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Introduction: Studies on the prevalence of asthma and allergies often lack representation of the pediatric population, and their impact has not been examined using children without these diseases as a reference group. This study aimed to determine the prevalence of asthma and allergies in children under 14 years old in Spain and their impact on health-related quality of life, activities, healthcare utilization, and environmental and household exposure risk factors., Methods: Data came from a Spanish population-based representative survey of children aged <14 years (N=6297). A sample of controls (1:4) from the same survey was matched using propensity score matching. Logistic regression models and population-attributable fractions were calculated to determine the impact of asthma and allergy., Results: The population prevalence of asthma was 5.7% (95% CI: 5.0%, 6.4%), and of allergy was 11.4% (95% CI: 10.5%, 12.4. In children with lower percentiles of health-related quality of life (≤20th), 32.3% (95% CI, 13.6%, 47.0%) was attributed to asthma and 27.7% (95% CI: 13.0%, 40.0%) to allergy. Forty-four percent of restrictions in usual activity were attributed to asthma (OR: 2.0, p-value: <0.001), and 47.9% to allergy (OR: 2.1, p-value: <0.001). 62.3% of all hospital admissions were attributed to asthma (OR: 2.8, p-value: <0.001), and 36.8% (OR: 2.5, p-value: <0.001) of all specialist consults to allergy., Conclusions: The high prevalence of atopic disease and its impact on daily life and healthcare utilization call for an integrated healthcare system focused on children and caregivers' needs with continuity of care across education and healthcare settings., (Copyright © 2023 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)

Objectives: Cardiopulmonary resuscitation (CPR) feedback applications can facilitate learning in brief training sessions, but they have never been tested in primary care settings. We aimed to see if brief CPR training sessions that include feedback improve the skills of primary care staff., Material and Methods: Randomized trial with a control group and 2 intervention groups (G) using the feedback app and a control group: in G1, the instructor gave spoken feedback to the trainee and both could see the app; in G2, only the instructor giving feedback could see the app; and in G3, the control group, neither the instructor nor the trainee could see the app. All trainees received 10 minutes of instruction on theory followed by 6 minutes of practical instruction according to group assignment. The trainees used a high-quality CPR manikin connected to the Skillreporter feedback app (Laerdal Medical). CPR results were measured immediately before and after training and 6 months later. The main outcome measure was the overall CPR quality score. Secondary outcomes were 6 measures related to compressions and 5 related to ventilation., Results: The main outcome improved with statistical significance in the two intervention groups (G1 and G2) respect to controls (G3). Most secondary outcome measures also improved after training. Trainees in the intervention groups scored better than trainees in G3 on the compression score (G1, P = .012), mean compression depth (G1, P = .001; G2, P = .022), number of compressions with adequate depth (G1, P = .026; G2, P = .019), and number of ventilations at adequate volume (G1, P = .033). The 2 intervention groups achieved statistically similar results. At 6 months, all outcome measures remained slightly improved over baseline levels, there were no between-group differences., Conclusion: Brief retraining sessions with feedback are useful for maintaining CPR skills in primary care, but skill improvement is not long lasting.

Objective: In Catalonia, the variety of the provision of Primary Healthcare has sparked intense debates over the last 20 years regarding the efficiency of the various management models. Our study analyzed the differences in the three existing management models of primary healthcare in Catalonia (the Catalan Health Institute, public consortiums and associative base entities)., Methods: The primary data were obtained from the reports of the Results Center of The Observatory of the Health System of Catalonia. Representative indicators were selected and compared with the Kruskall-Wallis test. They were later adjusted for confounding factors., Results: There were differences in the average number of visits per population attended, the percentage of the population attended in the subgroup of population over 75 years of age, the percentage of patients over 74 years with more than twelve appointments, the rate of potentially avoidable hospitalizations (total and in the subgroup of patients with chronic obstructive pulmonary disease (COPD)), polypharmacy, the use of lipid-lowering drugs and the detection of prostate-specific antigen (PSA). When adjusting for confounding variables, the differences disappeared in all of them except for the indicator on the detection of PSA., Conclusions: The differences favoured mainly the associative base entities disappear when they are corrected for confounding variables. The legal status of each provider does not significantly influence the health outcomes.

Aim: To determine the impact of an educational program to improve the management of chronic obstructive pulmonary disease (COPD) that contributes to an increase of the quality of life, exercise capacity, level of dyspnoea, and clinical risk., Design: Intervention study without controls., Location: Primary Healthcare Centre., Participants: 193 patients with COPD were invited, 73 accepted and 55 participated in the educational program., Interventions: Respiratory rehabilitation educational program with basic concepts of pulmonary and respiratory pathophysiology, respiratory physiotherapy exercises, practical workshop on the use of the most frequent inhalation devices, understanding of chronic disease and self-care measures in case of exacerbation., Main Measurements: The quality of life (the COPD assessment test), exercise tolerance (the Six-Minute Walk Test), rating of perceived exertion (Borg Dyspnoea Score) and clinical risk (BODE index) were assessed by means of validated questionnaires in Spanish., Results: A total of 43 (78.2%) participants completed the program. An improvement in the quality of life by a mean of 3.3 points was observed (95%CI; 1.76-4.84). Just over half (53.5%) of the participants obtained a clinically relevant improvement. Participants also improved their physical exercise capacity at post-intervention by increasing the distance that they walked in 6min by a mean of 20.76m (95%CI; 2.57-38.95). Improvements in the level of dyspnoea and clinical risk were also observed., Conclusions: The educational program shows a statistically significant and clinically relevant improvement in the quality of life, fatigue, symptomatology, exercise capacity, level of dyspnoea, and clinical risk. The program is adaptable to the health care routine of healthcare centres., (Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)

Objectives: The level of health literacy is examined, as well as its conditioning factors in patients with heart failure who are seen routinely in a Primary Health Care Area., Design: A multicentre cross-sectional study., Setting: 10 Primary care centres from the metropolitan area of Barcelona., Participants: Patients diagnosed with heart failure., Inclusion Criteria: to have visited the Primary Health Care centre in the last year, being able to arrive at the primary care setting independently, and voluntarily participation., Main Measurements: Health Literacy Survey-European Union - Questionnaire (HLS-EU-Q) and Spanish version of the European Heart Failure Self-care Behaviour Scale. An analysis was made of the relationships between health literacy, self-care practices, sociodemographic, and clinical variables using ANOVA test and a multiple linear regression model., Results: The study included 318 patients (51.2% women) with a mean age of 77.9±8.7 years. The index of health literacy of 79.6% (n=253) of the participants indicated problems in understanding healthcare information. Health literacy level was explained by academic level (P<.001), the extent of heart failure (P=.032), self-care, and age (P<.04).The academic level explained 61.6% of the health of literacy (95% bootstrap: 44.58%; 46.75%)., Conclusions: In patients with stable heart failure, it is important to consider all factors that help patients to understand the healthcare information. Health literacy explains patient self-care attitude in heart failure., (Copyright © 2016 Elsevier España, S.L.U. All rights reserved.)

Background and Objective: To determine the prevalence of abdominal aortic aneurysm (AAA) and abdominal aortic atheromatosis (AA-At) using a hand-held ultrasound by a general practitioner in the public Primary Health Care system., Patients and Method: Pilot study that prospectively studied a cohort of men over 50 years with cardiovascular risk factors: active smokers, former smokers, or hypertensive patients, attended in primary health care center. The general practitioner completed an ultrasonography training in an Ultrasound Unit under supervision of experienced radiologists using an standard ultrasound equipment and hand-held ultrasound (VScan(®), General Electric, USA). One hundred and six patients participated in the study and all imaging data recorded were blindly evaluated by a radiologist in order to establish the concordance in the interpretation of images between general practitioner and radiologist. The kappa index was calculated to study the agreement on the presence or absence of AAA and AA-At., Results: We observed a prevalence of 5.88% of AAA. Kappa index for concordance in AAA diagnosis was absolute (κ = 1.0), with a sensitivity and specificity of 100%. Otherwise, the general practitioner identified 59 patients (58.4%) with AA-At, while radiologist identified 39 (38.6%) in the image review, with moderate concordance (κ = .435), sensitivity 89.74% and specificity 57.14%. Hypercholesterolemia (odds ratio [OR] 2.61; 95% confidence interval [95% CI] 0.92-7.39) and diabetes mellitus (OR 3.35; 95%CI 0.89-12.55) were independent risk factors for AA-At development in logistic regression., Conclusions: After an adequate training in ultrasonography, hand-held ultrasound is a useful tool for AAA screening in Primary Care. Its simplicity, security, validity, cost-effectiveness and acceptance by the general population, makes it a feasible tool for cardiovascular risk assessment., (Copyright © 2012 Elsevier España, S.L. All rights reserved.)

The world population is making older increasing the sanitary resources consum. It makes the elderly patients are the main occupant of hospitalary beds, who generate more mortality, longer stays and more number of readmissions. Also they are who visit more the primary health care doctor and they are the first and the most numerous drugs consumer. The result rise the medical assistance demand in the different primary health care services. The chronic diseases that older patients suffer multiply in keeping with the age, existing one significative association between many chronic diseases and the urgences admissions in the older patients. To offer the necessary service, we must improve the primary health care centers autosufficiency, the resolutive capacity and the human resources management in agreement with the needs of each moment.

Objective: Drug related problems (DRP) are health problems associated with the pharmacological treatment of patients and interfere or can interfere with the expected results on their health. The aim of this study is to determine the prevalence of DRP in patients from an urban health centre that lead to hospitalisation, and its prevention., Design: It is a retrospective, observational and descriptive study., Setting: Les Corts Health Centre (HC), which is an urban health and teaching centre with a reference population of 32,318 inhabitants., Participants: Users of the les Corts HC admitted to the Barcelona Hospital Clinic from August 2005 to January 2006. RESULTS AND MAIN OUTCOME MEASUREMENTS: A pharmacist and a family doctor analysed the clinical histories and determined whether or not there was a DRP. A DRP was present in 13.4% of all hospital discharges, and 12% were implicated in the hospital admission. It was considered that 57.3% of all the discharges with a DRP as the causing factor in the hospital admission were avoidable. Admissions due to DRP were mainly in internal medicine, cardiology and pneumology. The health problems that lead to hospital admission due to DRP are mainly circulatory (38.5%) and respiratory (11.5%)., Conclusions: The number of hospital admissions due to drug related problems is avoidably high.

Objective: To evaluate how much women who attend primary care consultations understand about the correct use of emergency ("morning after") contraception (EC), their information requirements and their views about free EC prescription., Design: Cross-sectional study, using a questionnaire., Setting: Les Corts Primary Care Centre, Barcelona, Spain., Participants: A total of 130 women aged 15 to 45 years old who attended primary care consultations in May and June, 2005, were included. One-hundred and twenty-four of them (95.4%) agreed to the questionnaire., Main Measurements: We tested knowledge of EC, and we drew up a questionnaire to evaluate understanding. This had 4 multiple-choice questions, as well as socio-demographic data, contraception background, how they preferred to obtain EC, and their information requirements., Results: We found a lack of knowledge about several aspects of EC use: in particular, 33% of the women thought that EC eliminated completely the risk of pregnancy. We only found differences for better knowledge of EC in women who had used it before (3.03; 95% CI, 2.29-3.77) versus those who had never used it (2.47; 95% CI, 1.54-3.4; P=.028. Free prescription of EC in health centres was approved of by 75.8%, while 83.1% said they needed more information. Their preferred method to obtain this information was by leaflet., Conclusions: Women who attend primary health care clinics have a need for information on EC. Their lack of knowledge could limit the effectiveness of treatment. A brief explanation and handing out a leaflet could solve this problem.