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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Poor control of asthma treated in outpatient settings has been demonstrated&#46; The aim of this study was to perform a short intervention&#44; readily replicable in everyday practice&#44; to try to improve control of asthma symptoms&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Two primary health care clinics made appointments with asthma patients to administer a questionnaire and adapt their treatment to the guidelines of the Global Initiative for Asthma&#46; Patients also received an explanation of the disease lasting not more than 5 minutes&#46; The protocol was repeated at a second visit 4 months later&#46; Health care parameters were compared with those from the previous visit&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The characteristics of the 180 patients were as follows&#58; 70&#37; were women&#44; 17&#37; were smokers&#44; 8&#37; were illiterate&#44; 46&#37; had only primary education&#44; 45&#37; were in contact with cleaning products&#44; and 63&#37; had extrinsic asthma&#46; The asthma severity was as follows&#58; mild in 73&#37;&#44; moderate in 23&#37;&#44; and severe in 4&#37;&#46; Twenty-two percent had received previous explanations of the disease&#44; 50&#37; had a written treatment plan&#44; 14&#37; had a plan for exacerbations&#44; and 54&#37; were taking inhaled corticosteroids&#46; The second appointment was kept by 110 &#40;61&#37;&#41; of the patients&#44; who showed differences with respect to the previous visit 4 months earlier in the percentage taking inhaled corticosteroids &#40;78&#37;&#44; <span class="elsevierStyleItalic">P</span>&#60;&#46;001&#41;&#44; the number of visits to the physician &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;01&#41;&#44; visits to the physician due to exacerbations &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;001&#41;&#44; emergency visits to the outpatient clinic &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;002&#41;&#44; and disease severity &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;02&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">This minimal clinical intervention reduced the need for visits to health care centers and improved the clinical control of the disease&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Los pacientes asm&#225;ticos en r&#233;gimen ambulato-rio muestran un deficiente control de su enfermedad&#46; El objetivo de este estudio ha sido realizar una intervenci&#243;n cor-ta&#44; y factible de repetir en la pr&#225;ctica&#44; con el fin de intentar mejorar dicho control&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se cit&#243; a los pacientes asm&#225;ticos de 2 centros de asistencia primaria para encuestarles&#44; adaptar el tratamiento seg&#250;n las recomendaciones de la GINA &#40;Global Initiative for Asthma&#41; y explicarles en 5 min en qu&#233; consista la enfermedad&#46; A los 4 meses se realiz&#243; una segunda visita repitiendo el protocolo&#46; Se compararon los par&#225;me-tros asistenciales de los 4 meses anteriores a cada visita&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">De las caracter&#237;sticas cl&#237;nicas de los 180 pacientes destaca que un 70&#37; eran mujeres&#44; un 17&#37; fumaba&#44; un 8&#37; eran analfabetos&#44; un 46&#37; &#250;nicamente ten&#237;a estudios primarios&#44; un 45&#37; estaba en contacto con productos de lim-pieza y en un 63&#37; el asma era extr&#237;nseca&#46; Por lo que se re-fiere a la gravedad del asma&#44; en un 73&#37; &#233;sta era leve&#44; en un 23&#37;&#44; moderada y en un 4&#37;&#44; grave&#46; Un 22&#37; hab&#237;a recibido explicaciones sobre su enfermedad&#44; un 50&#37; ten&#237;a el tratamiento por escrito&#44; un 14&#37; ten&#237;a un plan para las exacerba-ciones y el 54&#37; recib&#237;a corticoides inhalados&#46; Los 110 &#40;61&#37;&#41; que acudieron a la segunda visita mostraron diferencias&#44; en los 4 meses previos a cada visita&#44; en el tratamiento con corticoi-des inhalados &#40;78&#37;&#44; p &#60; 0&#44;001&#41; en el n&#250;mero de visitas a su m&#233;dico &#40;p &#60; 0&#44;01&#41;&#44; en las visitas por agudizaci&#243;n a su m&#233;dico &#40;p &#60; 0&#44;001&#41; y a urgencias en su ambulatorio &#40;p &#60; 0&#44;002&#41;&#44; y tambi&#233;n en el estadio de la enfermedad &#40;p &#60; 0&#44;02&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Esta actuaci&#243;n cl&#237;nica m&#237;nima ha reduci-do la frecuentaci&#243;n a los centros asistenciales y ha mejorado el grado de control cl&#237;nico de los pacientes&#46;</p>"
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Vol. 43. Issue 1.
Pages 29-35 (January 2007)
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Vol. 43. Issue 1.
Pages 29-35 (January 2007)
Original Articles
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Monitoring of Asthma Outpatients After Adapting Treatment to Meet International Guidelines
Visits
3793
Ferran Morella,
Corresponding author
fmorell@vhebron.net

Correspondence: Dr. F. Morell. Servei de Pneumologia. Hospital Universitari Vall d'Hebron. Pg. Vall d'Hebron, 119-129. 08035 Barcelona. España
, Teresa Genovera, Leonardo Reyesb, Esther Benaqueb, Àlex Rogera, Jaume Ferrera
a Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Centre d'Assistència Primària San Rafael (SAP Muntanya), Barcelona, Spain
b Centre d'Assistència Primària Rio de Janeiro, Barcelona, Spain
This item has received
Article information
Objective

Poor control of asthma treated in outpatient settings has been demonstrated. The aim of this study was to perform a short intervention, readily replicable in everyday practice, to try to improve control of asthma symptoms.

Patients and methods

Two primary health care clinics made appointments with asthma patients to administer a questionnaire and adapt their treatment to the guidelines of the Global Initiative for Asthma. Patients also received an explanation of the disease lasting not more than 5 minutes. The protocol was repeated at a second visit 4 months later. Health care parameters were compared with those from the previous visit.

Results

The characteristics of the 180 patients were as follows: 70% were women, 17% were smokers, 8% were illiterate, 46% had only primary education, 45% were in contact with cleaning products, and 63% had extrinsic asthma. The asthma severity was as follows: mild in 73%, moderate in 23%, and severe in 4%. Twenty-two percent had received previous explanations of the disease, 50% had a written treatment plan, 14% had a plan for exacerbations, and 54% were taking inhaled corticosteroids. The second appointment was kept by 110 (61%) of the patients, who showed differences with respect to the previous visit 4 months earlier in the percentage taking inhaled corticosteroids (78%, P<.001), the number of visits to the physician (P<.01), visits to the physician due to exacerbations (P<.001), emergency visits to the outpatient clinic (P<.002), and disease severity (P<.02).

Conclusions

This minimal clinical intervention reduced the need for visits to health care centers and improved the clinical control of the disease.

Key words:
Asthma
Education
Adherence
Objetivo

Los pacientes asmáticos en régimen ambulato-rio muestran un deficiente control de su enfermedad. El objetivo de este estudio ha sido realizar una intervención cor-ta, y factible de repetir en la práctica, con el fin de intentar mejorar dicho control.

Pacientes y métodos

Se citó a los pacientes asmáticos de 2 centros de asistencia primaria para encuestarles, adaptar el tratamiento según las recomendaciones de la GINA (Global Initiative for Asthma) y explicarles en 5 min en qué consista la enfermedad. A los 4 meses se realizó una segunda visita repitiendo el protocolo. Se compararon los paráme-tros asistenciales de los 4 meses anteriores a cada visita.

Resultados

De las características clínicas de los 180 pacientes destaca que un 70% eran mujeres, un 17% fumaba, un 8% eran analfabetos, un 46% únicamente tenía estudios primarios, un 45% estaba en contacto con productos de lim-pieza y en un 63% el asma era extrínseca. Por lo que se re-fiere a la gravedad del asma, en un 73% ésta era leve, en un 23%, moderada y en un 4%, grave. Un 22% había recibido explicaciones sobre su enfermedad, un 50% tenía el tratamiento por escrito, un 14% tenía un plan para las exacerba-ciones y el 54% recibía corticoides inhalados. Los 110 (61%) que acudieron a la segunda visita mostraron diferencias, en los 4 meses previos a cada visita, en el tratamiento con corticoi-des inhalados (78%, p < 0,001) en el número de visitas a su médico (p < 0,01), en las visitas por agudización a su médico (p < 0,001) y a urgencias en su ambulatorio (p < 0,002), y también en el estadio de la enfermedad (p < 0,02).

Conclusiones

Esta actuación clínica mínima ha reduci-do la frecuentación a los centros asistenciales y ha mejorado el grado de control clínico de los pacientes.

Palabras clave:
Asma
Educación
Adherencia
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This study received partial funding from RedRespira-ISCiii-RTIC-03/11 and a grant from the Fundació Catalana de Pneumologia (FUCAP-Astra).

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