Gaps between prescription of anti-hypertensive and hypertension control in older adults of Buenos Aires suburbs
Background Medications delivered to primary care centers (PCC) all over the country through the Remediar program (RP) covers 80% of the most prevalent diseases. Among them, the prevalence of hypertension is 77% of 65 years or older . Objective To describe the pharmacological treatment and its approp...
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| Autores principales: | , , , , , , |
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2018
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/21446 |
| Aporte de: |
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I10-R10-article-21446 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
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I-10 |
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R-10 |
| container_title_str |
Revistas de la UNC |
| language |
Español |
| format |
Artículo revista |
| topic |
hypertension treatment Remediar Program hypertension complications to accessing hypertension treatment tratamiento antihipertensivo programa remediar hipertensión barreras al tratamiento antihipertensivo |
| spellingShingle |
hypertension treatment Remediar Program hypertension complications to accessing hypertension treatment tratamiento antihipertensivo programa remediar hipertensión barreras al tratamiento antihipertensivo Soriano, Enrique R. Dawidowski, Adriana R. Pereiro, Natalia Aliperti, Valeria I. Aragone, Soledad Abramovich, Isabel Figar, Silvana Berta Gaps between prescription of anti-hypertensive and hypertension control in older adults of Buenos Aires suburbs |
| topic_facet |
hypertension treatment Remediar Program hypertension complications to accessing hypertension treatment tratamiento antihipertensivo programa remediar hipertensión barreras al tratamiento antihipertensivo |
| author |
Soriano, Enrique R. Dawidowski, Adriana R. Pereiro, Natalia Aliperti, Valeria I. Aragone, Soledad Abramovich, Isabel Figar, Silvana Berta |
| author_facet |
Soriano, Enrique R. Dawidowski, Adriana R. Pereiro, Natalia Aliperti, Valeria I. Aragone, Soledad Abramovich, Isabel Figar, Silvana Berta |
| author_sort |
Soriano, Enrique R. |
| title |
Gaps between prescription of anti-hypertensive and hypertension control in older adults of Buenos Aires suburbs |
| title_short |
Gaps between prescription of anti-hypertensive and hypertension control in older adults of Buenos Aires suburbs |
| title_full |
Gaps between prescription of anti-hypertensive and hypertension control in older adults of Buenos Aires suburbs |
| title_fullStr |
Gaps between prescription of anti-hypertensive and hypertension control in older adults of Buenos Aires suburbs |
| title_full_unstemmed |
Gaps between prescription of anti-hypertensive and hypertension control in older adults of Buenos Aires suburbs |
| title_sort |
gaps between prescription of anti-hypertensive and hypertension control in older adults of buenos aires suburbs |
| description |
Background Medications delivered to primary care centers (PCC) all over the country through the Remediar program (RP) covers 80% of the most prevalent diseases. Among them, the prevalence of hypertension is 77% of 65 years or older . Objective To describe the pharmacological treatment and its appropriateness, and to understand needs and barriers among hypertensive beneficiaries of RP at Buenos Aires suburbs. Method Qualitative-quantitative triangulation: cross-sectional study with revision of medical records (MR) and in-depth interviews between December/2008 and February/2009 to hypertensive patients of 65 years or older and CAPS’s staff. Prevalence of correct treatment (CT); appropriate Indication (AI); Optimal control (OC) were analyzed Results The following PCCs were selected: Moreno, Tigre, Lomas de Zamora, Lanus and San Isidro. Prevalence of: CT: (10.2%; 95%CI 6,7-15,1); AI: (84.8%; 95% CI 80-89 ), and OC: 11,6% (95%CI 7-16) and OC among patients with good registry: 35.7% (95%CI 24,9-48,1). Eighty two % of patients received a prescription for enalapril. Deficient registry was detected in MR. Interviewees expressed difficulties in accessing treatment, lack of medication and use of alternative circuits to get them. Both, staff and patients were exposed to barriers generated by CAPSs and RP. Conclusions A low degree of blood pressure control was observed, even with adequate prescription. Multifactorial problems explain several barriers to access and maintain hypertension treatment. |
| publisher |
Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2018 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/21446 |
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I10-R10-article-214462019-05-10T12:41:14Z Gaps between prescription of anti-hypertensive and hypertension control in older adults of Buenos Aires suburbs Brechas entre la prescripción de anthipertensivos y el control de las hipertensión en adultos mayores de los caps del conurbano bonaerense Soriano, Enrique R. Dawidowski, Adriana R. Pereiro, Natalia Aliperti, Valeria I. Aragone, Soledad Abramovich, Isabel Figar, Silvana Berta hypertension treatment Remediar Program hypertension complications to accessing hypertension treatment tratamiento antihipertensivo programa remediar hipertensión barreras al tratamiento antihipertensivo Background Medications delivered to primary care centers (PCC) all over the country through the Remediar program (RP) covers 80% of the most prevalent diseases. Among them, the prevalence of hypertension is 77% of 65 years or older . Objective To describe the pharmacological treatment and its appropriateness, and to understand needs and barriers among hypertensive beneficiaries of RP at Buenos Aires suburbs. Method Qualitative-quantitative triangulation: cross-sectional study with revision of medical records (MR) and in-depth interviews between December/2008 and February/2009 to hypertensive patients of 65 years or older and CAPS’s staff. Prevalence of correct treatment (CT); appropriate Indication (AI); Optimal control (OC) were analyzed Results The following PCCs were selected: Moreno, Tigre, Lomas de Zamora, Lanus and San Isidro. Prevalence of: CT: (10.2%; 95%CI 6,7-15,1); AI: (84.8%; 95% CI 80-89 ), and OC: 11,6% (95%CI 7-16) and OC among patients with good registry: 35.7% (95%CI 24,9-48,1). Eighty two % of patients received a prescription for enalapril. Deficient registry was detected in MR. Interviewees expressed difficulties in accessing treatment, lack of medication and use of alternative circuits to get them. Both, staff and patients were exposed to barriers generated by CAPSs and RP. Conclusions A low degree of blood pressure control was observed, even with adequate prescription. Multifactorial problems explain several barriers to access and maintain hypertension treatment. Antecedentes El programa Remediar cubre el 80% de las patologías más prevalentes con medicación que se entrega en los centros de atención primaria del país (CAPS) en donde la prevalencia de hipertensión arterial es de 77% en mayores de 65 años. Objetivo Describir el tratamiento farmacológico, evaluar su adecuación y comprenderlas necesidades y barreras, en pacientes hipertensos beneficiarios del programa Remediar.Materiales y Métodos Triangulación cuali-cuantitativa: se realizó un estudio de corte transversal con revisión de Historias Clínicas(HC) y entrevistas en profundidad (entre diciembre/2008 y febrero/2009) en pacientes hipertensos mayores a 65 años y personal en CAPS del Gran Buenos Aires. Se evaluó la prevalencia de: tratamiento adecuado(TTA), Indicación Adecuada según Guías(IAG), y Control Óptimo(CO) Resultados CAPS seleccionados: Moreno, Tigre, Lomas de Zamora, Lanús y San Isidro. Se registraron las prevalencias de: TTA 10,2%(IC 95% 6,7-15,1), IAG 84,8%(IC95% 80-89), CO 11,6% (IC95%7-16) (todos los pacientes) y CO 35,71%(IC 95% 24,9-48,1) (pacientes con TA registrada en el último año). La prescripción registrada de Enalapril fue de 82%. Se identificó falta de registro en HC. En el estudio cualitativo, los entrevistados manifestaron dificultades para acceder al tratamiento, falta de medicamentos y existencia de circuitos alternativos para conseguirlos. Tanto personal como pacientes enfrentan barreras generadas por Remediar y los CAPS. Conclusiones Se observó bajo grado de control de TA, aún con prescripción adecuada; registro deficitario en las HC y dificultades para acceder y sostener el tratamiento, explicados por una problemática multifactorial. Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2018-09-28 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/21446 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 68 No. 4 (2011); 141-148 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 68 Núm. 4 (2011); 141-148 Revista da Faculdade de Ciências Médicas de Córdoba; v. 68 n. 4 (2011); 141-148 1853-0605 0014-6722 10.31053/1853.0605.v68.n4 spa https://revistas.unc.edu.ar/index.php/med/article/view/21446/21096 Derechos de autor 2018 Universidad Nacional de Córdoba |