Características clínicas y sociosanitarias en mayores de 65 años asistidos en atención primaria. Estudio PYCAF

  1. J.C. Romero Vigara 1
  2. J.L. Llisterri Caro 4
  3. M. Turégano Yedro 5
  4. S. Cinza Sanjurjo 6
  5. L. Muñoz González 2
  6. Y.A. Silvero 3
  7. Segura Fragoso, Antonio 7
  8. J. Santianes Patiño 8
  9. J.I. García García 9
  10. J. Benítez Rivero 10
  1. 1 Centro de Salud de Talarrubias, Talarrubias, Badajoz, España
  2. 2 Servicio de Urgencias, Hospital Regional Universitario Carlos Haya, Málaga, España
  3. 3 Servicio de Urgencias, Hospital General de Onteniente, Valencia, España
  4. 4 Centro de Salud Ingeniero Joaquín Benlloch, Valencia, España
  5. 5 Centro de Salud San Jorge, Cáceres, España
  6. 6 Centro de Salud de Porto do Son, EOXI Santiago de Compostela, Porto do Son, La Coruña, España
  7. 7 Instituto de Ciencias de la Salud de Castilla-La Mancha, Talavera de la Reina, Toledo, España
  8. 8 Servicio de Urgencias, Hospital Universitario Central de Asturias, Oviedo, España
  9. 9 Centro de Salud Puerto de Sagunto I, Sagunto, Valencia, España
  10. 10 Centro de Salud La Laguna, Cádiz, España
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Revista:
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Ano de publicación: 2019

Número: 6

Páxinas: 366-374

Tipo: Artigo

DOI: 10.1016/J.SEMERG.2018.10.004 DIALNET GOOGLE SCHOLAR

Outras publicacións en: Semergen: revista española de medicina de familia

Obxectivos de Desenvolvemento Sustentable

Resumo

Objective To describe the clinical and socio-sanitary characteristics of adults older than 65 years attended in a Primary Care setting. Material and methods The PYCAF study (Prevalence and Characteristics of the Fragile Elderly) is a descriptive, cross-sectional and multicentre study, in which patients older than 65 years attended in clinical practice in Primary Care in Spain were consecutively included. Results A total of 2,461 patients (mean age 76.0 ± 6.9 years, 57.9% women) were included in the study. The coexistence of cardiovascular risk factors and comorbidities was frequent, with arterial hypertension (73.7%) being the most prevalent, followed by dyslipidaemia (58.3%), arthrosis (56.4%), obesity (34.0%), and diabetes (28.9%). Some degree of cognitive impairment was observed in 13.4% of patients. Women had higher rates of frailty (61.0% vs. 51.8%; P < .001). Just under half (47.4%) of subjects were taking more than 6 drugs, with the prescription being higher in women (44.2% vs. 49.8%; P = .047). Just under half (49.5%) of patients made more than 10 visits to Primary Care, 25.9% of patients 4 or more visits to the specialist, and 22.3% of patients were admitted to hospital in the last year. Conclusions The PYCAF study shows that elderly patients have a higher prevalence of chronic cardiovascular and non-cardiovascular diseases, which leads to high polypharmacy. The latter has consequences both on patient safety and on the direct and indirect costs of the National Health System that emanate from the care of patients over 65 years of age. Half the sample has fragility.

Referencias bibliográficas

  • S. Cinza Sanjurjo, Prieto Díaz MÁ, J.L. Llisterri Caro, V. Pallarés Carratalá, A. Barquilla García, L. Rodríguez Padial, et al., en representación de los investigadores del estudio IBERICAN Baseline characteristics and clinical management of the first 3,000 patients enrolled in the IBERICAN study (Identification of the Spanish population at cardiovascular and renal risk) Semergen., 43 (2017), pp. 493-500 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • J. Tran, R. Norton, N. Conrad, F. Rahimian, D. Canoy, M. Nazarzadeh, et al. Patterns and temporal trends of comorbidity among adult patients with incident cardiovascular disease in the UK between 2000 and 2014: A population-based cohort study Plos Med., 15 (2018), p. e1002513 CrossRefView Record in ScopusGoogle Scholar
  • J.J. Gómez-Doblas, J. Muñiz, J.J. Martin, G. Rodríguez-Roca, J.M. Lobos, P. Awamleh, et al., OFRECE study collaborators Prevalence of atrial fibrillation in Spain. OFRECE study results Rev Esp Cardiol (Engl Ed)., 67 (2014), pp. 259-269 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • J. Redón, L. Cea-Calvo, J.V. Lozano, J.C. Martí-Canales, J.L. Llisterri, J. Aznar, et al., Investigators of the PREV-ICTUS study Blood pressure and estimated risk of stroke in the elderly population of Spain: the PREV-ICTUS study Stroke., 38 (2007), pp. 1167-1173 View Record in ScopusGoogle Scholar
  • G.C. Rodríguez-Roca, J.L. Llisterri, M.A. Prieto-Diaz, F.J. Alonso-Moreno, C. Escobar-Cervantes, V. Pallares-Carratala, et al. Blood pressure control and management of very elderly patients with hypertension in primary care settings in Spain Hypertens Res., 37 (2014), pp. 166-171 CrossRefView Record in ScopusGoogle Scholar
  • A. Rodríguez-Poncelas, J. Barrot-de la-Puente, G. Coll de Tuero, C. López-Arpí, B. Vlacho, F. López-Simarro, et al. Glycaemic control and treatment of type 2 diabetes in adults aged 75 years or older Int J Clin Pract., 72 (2018), p. e13075 View Record in ScopusGoogle Scholar
  • E. Galve, A. Cordero, A. Cequier, E. Ruiz, J.R. González-Juanatey Degree of lipid control in patients with coronary heart disease and measures adopted by physicians. REPAR Study Rev Esp Cardiol., 69 (2016), pp. 931-938 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • P. Jürschik, C. Nuin, T. Botigué, M.A. Escobar, A. Lavedán, M. Viladrosa Prevalence of frailty and factors associated with frailty in the elderly population of Lleida, Spain: The FRALLE survey Arch Gerontol Geriatr., 55 (2012), pp. 625-631 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • M.P. Molés, A. Lavedán, P. Jürschik, C. Nuin, T. Botigué, L. Maciá Estudio de fragilidad en adultos mayores. Diseño metodológico Gerokomos., 27 (2016), pp. 8-12 Google Scholar
  • J. Afilalo, S. Karunananthan, M.J. Eisenberg, K.P. Alexander, H. Bergman Role of frailty in patients with cardiovascular disease Am J Cardiol., 103 (2009), pp. 1616-1621 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • J.A. Avila-Funes, C. Helmer, H. Amieva, P. Barberger-Gateau, M. Le Goff, K. Ritchie, et al. Frailty among community-dwelling elderly people in France: the three-city study J Gerontol A Biol Sci Med Sci., 63 (2008), pp. 1089-1096 CrossRefView Record in ScopusGoogle Scholar
  • A. Clegg, J. Young, S. Iliffe, M.O. Rikkert, K. Rockwood Frailty in older people Lancet., 381 (2013), pp. 752-762 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • J.E. Morley, B. Vellas, G. Abellan van Kan, S.D. Anker, J.M. Bauer, R. Bernabei, et al. Frailty consensus: A call to action J Am Med Dir Assoc., 14 (2013), pp. 392-397 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • D. Fialová, E. Topinková, G. Gambassi, H. Finne-Soveri, P.V. Jónsson, I. Carpenter, et al. Potentially inappropriate medication use among elderly home care patients in Europe JAMA., 293 (2005), pp. 1348-1358 CrossRefView Record in ScopusGoogle Scholar
  • R.B. D’Agostino, R.S. Vasan, M.J. Pencina, P.A. Wolf, M. Cobain, J.M. Massaro, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study Circulation., 117 (2008), pp. 743-753 CrossRefView Record in ScopusGoogle Scholar
  • M.E. Charlson, R.E. Charlson, J.C. Paterson, S.S. Marinopoulos, W.M. Briggs, J.P. Hollenberg The Charlson comorbidity index is adapted to predict costs of chronic disease in primary care patients J Clin Epidemiol., 61 (2008), pp. 1234-1240 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • F.J. García, G. Gutiérrez, A. Alfaro, M.S. Amor, M. de los Ángeles, M.V. Escribano The prevalence of frailty syndrome in an older population from Spain. The Toledo study for healthy aging J Nutr Health Aging., 15 (2011), pp. 852-856 CrossRefGoogle Scholar
  • Ministerio de Sanidad, Consumo y Bienestar social. Encuesta Nacional de Salud 2016-2017. Publicado el 26 de Junio de 2018 [consultado 29 Ago 2018]. Disponible en: https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm Google Scholar
  • F. Mera, D. Mestre, J. Almeda, A. Ferrer, F. Formiga, S. Rojas Farreras, Grupo de Estudio Octabaix Inappropriate prescription in the community elderly, are we aware of? Rev Esp Geriatr Gerontol., 46 (2011), pp. 125-130 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • S. Sánchez-Fidalgo, M.I. Guzmán-Ramos, M. Galván-Banqueri, M. Bernabeu-Wittel, B. Santos-Ramos Prevalence of drug interactions in elderly patients with multimorbidity in primary care Int J Clin Pharm., 39 (2017), pp. 343-353 CrossRefView Record in ScopusGoogle Scholar
  • L. Campins, M. Serra-Prat, E. Palomera, I. Bolibar, Martínez MÀ, P. Gallo Reduction of pharmaceutical expenditure by a drug appropriateness intervention in polymedicated elderly subjects in Catalonia (Spain) Gac Sanit. (2017) [En prensa] Google Scholar
  • R.O. Teh, O.H. Menzies, M.J. Connolly, R.N. Doughty, T.J. Wilkinson, A. Pillai, et al. Patterns of multi-morbidity and prediction of hospitalisation and all-cause mortality in advanced age Age Ageing., 47 (2018), pp. 261-268 View Record in ScopusGoogle Scholar
  • T. Vega Alonso, M. Miralles Espí, J.M. Mangas Reina, D. Castrillejo Pérez, A.I. Rivas Pérez, M. Gil Costa, et al. Prevalence of cognitive impairment in Spain: The Gómez de Caso study in health sentinel networks Neurología., 33 (2018), pp. 491-498 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • F. Nourhashémi, S. Andrieu, S. Gillette-Guyonnet, B. Vellas, J.L. Albarède, H. Grandjean Instrumental activities of daily living as a potential marker of frailty: a study of 7364 community-dwelling elderly women (the EPIDOS study) J Gerontol A Biol Sci Med Sci., 56 (2001), pp. M448-M453 View Record in ScopusGoogle Scholar
  • T.M. Gill, E.A. Gahbauer, L. Han, H.G. Allore Trajectories of disability in the last year of life N Engl J Med., 362 (2010), pp. 1173-1180 View Record in ScopusGoogle Scholar
  • M. Checa López Utilidad de los instrumentos de valoración de la fragilidad en medios no geriátricos [tesis doctoral] Universidad Complutense, Madrid (2017), p. 135 View Record in ScopusGoogle Scholar
Fonte de datos: Dialnet