Irene Carrillo

Use of QR and EAN-13 codes by older patients taking multiple medications for a safer use of medication.

BACKGROUND Older persons following a prolonged complex drug regimen often make mistakes when taking their medication. Currently, the widespread use of tablets and smartphones has encouraged the development of applications to support self-management of medication. OBJECTIVE The aim of this study was to design, develop and assess an app that transforms medication-associated ean-13 (barcodes) and Quick Response codes (QR) into verbal instructions, to enable safer use of medication by the elderly patients taking multiple medications. METHODS Meetings were held in which participated a total of 61 patients. RESULTS The results showed that patients appreciated the application and found it useful for safer use of medicines. CONCLUSIONS The study results support the use of such technology to increase patient safety taking multiple medications safety.

Patient Satisfaction with Pre-Hospital Emergency Services. A Qualitative Study Comparing Professionals’ and Patients’ Views

Objective: To describe patient satisfaction with pre-hospital emergency knowledge and determine if patients and professionals share a common vision on the satisfaction predictors. Methods: A qualitative study was conducted in two phases. First, a systematic review following the PRISMA protocol was carried out searching publications between January 2000 and July 2016 in Medline, Scopus, and Cochrane. Second, three focus groups involving professionals (advisers and healthcare providers) and a total of 79 semi-structured interviews involving patients were conducted to obtain information about what dimensions of care were a priority for patients. Results: Thirty-three relevant studies were identified, with a majority conducted in Europe using questionnaires. They pointed out a very high level of satisfaction of callers and patients. Delay with the assistance and the ability for resolution of the case are the elements that overlap in fostering satisfaction. The published studies reviewed with satisfaction neither the overall care process nor related the measurement of the real time in responding to an emergency. The patients and professionals concurred in their assessments about the most relevant elements for patient satisfaction, although safety was not a predictive factor for patients. Response capacity and perceived capacity for resolving the situation were crucial factors for satisfaction. Conclusions: Published studies have assessed similar dimensions of satisfaction and have shown high patient satisfaction. Expanded services resolving a wide number of issues that can concern citizens are also positively assessed. Delays and resolution capacity are crucial for satisfaction. Furthermore, despite the fact that few explanations may be given due to a lack of face-to-face attention, finding the patient’s location, taking into account the caller’s emotional needs, and maintaining phone contact until the emergency services arrive are high predictors of satisfaction.

Drivers and strategies for avoiding overuse. A cross-sectional study to explore the experience of Spanish primary care providers handling uncertainty and patients’ requests

Objectives Identify the sources of overuse from the point of view of the Spanish primary care professionals, and analyse the frequency of overuse due to pressure from patients in addition to the responses when professionals face these demands. Design A cross-sectional study. Setting Primary care in Spain. Participants A non-randomised sample of 2201 providers (general practitioners, paediatricians and nurses) was recruited during the survey. Primary and secondary outcome measures The frequency, causes and responsibility for overuse, the frequency that patients demand unnecessary tests or procedures, the profile of the most demanding patients, and arguments for dissuading the patient. Results In all, 936 general practitioners, 682 paediatricians and 286 nurses replied (response rate 18.6%). Patient requests (67%) and defensive medicine (40%) were the most cited causes of overuse. Five hundred and twenty-two (27%) received requests from their patients almost every day for unnecessary tests or procedures, and 132 (7%) recognised granting the requests. The lack of time in consultation, and information about new medical advances and treatments that patients could find on printed and digital media, contributed to the professional’s inability to adequately counter this pressure by patients. Clinical safety (49.9%) and evidence (39.4%) were the arguments that dissuaded patients from their requests the most. Cost savings was not a convincing argument (6.8%), above all for paediatricians (4.3%). General practitioners resisted more pressure from their patients (x2=88.8, P<0.001, percentage difference (PD)=17.0), while nurses admitted to carrying out more unnecessary procedures (x2=175.7, P<0.001, PD=12.3). Conclusion Satisfying the patient and patient uncertainty about what should be done and defensive medicine practices explains some of the frequent causes of overuse. Safety arguments are useful to dissuade patients from their requests.

Grado de conocimiento de la campaña Compromiso por la Calidad y de las recomendaciones no hacer entre médicos de familia, pediatras y enfermería de Atención Primaria

Fundamento . Evaluar si la iniciativa campana Compromiso por la Calidad (ICC) era suficientemente conocida entre profesionales de atencion primaria (AP), y valorar el grado de conocimiento de determinadas recomendaciones de lo que no debiera hacerse dirigidas a profesionales de AP. Material y metodos . Estudio observacional basado en un muestreo de conveniencia a profesionales de medicina de familia (MF), pediatria (PED) y enfermeria (ENF). Se formulo una pregunta directa sobre si se conocia la ICC y una serie de preguntas dicotomicas basadas en las recomendaciones No Hacer para valorar el nivel de conocimiento. Se considero necesario un tamano muestral minimo de 288 profesionales por cada colectivo, considerando un error del 5%, nivel de confianza del 95% y p=0,75. El estudio de campo se realizo con la colaboracion de diversos servicios de salud y organizaciones profesionales y cientificas. Los datos se describieron como frecuencias o media (desviacion tipica), y se compararon mediante χ 2 /Fisher o ANOVA y t-test. Resultados . Respondieron 1.904 profesionales (936 MF, 682 PED y 286 ENF). De ellos, 828 (43,5%) conocian la ICC : 524 (56,0%) MF, 234 (34,3%) PED y 70 (24,5%) ENF (p<0,001). Respondieron correctamente a todas las preguntas 652 (69,7%) MF, 631 (92,5%) PED y 116 (40,6%) ENF. Cometieron significativamente mas errores (p<0,001) quienes no conocian la ICC , trabajaban en el sector privado o no se consideraban responsables de la sobreutilizacion. Pese a no conocer la ICC , 60% MF y 90% PED contestaron correctamente a todas las preguntas del test. Conclusiones. ENF y MF podrian beneficiarse de una mayor difusion de la ICC. Tambien quienes trabajan en el sector privado y quienes creen que los profesionales tienen escasa responsabilidad en la sobreutilizacion innecesaria.