, se hace necesario tomar medidas que intenten mejorar esta situación. Para ello, con el objetivo de definir soluciones/recomendaciones que ayuden a un mejor diagnóstico, tratamiento y seguimiento de los pacientes con enfermedades crónicas, un grupo de expertos de SEMERGEN ha tratado de identificar los problemas en la atención de estos pacientes, buscando posibles soluciones y áreas de mejora. En concreto, el presente documento se ha centrado en 4 de las enfermedades crónicas más prevalentes en atención primaria: dislipemia, hipertensión arterial, enfermedad venosa crónica y depresión.

Referencias bibliográficas

  • C. Hajat, E. Stein The global burden of multiple chronic conditions: A narrative review Prev Med Rep, 12 (2018), pp. 284-293 View PDFView articleView in ScopusGoogle Scholar
  • K.M. Foo, M. Sundram, H. Legido-Quigley Facilitators and barriers of managing patients with multiple chronic conditions in the community: A qualitative study BMC Public Health, 20 (2020), p. 273 View PDF This article is free to access. View in ScopusGoogle Scholar
  • A. Marengoni, S. Angleman, R. Melis, F. Mangialasche, A. Karp, A. Garmen, et al. Aging with multimorbidity: A systematic review of the literature Ageing Res Rev, 10 (2011), pp. 430-439 View PDFView articleView in ScopusGoogle Scholar
  • A.V. Mattioli, M. Ballerini Puviani, M. Nasi, A. Farinetti COVID-19 pandemic: the effects of quarantine on cardiovascular risk Eur J Clin Nutr, 74 (2020), pp. 852-855 View PDF This article is free to access. CrossRefView in ScopusGoogle Scholar
  • A. Fisher, A. Roberts, A.R. McKinlay, D. Fancourt, A. Burton The impact of the COVID-19 pandemic on mental health and well-being of people living with a long-term physical health condition: A qualitative study BMC Public Health, 21 (2021), p. 1801 View PDF This article is free to access. View in ScopusGoogle Scholar
  • G.T. Gerotziafas, M. Catalano, Y. Theodorou, P.V. Dreden, V. Marechal, A.C. Spyropoulos, et al. The COVID-19 Pandemic and the Need for an Integrated and Equitable Approach: An International Expert Consensus Paper Thromb Haemost, 121 (2021), pp. 992-1007 View PDF View in ScopusGoogle Scholar
  • A. Faisal-Cury, C. Ziebold, D.M.O. Rodrigues, A. Matijasevich Depression underdiagnosis: Prevalence and associated factors. A population-based study J Psychiatr Res, 151 (2022), pp. 157-165 View PDFView articleView in ScopusGoogle Scholar
  • K. Bell, J. Doust, K. McGeechan, A.R. Horvath, A. Barratt, A. Hayen, et al. The potential for overdiagnosis and underdiagnosis because of blood pressure variability: A comparison of the 2017 ACC/AHA, 2018 ESC/ESH and 2019 NICE hypertension guidelines J Hypertens, 39 (2021), pp. 236-242 View article CrossRefView in ScopusGoogle Scholar
  • D. Atar, J.W. Jukema, B. Molemans, P.R. Taub, S. Goto, F. Mach, et al. New cardiovascular prevention guidelines: How to optimally manage dyslipidaemia and cardiovascular risk in 2021 in patients needing secondary prevention? Atherosclerosis, 319 (2021), pp. 51-61 View PDFView articleView in ScopusGoogle Scholar
  • L.L. Pantuzza, M.D.G.B. Ceccato, M.R. Silveira, L.M.R. Junqueira, A.M.M. Reis Association between medication regimen complexity and pharmacotherapy adherence: A systematic review Eur J Clin Pharmacol, 73 (2017), pp. 1475-1489 View PDF Your institution provides access to this article. CrossRefView in ScopusGoogle Scholar
  • J.R. Banegas, T. Gijón-Conde Hypertension: The most common chronic health problem in Spain. A call to action Hipertens Riesgo Vasc, 39 (2022), pp. 121-127 View PDFView articleView in ScopusGoogle Scholar
  • F. Mazhar, P. Hjemdahl, C.M. Clase, K. Johnell, T. Jernberg, J.J. Carrero Lipid-lowering treatment intensity, persistence, adherence and goal attainment in patients with coronary heart disease Am Heart J (2022), 10.1016/j.ahj.2022.05.021 View PDF This article is free to access. Google Scholar
  • N.J. Ji, S.Y. Jeon, K.J. Min, M. Ki, W.Y. Lee The effect of initial antidepressant type on treatment adherence in outpatients with new onset depression J Affect Disord (2022), 10.1016/j.jad.2022.05.011 View PDF Your institution provides access to this article. Google Scholar
  • A. Freiberg, M. Schubert, K. Romero Starke, J. Hegewald, A. Seidler A Rapid Review on the Influence of COVID-19 Lockdown and Quarantine Measures on Modifiable Cardiovascular Risk Factors in the General Population Int J Environ Res Public Health, 18 (2021), p. 8567 View PDF CrossRefView in ScopusGoogle Scholar
  • P. Rovere Querini, R. De Lorenzo, C. Conte, E. Brioni, C. Lanzani, M.R. Yacoub, et al. Post-COVID-19 follow-up clinic: Depicting chronicity of a new disease Acta Biomed, 91 (2020), pp. 22-28 View in ScopusGoogle Scholar
  • V. Barrios, J. Cosín-Sales, M. Bravo, C. Escobar, J.M. Gámez, A. Huelmos, et al. La consulta telemática para el cardiólogo clínico en tiempos de la COVID-19: presente y future. Documento de consenso de la Sociedad Española de Cardiología Rev Esp Cardiol, 73 (2020), pp. 910-918 View PDFView articleView in ScopusGoogle Scholar
  • M.A. Hincapié, J.C. Gallego, A. Gempeler, J.A. Piñeros, D. Nasner, M.F. Escobar Implementation and Usefulness of Telemedicine During the COVID-19 Pandemic: A Scoping Review J Prim Care Community Health, 11 (2020), 10.1177/2150132720980612 View article Google Scholar
  • A. Abd-Alrazaq, A. Hassan, I. Abuelezz, A. Ahmed, M.S. Alzubaidi, U. Shah, et al. Overview of Technologies Implemented During the First Wave of the COVID-19 Pandemic: Scoping Review J Med Internet Res, 23 (2021), p. e29136 View PDF CrossRefView in ScopusGoogle Scholar
  • S. Omboni, R.S. Padwal, T. Alessa, B. Benczúr, B.B. Green, I. Hubbard, et al. The worldwide impact of telemedicine during COVID-19: Current evidence and recommendations for the future Connect Health, 1 (2022), pp. 7-35 View in ScopusGoogle Scholar
  • B.A. Ference, I. Graham, L. Tokgozoglu, A.L. Catapano Impact of Lipids on Cardiovascular Health: JACC Health Promotion Series J Am Coll Cardiol, 72 (2018), pp. 1141-1156 View PDFView articleView in ScopusGoogle Scholar
  • B.A. Ference, H.N. Ginsberg, I. Graham, K.K. Ray, C.J. Packard, E. Bruckert, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel Eur Heart J, 38 (2017), pp. 2459-2472 View PDF CrossRefGoogle Scholar
  • F. Mach, C. Baigent, A. Catapano, K.C. Koskinas, M. Casula, L. Badimon, et al. 2019 ESC/EASCES 2019 ESC/EAS guidelines for the mana, 41 (2020), pp. 111-188 View article CrossRefView in ScopusGoogle Scholar
  • F.L.J. Visseren, F. Mach, Y.M. Smulders, D. Carballo, K.C. Koskinas, M. Bäck, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice Eur Heart J, 42 (2021), pp. 3227-3337 View PDF CrossRefGoogle Scholar
  • C.P. Cannon, M.A. Blazing, R.P. Giugliano, A. McCagg, J.A. White, P. Theroux, et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes N Engl J Med, 372 (2015), pp. 2387-2397 View article CrossRefView in ScopusGoogle Scholar
  • M.G. Silverman, B.A. Ference, K. Im, S.D. Wiviott, R.P. Giugliano, S.M. Grundy, et al. Association between lowering LDL-C and cardiovascular risk reduction among different therapeutic interventions: A systematic review and meta-analysis JAMA, 316 (2016), pp. 1289-1297 View PDF This article is free to access. CrossRefView in ScopusGoogle Scholar
  • K.K. Ray, B. Molemans, W.M. Schoonen, P. Giovas, S. Bray, G. Kiru, et al. EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care: the DA VINCI study Eur J Prev Cardiol, 28 (2021), pp. 1279-1289 View PDF CrossRefView in ScopusGoogle Scholar
  • V. Pascual Fuster, E. Ruiz Olivar, X. Pintò Sala LIPEDIA. Control de la dislipidemia aterogénica en paciente diabético tipo 2: Procedimientos en la práctica clínica - Estudio LIPEDIA Clin Investig Arterioscler, 27 (2015), pp. 45-56 View PDFView articleView in ScopusGoogle Scholar
  • F. López-Simarro, C. Brotons, I. Moral, C. Cols-Sagarra, A. Selva, A. Aguado-Jodar, et al. Inercia y cumplimiento terapéutico en pacientes con diabetes mellitus tipo 2 en atención primaria Med Clin (Barc), 138 (2012), pp. 377-384 View PDFView articleView in ScopusGoogle Scholar
  • S. Ye, I.M. Kronish Cumplimiento terapéutico del tratamiento con estatinas: medicina de precisión para optimizar la adherencia Rev Esp Cardiol, 71 (2018), pp. 4-5 View PDFView articleGoogle Scholar
  • J.A. Rash, D.J. Campbell, M. Tonelli, T.S. Campbell A systematic review of interventions to improve adherence to statin medication: What do we know about what works? Prev Med, 90 (2016), pp. 155-169 View PDFView articleView in ScopusGoogle Scholar
  • V. Barrios, C. Escobar, J. Gamarra, J.C. Obaya, V. Pallarés Manejo del paciente con dislipidemia en España. Proyecto Cardio Right Care Control del Riesgo Cardiovascular Semergen, 47 (2021), pp. 28-37 View PDFView articleView in ScopusGoogle Scholar
  • C.N. Merz, J.B. Buse, D. Tuncer, G.B. Twillman Physician attitudes and practices and patient awareness of the cardiovascular complications of diabetes J Am Coll Cardiol, 40 (2002), pp. 1877-1881 View PDFView articleView in ScopusGoogle Scholar
  • A.M. Cebrián-Cuenca, M. Mata-Cases, J. Franch-Nadal, D. Mauricio, D. Orozco-Beltrán, L. Consuegra-Sánchez Half of patients with type 2 diabetes mellitus are at very high cardiovascular risk according to the ESC/EASD: Data from a large Mediterranean population Eur J Prev Cardiol, 28 (2022), pp. e32-e34 View article CrossRefGoogle Scholar
  • A. Cebrian, C. Escobar, U. Aranda, B. Palacios, M. Capel, A. Sicras, et al. Incluir la estratificación de riesgo KDIGO en la escala SCORE podría mejorar la exactitud para estratificar mejor el riesgo cardiovascular Nefrologia (2022), 10.1016/j.nefro.2021.11.010 View PDF This article is free to access. Google Scholar
  • M.L. Morieri, O. Lamacchia, E. Manzato, A. Giaccari, A. Avogaro, Lipid-Lowering-Relevance Study Group Physicians’ misperceived cardiovascular risk and therapeutic inertia as determinants of low LDL-cholesterol targets achievement in diabetes Cardiovasc Diabetol, 21 (2022), p. 57 View PDF This article is free to access. View in ScopusGoogle Scholar
  • C. Morales, N. Plana, A. Arnau, L. Matas, M. Mauri, À. Vila, et al. Causas de no consecución del objetivo terapéutico del colesterol de las lipoproteínas de baja densidad en pacientes de alto y muy alto riesgo vascular controlados en Unidades de Lípidos y Riesgo Vascular. Estudio EROMOT Clin Investig Arterioscler, 30 (2018), pp. 1-9 View PDFView articleView in ScopusGoogle Scholar
  • C. Escobar, M. Anguita, V. Arrarte, V. Barrios, Á. Cequier, J. Cosín-Sales, et al. Recomendaciones para mejorar el control lipídico. Documento de consenso de la Sociedad Española de Cardiología Rev Esp Cardiol, 73 (2020), pp. 161-167 View PDFView articleView in ScopusGoogle Scholar
  • T. Unger, C. Borghi, F. Charchar, N.A. Khan, N.R. Poulter, D. Prabhakaran, et al. 2020 International Society of Hypertension global hypertension practice guidelines J Hypertens, 38 (2020), pp. 982-1004 View PDF CrossRefView in ScopusGoogle Scholar
  • B. Williams, G. Mancia, W. Spiering, E. Agabiti Rosei, M. Azizi, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Cardiology and the European Society of Hypertension J Hypertens, 36 (2018), pp. 1953-2041 View article CrossRefGoogle Scholar
  • S. Cinza Sanjurjo, J.L. Llisterri Caro, A. Barquilla García, J. Polo García, S. Velilla Zancada, G.C. Rodríguez Roca, et al. Descripción de la muestra, diseño y métodos del estudio para la identificación de la población española de riesgo cardiovascular y renal (IBERICAN) Semergen, 46 (2020), pp. 4-15 View PDFView articleView in ScopusGoogle Scholar
  • S. Cinza-Sanjurjo, R.M. Micó-Pérez, S. Velilla-Zancada, M.A. Prieto-Díaz, G.C. Rodríguez-Roca, A. Barquilla García, et al. Factores asociados al riesgo cardiovascular y enfermedad cardiovascular y renal en el estudio IBERICAN Semergen, 46 (2020), pp. 368-378 View PDFView articleView in ScopusGoogle Scholar
  • V. Barrios, C. Escobar, J.L. Llisterri, G. Rodríguez Roca, J.J. Badimón, J. Vergara, et al. Características clínicas basales y manejo de los pacientes incluidos en el estudio IBERICAN Semergen, 41 (2015), pp. 3-12 View PDFView articleView in ScopusGoogle Scholar
  • T. Gijón-Conde, M. Gorostidi, J.R. Banegas, A. De la Sierra, J............. Segura, E. Vinyoles, et al. Documento de la Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA) sobre monitorización ambulatoria de la presión arterial (MAPA) 2019 Hipertens Riesgo Vasc, 36 (2019), pp. 199-212 View PDFView articleView in ScopusGoogle Scholar
  • O. Penín, B. Villasuso, M. Domenech, A. Moyá, J. Torras, M.J. Peña, et al. Guía para el abordaje de la hipertensión por el farmacéutico comunitario en el ámbito de la atención primaria: documento de consenso multidisciplinar. SEFAC, Madrid (2022) Google Scholar
  • C.S. Doménech, J.L. Caro, V.P. Sanz, F.J. Moreno, I.L. Rodríguez, A.N. Loro, et al. Inercia terapéutica en pacientes hipertensos asistidos en atención primaria en España. Estudio Objetivo Kontrol Aten Primaria, 43 (2011), pp. 638-647 Google Scholar
  • E. Márquez Contreras, N. Martel Claros, V. Gil Guillén, J.L. Martín De Pablos, M. De La Figuera Von Wichman, et al. El control de la inercia terapéutica en el tratamiento de la hipertensión arterial mediante diferentes estrategias Aten Primaria, 41 (2009), pp. 315-323 View PDFView articleView in ScopusGoogle Scholar
  • D. Estrada Reventos, E. Pujol Navarro Medida de la presión arterial Rev Enferm, 31 (2008), pp. 15-18 View in ScopusGoogle Scholar
  • D.M. Bard, J.I. Joseph, N. van Helmond Cuff-less methods for blood pressure telemonitoring Front Cardiovasc Med, 6 (2019), p. 40 View PDF View in ScopusGoogle Scholar
  • S. Omboni, E. Panzeri, L. Campolo E-Health in Hypertension Management: an Insight into the Current and Future Role of Blood Pressure Telemonitoring Curr Hypertens Rep, 22 (2020), p. 42 View PDF Your institution provides access to this article. View in ScopusGoogle Scholar
  • B. Citoni, I. Figliuzzi, V. Presta, M. Volpe, G. Tocci Home Blood Pressure and Telemedicine: A Modern Approach for Managing Hypertension During and After COVID-19 Pandemic High Blood Press Cardiovasc Prev, 29 (2022), pp. 1-14 View PDF This article is free to access. CrossRefGoogle Scholar
  • T. Fujiwara, R.J. McManus, K. Kario Management of hypertension in the digital era: Perspectives and future directions Hipertens Riesgo Vasc, 39 (2022), pp. 79-91 View PDFView articleView in ScopusGoogle Scholar
  • J.R. Escudero Rodríguez, F. Fernández Quesada, S. Bellmunt Montoya Prevalencia y características clínicas de la enfermedad venosa crónica en pacientes atendidos en Atención Primaria en España: resultados del estudio internacional Vein Consult Program Cir Esp, 92 (2014), pp. 539-546 View PDFView articleView in ScopusGoogle Scholar
  • E. Carrasco Carrasco Recomendaciones para el manejo de la Enfermedad Venosa Crónica en Atención Primaria. Informaciones Digitales y Comunicación (2020) Madrid
  • M.G.D. Maeseneer, S.K. Kakkos, T. Aherne, N. Baekgaard, S. Black, L. Blomgren, et al. European Society for Vascular Surgery (ESVS) 2022 Clinical practice guidelines on the management of chronic venous disease of the lower limbs Eur J Vasc Endovasc Surg, 63 (2022), pp. 184-267 Google Scholar
  • Abbad C M, Horcajo RR, Ortega MDB, Madrid CG. Guías de práctica clínica en enfermedad venosa crónica. Id Médica. 2015. Disponible en: https://www.mision-compresion.es/upload/publicaciones/PDF2_Guias-Practica-Clinica-Enfermedad-Venosa-Cronica_431.pdf Google Scholar
  • A.H. Davies The Seriousness of Chronic Venous Disease: A Review of Real-World Evidence Adv Ther, 36 (Suppl 1) (2019), pp. 5-12 View PDF This article is free to access. CrossRefView in ScopusGoogle Scholar
  • A.N. Nicolaides, N. Labropoulos Burden and Suffering in Chronic Venous Disease Adv Ther, 36 (Suppl 1) (2019), pp. 1-4 View PDF This article is free to access. CrossRefGoogle Scholar
  • A. Mansilha, J. Sousa Pathophysiological Mechanisms of Chronic Venous Disease and Implications for Venoactive Drug Therapy Int J Mol Sci, 19 (2018), p. 1669 View PDF CrossRefView in ScopusGoogle Scholar
  • M. McArdle, E.A. Hernandez-Vila Management of Chronic Venous Disease Tex Heart Inst J, 44 (2017), pp. 347-349 View in ScopusGoogle Scholar
  • S.K. Kakkos, A.N. Nicolaides Efficacy of micronized purified flavonoid fraction (Daflon®) on improving individual symptoms, signs and quality of life in patients with chronic venous disease: A systematic review and meta-analysis of randomized double-blind placebo-controlled trials Int Angiol, 37 (2018), pp. 143-154 View in ScopusGoogle Scholar
  • J.H. Ulloa Micronized Purified Flavonoid Fraction (MPFF) for Patients Suffering from Chronic Venous Disease: A Review of New Evidence Adv Ther, 36 (Suppl 1) (2019), pp. 20-25 View PDF This article is free to access. CrossRefView in ScopusGoogle Scholar
  • J.M. Ramírez Torres, J. Caballer Rodilla, M. Frías Vargas, O. García Vallejo, I. Gil Gil Enfermedad Venosa Crónica en los nuevos tiempos. Propuesta Venocheck. Medicina de Familia Semergen, 48 (2022), pp. 344-355 View PDFView articleView in ScopusGoogle Scholar
  • L.T. Park, C.A. Zarate Jr. Depression in the Primary Care Setting N Engl J Med, 380 (2019), pp. 559-568 View article CrossRefGoogle Scholar
  • M. Fava, A.J. Rush, J.E. Alpert, G.K. Balasubramani, S.R. Wisniewski, C.N. Carmin, et al. Difference in treatment outcome in outpatients with anxious versus nonanxious depression: A STAR*D report Am J Psychiatry, 165 (2008), pp. 342-351 View article CrossRefView in ScopusGoogle Scholar
  • R.C. Kessler, P. Berglund, O. Demler, R. Jin, D. Koretz, K.R. Merikangas, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R) JAMA, 289 (2003), pp. 3095-3105 Google Scholar
  • R.G. Frank, H.A. Huskamp, H.A. Pincus Aligning incentives in the treatment of depression in primary care with evidence-based practice Psychiatr Serv, 54 (2003), pp. 682-687 View in ScopusGoogle Scholar
  • T.L. Mark, K.R. Levit, J.A. Buck Data-points: Psychotropic drug prescriptions by medical specialty Psychiatr Serv, 60 (2009), p. 1167 View article CrossRefView in ScopusGoogle Scholar
Fuente de los datos: Dialnet