Description

Atención Primaria es una revista que publica trabajos de investigación relativos al ámbito de la atención primaria de salud, y es el órgano de expresión oficial de la Sociedad Española de Medicina de Familia y Comunitaria. Desde el punto de vista conceptual, Atención Primaria asume el nuevo modelo de atención primaria de salud, orientado no sólo a la curación de la enfermedad, sino también a su prevención y a la promoción de la salud, tanto en el plano individual como en el de la familia y la comunidad. En estos nuevos aspectos que definen el modelo de atención primaria de salud es en los que se centran los trabajos de investigación que publica Atención Primaria, la primera revista de originales española creada para recoger y difundir la producción científica realizada desde los centros de atención primaria de salud, sobre cuestiones como protocolización de la asistencia, programas de prevención, seguimiento y control de pacientes crónicos, organización y gestión de la asistencia primaria y otros.

Publisher details

Elsevier

Publications in this journal

• [Towards an assesment of the instrumental abilities of the elderly validated in our environment.]

  Authors: Gabriel Coll-De-Tuero, Josep Garre-Olmo, Secundino López-Pousa

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

• [Reply to letter: Do Primary Care doctors empathise with pregnant women?]

  Authors: Dolores Sánchez Mariscal, Emilia Bailón Muñoz

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

• [Comparison between aquatic-biodanza and stretching for improving quality of life and pain in pations with fibromyalgia.]

  Authors: María Del Mar López-Rodríguez, Adelaida María Castro-Sánchez, Manuel Fernández-Martínez, Guillermo A Matarán-Peñarrocha, María Encarnación Rodríguez-Ferrer

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

  OBJECTIVE: To determine the level of improvement, as regards pain, impact on fibromyalgia and depression, achieved by patients with fibromyalgia by comparing aquatic biodanza and stretchingOBJECTIVE: To determine the level of improvement, as regards pain, impact on fibromyalgia and depression, achieved by patients with fibromyalgia by comparing aquatic biodanza and stretching exercises. DESIGN: Randomised controlled trial with two intervention groups. LOCATION: Five health centres (Almeria). PATIENTS: A total of 82 fibromyalgia patients between 18 and 65 years old, diagnosed by American College of Rheumatology criteria, were included, with 12 patients declining to take part in the study. The 70 remaining patients were randomly assigned to two groups of 35 patients each: aquatic biodanza and stretching exercises. Those who did not attend in at least 14 sessions or changed their treatment during the studio were excluded. The final sample consisted of 19 patients in aquatic biodanza group and 20 in stretching group. The limitations of the study included, the open evaluation design and a sample size reduced by defaults. MAIN MEASURES: The outcome measures were sociodemographic data, quality of life (Fibromyalgia Impact Questionnaire), pain (McGill-Melzack questionnaire; and Visual Analogue Scale), pressure algometry (Wagner FPI10 algometer) and depression (Beck Inventory). These were carried out before and after a 12-week therapy. RESULTS: The mean age of the sample was 55.41 years. The mean period from diagnosis was 13.44 years. The sample consisted mainly of housewives. There were significant differences (P<.05) between groups, in pain (P<.01), fibromyalgia impact (P<.01), and depression (P<.04) after the treatment. CONCLUSIONS: The biodanza aquatic exercises improve pain and quality of life in fibromyalgia patients.

• [Impact of the smoke-free legislation on the prevalence and referred time exposure to the environmental tobacco smoke in Zaragoza.]

  Authors: María Victoria Villaverde Royo, María Pilar Marín Izaguerri, María Nuria Requeno Jarabo, Laura Val Esco, Sonia Coronas Mateos, Rodrigo Córdoba-García

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

  OBJECTIVES: To assess the impact of the Law 42/2010, on the health measures on smoking, on the prevalence of the exposure to environmental tobacco smoke (ETS), the repercussions in frequently visitedOBJECTIVES: To assess the impact of the Law 42/2010, on the health measures on smoking, on the prevalence of the exposure to environmental tobacco smoke (ETS), the repercussions in frequently visited places, and support of the new legislation. DESIGN: A before-after evaluation by comparing two cross-sectional studies the comparison of two transverse surveys. PLACE: Primary Care, Delicias district (115,446 inhabitants) of Zaragoza city, including the Delicias Sur, Delicias Norte, Bombarda and Univérsitas basic health districts. PARTICIPANTS: A total of 387 users in 2009, and 400 in 2011 with ages between 20 and 79 years old assigned to the participating Primary Care Centres. MAIN MEASUREMENTS: Prevalences and mean exposure times, with their confidence intervals (CI). The differences were then calculated using the Chi-squared test and Analysis of Variance (ANOVA). RESULTS: The exposure prevalence to the ETS in 2011 was shown to be lower and statistically significant than that found before the implementation of the new legislative measure, falling from the 61.9% to the 40.5% (CI 95%=35.8-45.4%), with 61.5% of those polled being in favour of the new law (CI 95%=59.2-68.75), and 80.5% (79,08-86.44) mentioned still going to the same places with the same frequency. CONCLUSIONS: The impact has been favourable, decreasing the exposure by more than 20%, with this fall being more marked in the population that currently define themselves as non-smokers. There is population support for the new legislation. Finally, there has been no observed fall in the frequency of visits to the same places.

• [Criteria for between-care-level referrals of patients with vascular disease. semFYC-SEACV consensus document.]

  Authors: Sergio Bellmunt Montoya, Santiago Díaz Sánchez, Ignacio Sánchez Nevárez, Eva Fuentes Camps, Fidel Fernández Quesada, Nuria Piquer Farrés

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

  The Spanish Society of Family and Community Medicine (semFYC) and the Spanish Society of Angiology and Vascular Surgery (SEACV), through a Joint Working Group, have prepared a document on betweenThe Spanish Society of Family and Community Medicine (semFYC) and the Spanish Society of Angiology and Vascular Surgery (SEACV), through a Joint Working Group, have prepared a document on between care-level referrals of patients with the main vascular diseases; peripheral arterial disease, venous insufficiency, and diabetic foot. The responsibilities and skills required at each care level have been defined, as well as the criteria for mutual referral and how to prioritise them. The preparation of this consensus document attempt to provide an efficient tool that may ensure the continuity of health care, always respecting the specific characteristics and needs of each health care area.

• [Reflections on conflicts of interests.]

  Authors: Pedro J Subías Loren, Maria Carmen Ginés García

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

• [The crisis and medicines policy.]

  Authors: Joan-Ramon Laporte, Montserrat Bosch

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

• [Author's reply.]

  Authors: Carlos Sanchis Doménech, Isidro López Rodríguez, Francisco Javier Alonso Moreno, José Luis Llisterri Caro, Armando Nevado Loro, Vicente Palomo Sanz

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

• [Views of patients diagnosed with depression and cared for by general practitioners and psychiatrists.]

  Authors: Carlos Calderón Gómez, Ander Retolaza Balsategui, Janire Payo Gordon, Amaia Bacigalupe De La Hera, Eskarne Zallo Atxutegi, Isabel Mosquera Metcalfe

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

  OBJECTIVES: To explore the experiences of patients treated for depression either by general practitioners (GPs) or psychiatrists (Ps) with the aim of identifying improvement strategies. DESIGN:OBJECTIVES: To explore the experiences of patients treated for depression either by general practitioners (GPs) or psychiatrists (Ps) with the aim of identifying improvement strategies. DESIGN: Health services research-oriented qualitative methodology. Exploratory design. PARTICIPANTS AND CONTEXTS: A total of 31 patients diagnosed with depression receiving pharmacological treatment for at least one year, belonging to 20 Health Centres and 8 Mental Health Centres of the Basque Health Service-Osakidetza in Bizkaia, and grouped according to the type of professional (GPs/Ps) and socioeconomic level. METHOD: Information generation by means of 5 discussion groups and 2 in-depth interviews carried out in 2009 and 2010. Recording and transcription with previous confidentiality agreement and informed consent. Sociological discourse analysis. Technique triangulation and agreement among researchers. RESULTS: Patients' experiences of depression are associated with their social contexts and their previous experience outside and inside the health services. These components also appear in perceptions on quality of care, with different expectations related to GPs and Ps. Deficiencies in time and psychotherapy are mentioned in general. Collaboration between both professionals does not spontaneously emerge as a patient priority. CONCLUSIONS: Patient assessments provide dimensions of individual and contextual components in the diagnosis and treatment of depression. These dimensions should be taken into account in the identification of needs and the design of strategies shared by GPs and Psychiatrists to improve care.

• [The prescription and the Twelve Tasks of Hercules: beyond the active ingredient].

  Authors: Miguel Ángel Hernández Rodríguez, Fernando Palacio Lapuente

  Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria. 44(5):245-7.

• [Public Health injury surveillance: still an unresolved matter].

  Authors: Katherine Pérez

  Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria. 44(5):256-7.

• [Validation of Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) in a Spanish population.]

  Authors: Juan Carlos Sierra, Pablo Vallejo-Medina, Pablo Santos-Iglesias, María Lameiras Fernández

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

  OBJECTIVE: Due to the lack of psychometric studies using the Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) in Spain, its Spanish validation is proposed in the presentOBJECTIVE: Due to the lack of psychometric studies using the Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) in Spain, its Spanish validation is proposed in the present study, by analysing its reliability and validity. DESIGN: Cross-sectional descriptive study. SETTING: General population. Conducted in 20 provinces. PARTICIPANTS: The sample consisted of 3,050 participants (45.41% men and 54.59% women) and was selected using a quota convenience sampling procedure. They ranged in age from 18 to 83 years-old (M=41.51; SD=13.45). MAIN MEASUREMENTS: Spanish versions of the MGH-SFQ, Sexual Assertiveness Scale, Sexual Desire Inventory, and Index of Sexual Satisfaction. RESULTS: The MGH-SFQ showed a single dimensional structure, which explained 71.35% of variance in men and 83.56% in women. Reliability values were .90 and .93, respectively. Convergent validity was adequate as their scores were positively correlated to initiation sexual assertiveness, dyadic sexual desire, and sexual satisfaction. The MGH-SFQ identified that females showed more sexual dysfunctions than males, and detected more sexual dysfunctions as age increases. CONCLUSIONS: The Spanish validation of the MGH-SFQ is a reliable and valid self-reporting questionnaire to assess sexual dysfunctions in Spain. Its psychometric goodness of fit, together with its brevity and ease of use, make it a useful instrument to detect overall, as well as particular sexual dysfunctions.

• [Levothyroxine therapy compliance. What can we do to improve it?]

  Authors: Rosa López-Torres Hidalgo, Jose Antonio Carbajal de Lara

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

• [Recommendations against prostate cancer screening with PSA.]

  Authors: Mercè Marzo-Castillejo, María Ángeles Nuin-Villanueva, Carmen Vela-Vallespín

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

• [Efficacy of lipid lowering agents in functional foods.]

  Authors: Jaime Algorta, Jose Javier Aguirre Anda, Maria Angeles Pena Pardo, Silvia Francisco Terreros, Fernando Aros Borau

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

• [The most read Spanish medical journals in Primary Care. Reply.]

  Authors: Javier González De Dios, Angeles Flores Canoura, Josep Jiménez Villa, José Antonio Gutiérrez Fuentes

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

• [Access to diagnostic technology by Primary Care doctors].

  Authors: Jose Granell

  Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria. 44(4):199-200.

• [In Process Citation].

  Authors: Juan Ángel Bellón, Jesús López-Torres

  Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria. 44(4):185-6.

• [How to identify physical inactivity in Primary Care: Validation of the Catalan and Spanish versions of 2 short questionnaires.]

  Authors: Anna Puig Ribera, Oscar Peña Chimenis, Montserrat Romaguera Bosch, Eulàlia Duran Bellido, Antonio Heras Tebar, Mercè Solà Gonfaus, Manuel Sarmiento Cruz, Amanda Cid Cantarero

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

  OBJECTIVE: The Brief Physical Activity Assessment Tool (BPAAT) and the General Practice Physical Activity Questionnaire (GPPAQ) are valid and reliable assessment tools to identify "inactive" patientsOBJECTIVE: The Brief Physical Activity Assessment Tool (BPAAT) and the General Practice Physical Activity Questionnaire (GPPAQ) are valid and reliable assessment tools to identify "inactive" patients in primary care. No similar tools exist for the Spanish population. The study aimed to evaluate the reliability and validity of the Catalan and Spanish versions (CBPAAT-CGPPAQ; CBPAAT-EGPPAQ) of such tools. DESIGN: Validation study of the linguistic and cultural adaptation of two questionnaires into Catalan/Spanish. Setting: Centres of Primary Care. PARTICIPANTS: The load for administering the questionnaires was evaluated by 7 general practitioners and 44 patients. Construct validity and reliability was assessed in 105 patients (58 years old±20; 37% men) without any contraindication for physical activity (PA). MAIN VARIABLES: After carrying out the translation and back-translation, construct validity was assessed against the International Physical Activity Questionnaire (IPAQ short form). Reliability was assessed administering the questionnaires again within 14 to 28 days. RESULTS: The validity of the CBPAAT-EBPAAT showed a moderate percentage agreement, correctly classifying over 80% and 83% of the "inactive" cases. Reliability was also good, correctly classifying over 86% and 88% of the cases. The validity of the CGPPAQ-EGPPAQ showed a moderate percentage agreement, correctly classifying over 70% and 60% of the "inactive" cases. Reliability was good, correctly classifying over 82% and 72% of the cases. CONCLUSIONS: The CBPAAT-CGPPAQ and EBPAAT-EGPPAQ are valid instruments to identify "inactive" patients that should receive advice on PA.

• [The social and cultural dimension of prevention: Considerations on the collective and individual benefits of prevention.]

  Authors: Andreu Segura Benedicto

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

• [Smoking intervention in patients with cardiovascular diseases.]

  Authors: José Ignacio de Granda-Orive, Segismundo Solano-Reina, Carlos Andrés Jiménez-Ruiz

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

  Smoking tobacco is the main cardiovascular risk factor and has a dose-dependent response. It has been shown that an aggressive policy, not only against consumption, achieves a significant decrease inSmoking tobacco is the main cardiovascular risk factor and has a dose-dependent response. It has been shown that an aggressive policy, not only against consumption, achieves a significant decrease in cardiovascular deaths. Thus, we must provide and carry out activities to prevent or decrease the incidence of smoking (primary prevention), and to the early detection of the smoker and to reduce the prevalence (secondary prevention), and lastly to act on the effects of tobacco smoke, preventing complication and remissions (tertiary prevention). Thus, all health care levels must act in order that smokers do not develop cardiovascular disease when they quit smoking, both from Primary, as well as specialist care.

• [Stratification of the population in the Basque Country: results in the first year of implementation.]

  Authors: Juan F Orueta, Maider Mateos Del Pino, Irantzu Barrio Beraza, Roberto Nuño Solinis, Maite Cuadrado Zubizarreta, Carlos Sola Sarabia

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

  Predictive models allow populations to be stratified according to their health requirements for the following year. They offer health care organizations the opportunity to act proactively, designingPredictive models allow populations to be stratified according to their health requirements for the following year. They offer health care organizations the opportunity to act proactively, designing specific interventions adapted to the level of need of different groups of people. The "Strategy for tackling the challenge of chronic illness in the Basque Country" proposes the use of such models, integrating them with other policies. The prospective categorization of all the population assigned to Osakidetza was performed for the first time in 2010 using the Johns Hopkins Adjusted Clinical Groups predictive model (ACG-PM). For this purpose, already recorded information extracted from electronic health records of primary care and hospital discharge reports was used. This article discusses the advantages of the combined use of various sources of information, and describes the application of the stratification in three programs, targeted at chronic patients who suffer different burdens of comorbidity.

• [The most read Spanish medical journals in primary care.]

  Authors: Guillermo Burillo-Putze, Lissete Travería-Becker, Angeles López-Hernández, Ion Iriarte-Aseguinolaza

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

• [COPD as a cardiovascular risk factor.]

  Authors: Javier de Miguel Diez, Liliana Morán Caicedo, Paula Rodríguez Rodríguez, Maria Carmen Juárez Morales, Luis Puente Maestu, Luis Alvarez-Sala Walther

  Atencion primaria / Sociedad Espanola de Medicina de Familia y Comunitaria.

  Cardiovascular events are amongst the most frequent comorbidities associated with chronic pulmonary obstructe disease (COPD). It is believed that smoking is the main risk factor shared by bothCardiovascular events are amongst the most frequent comorbidities associated with chronic pulmonary obstructe disease (COPD). It is believed that smoking is the main risk factor shared by both diseases. However, there are other determining factors, such as the inflammatory system, oxidative stress, hpoxaemia, endotheleal dysfunction, and age itself, that could also be common aetio-pathogenic mechanisms. Cardiovascular disease includes a wide spectrum of diseases, including, coronary artery disease, heart failure, arrhythmias, and right ventricular function. These processes can complicate the clinical course of patients with COPD and have a clear effect on their survival. It has been shown, from a therapeutic point of view, that the combined treatment of COPD and cardiovascular diseases could lead to an improvement in the morbidity and mortality in patients with both diseases. However, given that there is still insufficient evidence, its use in patients with COPD can only be recommended when there is an indication for its use, in accordance with the current clinical practice guidelines.

• [The Catalan Primary Care Forum: a contribution to the health debate].

  Authors: F Zapater Torras

  Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria. 44(3):123-4.

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