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Objetivo: Crear una escala y herramienta que nos permita medir la fragilidad del paciente crónico. Diseño: Estudio observacional sobre crónicos del área. Emplazamiento: Se ha realizado entre enero de 2011 a diciembre 2015, una población de 2.108 individuos. Los datos se recogieron de la historia clínica y aplicación expresa para el registro de los pacientes frágiles, sobre hoja estructurada de recogida de datos. Participantes: Sujetos frágiles del área Sanitaria Norte de Málaga. Intervención: Diseño y validación de una escala. Mediciones principales: Variable principal de resultado: escala de fragilidad Antequera (EPADI) constituida por seis criterios/factores valorables: edad, Pfeiffer, Barthell, Charlson, sociofamiliar y pluripatológico. Las variables de resultados en accesibilidad se utilizaron como variables de predicción. Las variables cuantitativas se describen mediante la media y desviación estándar. Las variables cualitativas las presentamos en frecuencias junto con sus porcentajes. Para obtener un modelo de predicción de la utilización de recursos la muestra se dividió en dos sub-muestras de igual tamaño. Resultados: A partir de las variables de interés por expertos, se identificaron predictores univariantes en la utilización de recursos en la muestra M_EPADI1, para construir un modelo de regresión logística multivariante que permita predecir la utilización de recursos. Para la validación de la escala se utilizó la muestra M_EPADI2. Conclusiones: Se ha podido comprobar que los criterios utilizados en nuestra escala son adecuados para definir la fragilidad, por lo tanto la escala EPADI valora perfectamente el grado de fragilidad de los usuarios crónicos en base a los recursos consumidos

Objective: To create a scale and tool that allows us to measure the fragility of the chronic patient. Design: Observational study on the area's chronicles. Location: Between January 2011 and December 2015, a population of 2108 individuals. Data were collected from the medical history and expressed application for the registration of fragile patients, on structured data collection sheet. Participants: Fragile subjects of the North Sanitary Area of Malaga. Intervention: Design and validation of a scale. Main measurements: Study variables. Main outcome variable: Antequera Fragility Scale (EPADI) consisting of five criteria / factors: age, Pfeiffer, Barthell, Charlson, sociofamiliar and pluripatological. Accessibility outcome variables were used as prediction variables. Quantitative variables are described by mean and standard deviation. The qualitative variables are presented in frequencies along with their percentages. To obtain a predictive model of resource utilization the sample was divided into two subsamples of equal size. Results: From the variables of interest by experts, univariate predictors were identified in the use of resources in the sample M_EPADI1, to construct a model of multivariate logistic regression that allows to predict the resource utilization. For the validation of the scale, the sample M_EPADI2 was used. Conclusions: It was verified that the criteria used in our scale are adequate to define the fragility, therefore the EPADI scale perfectly values the degree of fragility of chronic users based on the resources consumed. Conclusions: It has been verified that the criteria used in our scale are adequate to define the fragility, therefore the EPADI scale perfectly evaluates the degree of fragility of chronic users based on the resources consumed

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OBJECTIVE: To create a scale and tool that allows us to measure the fragility of the chronic patient. DESIGN: Observational study on the area's chronicles. LOCATION: Between January 2011 and December 2015, a population of 2108 individuals. Data were collected from the medical history and expressed application for the registration of fragile patients, on structured data collection sheet. PARTICIPANTS: Fragile subjects of the North Sanitary Area of Malaga. INTERVENTION: Design and validation of a scale. MAIN MEASUREMENTS: Study variables. MAIN OUTCOME VARIABLE: Antequera Fragility Scale (EPADI) consisting of five criteria / factors: age, Pfeiffer, Barthell, Charlson, sociofamiliar and pluripatological. Accessibility outcome variables were used as prediction variables. Quantitative variables are described by mean and standard deviation. The qualitative variables are presented in frequencies along with their percentages. To obtain a predictive model of resource utilization the sample was divided into two subsamples of equal size. RESULTS: From the variables of interest by experts, univariate predictors were identified in the use of resources in the sample M_EPADI1, to construct a model of multivariate logistic regression that allows to predict the resource utilization. For the validation of the scale, the sample M_EPADI2 was used. CONCLUSIONS: It was verified that the criteria used in our scale are adequate to define the fragility, therefore the EPADI scale perfectly values the degree of fragility of chronic users based on the resources consumed. CONCLUSIONS: It has been verified that the criteria used in our scale are adequate to define the fragility, therefore the EPADI scale perfectly evaluates the degree of fragility of chronic users based on the resources consumed.

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PURPOSE: To determine the prevalence of Ineffective Self-Health Management (ISHM) (00078) and its related factors in polymedicated patients over the age of 65 years. METHODS: A cross-sectional, descriptive design was used. A home interview was conducted with each participant (N = 375) for data collection. FINDINGS: The prevalence of ISHM was 37.3%. The risk factors associated were social risk, depression, noncompliance, medication errors, and confusion with medications. CONCLUSIONS: Among polymedicated elderly patients, the prevalence of ISHM is high. The diagnosis is closely connected to the compliance and complexity of the treatment regimen, in addition to those relating strictly to social and emotional factors. IMPLICATIONS: Nursing methodology encompasses instruments that allow nurses in clinical practice to evaluate the issue of compliance.

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METHODS AND DESIGN: Objective: To describe the relationship between medication-related factors and the health-related quality of life in patients older than 65 years who use multiple medications (polypharmacy). Design: Cross-sectional descriptive study. Setting: Primary care. Participants: Patients older than 65 years who use multiple medications (n = 375). Measurements: The main outcome measure was health-related quality of life according to the EuroQol-5D instrument. Sociodemographic, clinical and medication-related variables were recorded during home interviews. RESULTS: Mean age was 74.72 ± 5.59 years, and 65.5% of our participants were women. The global level of health-related quality of life according to the EQ-5D visual analog scale was 59.25 ± 20.92. Of the five EuroQol dimensions, anxiety/depression and pain were the most frequently reported, while mobility and self-care were the dimensions with the greatest impact on self-reported quality of life. Multivariate analysis indicated that functional independence was the factor most strongly associated (ß = 14.27 p < 0.001) with better health-related quality of life, while illiteracy (ß = -13.58 p < 0.001), depression (ß = -10.13 p < 0.001), social risk (ß = -7.23 p = 0.004) and using more than 10 medicines (ß = -4.85 p = 0.009) were strongly associated with a poorer health-related quality of life. CONCLUSIONS: Factors inherent within the patient such as functional incapacity, cognitive impairment and social and emotional problems were the main constraints to quality of life in our study population. The number of medicines taken was negatively related with quality of life.

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