RESUMEN

Objetivo Con el objetivo de mejorar la gestión clínica de la osteoporosis posmenopáusica, se ha realizado una intervención basada en la implantación y seguimiento de un protocolo consensuado entre la Atención Primaria y la Especializada de la Mútua de Terrassa. Métodos Estudio descriptivo y de intervención. La intervención consistió en la elaboración de un protocolo consensuado, que fue presentado en todos los centros. Los datos se han evaluado a partir de densitometrías óseas solicitadas por los médicos de familia durante 1 año. Resultados Se han solicitado un total de 1.165 densitometrías, de las cuales 689 son para diagnóstico de nuevas pacientes. Para la evaluación del protocolo se han obtenido datos de 560. 502 densitometrías realizadas (89,6%, IC95%: 87,1–92,2) cumplían con los criterios de indicación marcados por el protocolo. Del total de pacientes que recibieron tratamiento con fármacos antirresortivos (43 osteopénicas y 167 osteoporóticas), el 83,7% (IC95%: 69,3–93,2) y el 89,8% (IC95%: 85,2–94,4), respectivamente, cumplía con las recomendaciones de primera elección. El consumo de fármacos durante el año 2007 se ha reducido en 152.745 euros (−6,3%), aunque el número de pacientes tratadas ha aumentado en 565 (+4,9%) respecto al año anterior. 442 (78,9%, IC95%: 75,6–82,3) densitometrías presentaron un resultado de osteopenia u osteoporosis. Se observan diferencias estadísticamente significativas de los resultados según la edad de las pacientes y el motivo de solicitud. Conclusiones La puesta en marcha del protocolo ha permitido gestionar de forma eficiente el proceso clínico de la osteoporosis en nuestro ámbito (AU)

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Objective To improve the clinical management of postmenopausal osteroporosis, an intervention based on the implementation of a guideline agreed to between the Primary Care and Specialized departments of all centers at “Mutua of Terrassa” was carried out. Methods Descriptive and interventional study. The intervention consisted of the elaboration of a consensus guideline that was presented in all centers. Results were assessed from bone densitometry studies requested by family physicians over 1 year. Results 1.165 densitometric studies were requested, of which 689 were for the diagnosis of new patients. For the evaluation of the guidelines, details were obtained from 560. 502 studies (89,6% IC95% 87,1–92,2) complied with indication criteria established in the guideline. Of the total of patients who received bisphosphonates and other drugs affecting bone metabolism (43 osteopenic and 167 osteoporotic), 83,7% (IC95% 69,3–93,2) and 89,8% (IC95% 85,2–94,4) respectively complied with drug recommendations. Drug consumption during the year 2007 was reduced by 152.745 euros (−6,3%) although the number of patients increased in 565 (+4,9%) with respect to the previous year. 442 (78,9% IC95% 75,6–82,3) densitometries presented a result in the osteopenia or osteroporosis category. There were statistically significant differences of the results according to the patients' age and the motive for the bone densitometry request. Conclusions Implementation of the guideline allowed for the effective management of the clinical process of osteroporosis in our field (AU)

Asunto(s)

Humanos , Femenino , Persona de Mediana Edad , Atención Primaria de Salud/métodos , Osteoporosis/epidemiología , Posmenopausia/fisiología , Enfermedades Óseas Metabólicas/epidemiología , Reumatología/normas , Enfermedades Reumáticas/epidemiología , Protocolos Clínicos , Densitometría/tendencias

RESUMEN

OBJECTIVE: To improve the clinical management of postmenopausal osteroporosis, an intervention based on the implementation of a guideline agreed to between the Primary Care and Specialized departments of all centers at "Mutua of Terrassa" was carried out. METHODS: Descriptive and interventional study. The intervention consisted of the elaboration of a consensus guideline that was presented in all centers. Results were assessed from bone densitometry studies requested by family physicians over 1 year. RESULTS: 1.165 densitometric studies were requested, of which 689 were for the diagnosis of new patients. For the evaluation of the guidelines, details were obtained from 560. 502 studies (89,6% IC95% 87,1-92,2) complied with indication criteria established in the guideline. Of the total of patients who received bisphosphonates and other drugs affecting bone metabolism (43 osteopenic and 167 osteoporotic), 83,7% (IC95% 69,3-93,2) and 89,8% (IC95% 85,2-94,4) respectively complied with drug recommendations. Drug consumption during the year 2007 was reduced by 152.745 euros (-6,3%) although the number of patients increased in 565 (+4,9%) with respect to the previous year. 442 (78,9% IC95% 75,6-82,3) densitometries presented a result in the osteopenia or osteroporosis category. There were statistically significant differences of the results according to the patients' age and the motive for the bone densitometry request. CONCLUSIONS: Implementation of the guideline allowed for the effective management of the clinical process of osteroporosis in our field.