Search

Objective: To explore the perceptions of Primary Health Care (PHC) professionals on changes in consultation modalities and their impact on PHC fundamentals during the pandemic., Design: Qualitative exploratory research conducted between October and November, 2021., Location: Four urban and one rural primary health care centers with different socioeconomic profiles in the threeterritories of the Basque Country., Participants: Forty-six professionals from different categories of the PHC team and health centre directors., Method: Purposive sampling. Five focus groups and fourin-depth interviews. Thematic analysis with the support of the Atlas.ti programme. Triangulation of results among the research team., Results: Experiences with the development of teleconsultation appear to be directly conditioned by the pandemic context in its different phases and by the PC situation. The professionals identified communication barriers, as well as potentialities of its use that require adequate training and evaluation. Risks of inequity were perceived in the use of teleconsultations that could be affecting the quality of care. Longitudinality was assessed as a facilitating factor and problems of coordination and communication through teleconsultation between care levels were identified., Conclusions: The replacement of face-to-face consultation by teleconsultation had an impact on fundamental aspects of PHC such as quality, accessibility, equity, coordination and longitudinality. Teleconsultation in PHC should always be evaluated considering the specific circumstances and contexts of its implementation., (Copyright © 2023 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Aim: To explore the perceptions and experiences of the general population regarding the impact of the implementation of teleconsultation in primary health care during the pandemic., Design: methodology with a descriptive-interpretative approach, whose fieldwork was carried out between May and November 2020., Place: Study conducted in Navarra and Euskadi. Population groups with different profiles of associated and non-associated citizenship in both Autonomous Communities. A total of 62 primary health care users have participated and 10 focus groups were carried out., Method: The focus groups followed a semi-structured script based on the variables of analysis and dimensions of interest according to the different participant profiles and objectives. The sessions were recorded and transcribed. An inductive content analysis was performed. Data triangulation was realized in order to ensure validity., Results: The perception of teleconsultation by the population has varied throughout the pandemic and has been heterogeneous. The participants consider that the non-face-to-face modality may have repercussions on the quality of care, as well as amplifying inequalities in access to primary health care., Conclusions: It is essential to carry out analyses and evaluations from a health equity perspective in order to make decisions related to the use of technology in general and teleconsultation in particular, in the post-pandemic future of primary health care., (Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To determine whether a letter-based intervention to patients taking benzodiazepines reduces their consumption., Method: A before-after study without control group performed in primary care in May 2016. 1582 patients who took a single daily dose of benzodiazepines as hypnotic for more than 3 months were sent a personalized letter from their family doctor. The letter contained information about the risks of long-term benzodiazepine consumption and the recommendation to discontinue them with a gradual drop protocol (Benzoletter). The percentage of patients who stopped or decreased the use of benzodiazepines, and the difference in the total dose dispensed (mg equivalents of diazepam dispensed in three months) between the pre- and post-intervention period (at 6 and 12 months) were evaluated., Results: Dispensing data from 1561 patients were collected (average age: 69.3 years; 74% women). Twelve months after the intervention, 22.0% (95% confidence interval [95%CI]: 19.9-24.0) discontinued benzodiazepine consumption and 18.8% (95%CI: 16.9-20.8) reduced their consumption. A statistically significant reduction was observed in the total dose dispensed (mean difference: 89mg; 95%CI: 72.2-105.7)., Conclusion: The Benzoletter is associated with a significant decrease in the consumption of hypnotics. It is a simple and feasible intervention that allows acting on large populations, and it could even be periodically repeated. Controlled studies are required to confirm its effectiveness., (Copyright © 2019 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To determine the perceptions and attitudes of the general practitioners (GP) towards consultations with great emotional component, initially called "sacred encounters", and to identify areas of improvement., Design: A qualitative methodology based on a socio-subjective approach and focused on health services research. Descriptive-interpretative study., Location: Health Centres of Alava and Biscay., Participants: Selection of 23 GP from 23 urban and rural Health Centres., Method: Intentional sampling aimed at looking for discursive diversity. Data generated in 2016 by means of 3 discussion groups and 3 individual interviews recorded and transcribed after informed consent. Presentation to the ethics committee of the Basque Country. Thematic analysis with the aid of conceptual maps and MaxQDA program. Triangulation of the results between researchers and verification by the participants., Results and Discussion: The findings were clustered into overlapping thematic areas related to the meaning of these encounters, attitudes of GP, health context, and patients. The importance of the emotions in primary care encounters and their invisibility is underlined, but the adequacy of the term "sacred" is questioned. This expression is built into the GP-patient relationship, if GP favours it and the patient also allows it, discussing the main circumstances that intervene in an essential dimension of integral care., Conclusions: The attention to the emotional dimension in the encounters has deficiencies that need to be corrected. In addition to its recognition and evaluation, it would be necessary to modify the organisational, training and professional factors that determine the involvement of the GPs in their good health care., (Copyright © 2019 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)