RESUMO
Introducción: La atención a pacientes nefrogeriátricos requiere de nuevas acciones que propicien mejores resultados de forma armónica e integrada. Objetivo: Caracterizar el estado actual del desempeño profesional del médico de familia en nefrogeriatría en la Atención Primaria de Salud. Métodos: Estudio observacional, descriptivo y transversal, desde mayo de 2014 a mayo de 2015, dirigido a 39 médicos de familia del área 5 de septiembre. Se emplearon métodos teóricos, empíricos y estadísticos para evaluar el desempeño profesional del médico de familia en nefrogeriatría. Se tuvo en cuenta el consentimiento informado. Resultados: Se identificó el estado actual de la variable estudiada, con la identificación de problemas relacionados con la dimensión cognitiva, asistencial, educativa e investigativa en la atención al paciente nefrogeriátrico en la Atención Primaria de Salud. Conclusiones: El desempeño profesional del médico de familia en nefrogeriatría carece de integración en la atención integral a los pacientes, la familia y la comunidad(AU)
Introduction: The care for nephrogeriatric patients requires new actions with better outcomes in a harmonic and integrated way. Objective: To characterize the current state of professional performance of family physicians in nephrogeriatrics in primary healthcare. Methods: Observational, descriptive and cross-sectional study carried out from May 2014 to May 2015, targeted at 39 family physicians belonging to 5 de Septiembre health area. Theoretical, empirical and statistical methods were used to evaluate the professional performance of the family physician in nephrogeriatrics. Informed consent was taken into account. Results: The current state of the studied variable was identified, with the identification of problems related to the cognitive, assistance, educational and investigative dimensions in the care of nephrogeriatric patients in primary healthcare. Conclusions: The professional performance of the family physician in nephrogeriatrics lacks integration regarding the comprehensive care of patients, family and the community(AU)
Assuntos
Humanos , Masculino , Feminino , Médicos de Família , Prática Profissional , Desempenho Profissional , Epidemiologia Descritiva , Estudos Transversais , Estudo ObservacionalRESUMO
La prescripción social permite al médico de familia orientar, indicar, prescribir al paciente servicios y ayudas no médicas disponibles en la comunidad, que podrían proporcionarles bienestar y remediar problemas que tradicionalmente se van de la típica solución ofrecida por el profesional de la atención primaria. La prescripción social está relacionada con la prescripción de activos de salud, estilos de vida, intersectorialidad y determinantes sociales de la salud en la localidad que trabaja el médico de familia, y puede ser un componente de un nuevo modelo de salud en la atención primaria. En este trabajo se ofrecen ejemplos de servicios de prescripción social y se sugiere ampliar la lista con facilitadores/pacientes/usuarios en la comunidad(AU)
Social prescription allows the family physician to guide, indicate, prescribe the patient services and non-medical aids available in the community, which could provide welfare and solve problems that traditionally go away from the typical solution offered by the primary care professional. Social prescription is related to the prescription of health assets, lifestyles, intersectoriality and social determinants of health in the community where the family physicians works and can be a component of a new health model in primary care. This paper offers examples of social prescription services, while it is suggested to expand the list with facilitators, patients and users in the community(AU)
Assuntos
Humanos , Masculino , Feminino , Médicos de Família , Atenção Primária à Saúde , Prescrições , Promoção da SaúdeRESUMO
BACKGROUND: The Brazilian undergraduate medical course is six years long. As in other countries, a medical residency is not obligatory to practice as a doctor. In this context, this paper aims to clarify what and when competencies in communication and professionalism should be addressed, shedding light on the role of university, residency and post-residency programmes. METHODS: Brazilian family physicians with diverse levels of medical training answered a questionnaire designed to seek a consensus on the competencies that should be taught (key competencies) and when students should achieve them during their medical training. The data were analysed using descriptive statistics and correlation tests. RESULTS: A total of seventy-four physicians participated; nearly all participants suggested that the students should achieve communication and professionalism competencies during undergraduate study (twenty out of thirty competencies - 66.7%) or during residency (seven out of thirty competencies - 23.33%). When competencies were analysed in domains, the results were that clinical communication skills and professionalism competencies should be achieved during undergraduate medical education, and interpersonal communication and leadership skills should be reached during postgraduate study. CONCLUSION: The authors propose that attainment of clinical communication skills and professionalism competencies should be required for undergraduate students. The foundation for Leadership and Interpersonal Abilities should be particularly formed at an undergraduate level and, furthermore, mastered by immersion in the future workplace and medical responsibilities in residency.
Assuntos
Comunicação , Educação de Graduação em Medicina , Médicos de Família/psicologia , Profissionalismo/educação , Adulto , Brasil , Competência Clínica , Feminino , Guias como Assunto , Humanos , Internato e Residência , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Introdução: O cirurgião-dentista é o profissional mais capacitado para trabalhar assuntos relativos à situação de saúde bucal. No entanto, algumas equipes de ESF ainda não possuem o profissional cirurgião-dentista presente. Muitas vezes, o profissional médico passa a ser o principal contato da equipe de saúde com a população. Assim, observa-se a necessidade do mesmo ter o conhecimento de práticas preventivas em relação à saúde bucal. Objetivos: Verificar o conhecimento em saúde bucal da criança dos médicos de família. Material e Métodos: Foi realizada uma entrevista semiestruturada com oito Médicos de Família do Serviço de Saúde Comunitária (SSC) do Grupo Hospitalar Conceição (GHC) Resultados: Apenas 37,5% da amostra citaram que a dentição decídua deveria estar completa abaixo de 4 anos. Quanto à transmissibilidade da doença cárie, 50% dos médicos consideraram que esta não é transmissível de uma pessoa para outra. Todos os médicos entrevistados consideraram que o fator bacteriano não é o único capaz de desencadear o processo carioso, necessitando de outras variáveis associadas. O período mais recomendado pelos médicos para a 1ª consulta odontológica da criança seria quando da erupção dos primeiros dentes (37,50%). Em relação à utilização de mamadeiras, 50% dos entrevistados orientam a higienização bucal após a mamada e 62,50% orientam mínima ou não utilização de açúcar nas mamadeiras. Conclusão: Diante do número reduzido de dentistas em atenção primária no Brasil, e das necessidades odontológicas apresentadas pela população, vê-se a necessidade de capacitação de profissionais médicos para atuação direcionada à prevenção em saúde bucal.
Introduction: The dentist is the most skilled professional for work on matters relating to oral health. However, some FHS (Family Health Strategy) teams still do not include a professional dental surgeon. Often, the medical professional will be the main health team contact with the population. Thus, it is the necessary that this professional has an understanding of preventive practices in relation to oral health. Objectives: verify the knowledge of family physicians regarding children's oral health. Material and Methods: a semistructured interview was conducted with eight family physicians from the Community Health Service (CHS) of the Grupo Hospitalar Conceição (GHC). Results: Only 37.5% of the sample stated that complete deciduous dentition should occur by 4 years of age. As to the transmissibility of the caries disease, 50% of the doctors felt that this is not transferable from one person to another. All the doctors interviewed considered that the bacterial factor is not solely capable of triggering the caries process, requiring other associated variables. Most doctors recommended that the first dental appointment of the child would be when the first tooth erupted (37.5%). In relation to the use of baby bottles, 50% of respondents recommended oral hygiene after feeding and 62.5% recommended little or no use of sugar in baby bottles. Conclusion: Considering the limited number of dentists participating in primary health care in Brazil, and the dental requirements of the population, there is a need to train medical professionals to act in preventative measures in oral health.
Assuntos
Saúde Bucal , Prevenção Primária , Saúde da Criança , Serviços de SaúdeRESUMO
BACKGROUND: Quaternary Prevention is defined as the action taken to identify patients at risk of overtreatment, to protect them from additional medical treatments, and to suggest interventions that are ethically acceptable. Many countries and organizations have joined in the efforts to practice quaternary prevention. These countries started a campaign called Choosing Wisely that implements recommendations in order to avoid harming patients. OBJECTIVE: To determine the attitudes, perceptions and awareness towards Quaternary Prevention and the practice of Choosing Wisely Canada Recommendations among family doctors working in the Social Security System in Peru. METHODS: A questionnaire was developed after reviewing the literature and contacting experts in the field and was sent by email to all 64 family physicians in the Social Security System (Essalud) in Lima Peru. Responses were received from 40 participants. RESULTS: The response rate was 64%. Approximately 95% reported that they understand the concept of quaternary prevention. Agreement with all the recommendations was 90% or higher. In most of the recommendations the applicability was more than 80%. The most important barriers perceived for the practice of Quaternary Prevention were patients expectations (33%). CONCLUSIONS: There are positive perceptions towards Quaternary Preventions and Choosing Wisely recommendations in the family doctors of social security in Lima Peru.
INTRODUCCIÓN: La prevención cuaternaria se define como la acción llevada a cabo para identificar pacientes en riesgo de sobretratamiento, a fin de protegerlos de una nueva intervención médica y para recomendar intervenciones que son éticamente aceptables. Muchos países y organizaciones han unido esfuerzos para la práctica de la prevención cuaternaria. Estos países iniciaron una campaña llamada Choosing Wisely, que implementa recomendaciones para evitar hacer daño a los pacientes. OBJETIVO: Determinar las actitudes, percepciones y preocupaciones hacia la prevención cuaternaria y la práctica de las recomendaciones Choosing Wisely Canadá entre médicos de familia que trabajan en el Seguro Social del Perú. MÉTODOS: Se desarrolló un cuestionario después de revisar la literatura y consultar expertos en el tema. Éste fue enviado por correo electrónico a todos los médicos de familia (64) del Seguro Social del Perú (EsSalud) en Lima, Perú. Se recibieron respuestas de 40 participantes. RESULTADOS: La tasa de respuesta fue del 64%. Aproximadamente, 95% reportó que comprende el concepto de prevención cuaternaria. La concordancia con las recomendaciones fue del 90% o superior. En la mayoría de las recomendaciones, la aplicabilidad fue mayor del 80%. La barrera percibida como más importante para la práctica de prevención cuaternaria fue la expectativa de los pacientes (33%). CONCLUSIONES: Existen percepciones positivas hacia la prevención cuaternaria y las recomendaciones Choosing Wisely entre los médicos de familia de la Seguridad Social del Perú.
Assuntos
Atitude do Pessoal de Saúde , Médicos de Família/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Previdência Social , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Percepção , Peru , Inquéritos e QuestionáriosRESUMO
Introducción: El síndrome de disfunción temporomandibular tiene alta incidencia a nivel mundial. Estudios epidemiológicos en relación con su prevalencia indican que más del 50 % de la población ha padecido esta entidad. A la consulta del Servicio de Máximo-Facial del Hospital Docente Territorial “Dr. Mario Muñoz”, de Colón, provincia de Matanzas, acuden pacientes con síntomas y signos relacionados con esta enfermedad. Objetivo: determinar el conocimiento teórico en los médicos de la familia sobre el síndrome de disfunción de la articulación temporomandibular. Materiales y métodos: el universo estuvo constituido por 171 médicos de la familia de los tres policlínicos comunitarios del municipio de Colón, y la muestra la conformaron 35 médicos. Se realizó en el período comprendido de septiembre a noviembre de 2012. El programa contó con tres fases de ejecución: inicial, de intervención y final. Resultados: el nivel de capacitación del personal médico se elevó a un 95,4 %.
Background: The temporomandibular dysfunction syndrome has high incidence around the world. Epidemiologic studies related with its prevalence show that more than 50 % of the population has suffered this entity. Patients with symptoms and signs related with this disease assist the consultation of the Maxilla-Facial Service of the Teaching Territorial Hospital “Dr. Mario Muñoz” of Colon, province of Matanzas. Aim: To determine family physicians theoretical knowledge on the temporomandibular joint dysfunction syndrome. Materials and methods: the universe was formed by 171 family physicians form the three community polyclinics of the municipality of Colon, and the sample were 35 physicians. The study was carried out in the period from September to November 2012. The program had three phases: initial, interventional and final. Outcomes: The medical staff training level reached 95,4 %.
RESUMO
Se realizó la descripción de una intervención integral dirigida a médicos de familias y grupos básicos de trabajo, en consulta externa, a la comunidad y a los hipertensos del Policlínico Héroes del Moncada, del 1 de enero al 31 de diciembre de 2013. Se consignaron los temas que se impartirán a los médicos de familia y a los grupos básicos de trabajo, según la guía del Programa de Hipertensión Arterial. Se señalaron los acápites que deben ser llenados en la historia clínica y las acciones a desarrollar por el médico de familia en la consulta externa del hipertenso. Se expresaron las actividades y el procedimiento de intervención en la comunidad, así como la metodología y el programa para llevar a cabo en las escuelas de hipertensos.
We described an integral intervention directed to family physicians and basic work groups in external consultation, to the community and hypertensive patients of the Policlinic Heroes del Moncada, carried out from January 1st to December 31st 2013. The themes taught to family physicians and basic work groups were identified taking into account the Arterial Hypertension Program guidelines. We indicated the items of the clinical record that should be filled out and the actions the family physician should develop in the hypertensive patient external consultation. We explained the activities and the intervention procedure in the community, and also the methodology and program to develop in the hypertensive patients schools.
Assuntos
Humanos , Masculino , Feminino , Educação de Pacientes como Assunto , Educação em Saúde , Hipertensão/prevenção & controle , Médicos de Família/educaçãoRESUMO
Se describen las ideas conceptuales de la especialidad de Medicina General Integral y el médico de la familia a través de la realización de una investigación histórica desde enero del año 1959 hasta septiembre del año 2009 utilizando el submétodo cronológico y el análisis de contenido de tipo descriptivo de un universo de 180 intervenciones del Comandante en Jefe Fidel Castro Ruz. Se concluye que Cuba enfrentó una campaña para dejarnos sin médicos que fue vencida por la formación de miles de médicos cubanos con una ética revolucionaria y la formación de médicos para el mundo. Las funciones del médico incluyen la función social, la función internacionalista. El médico de la familia se constituyó en un guardián de la salud del pueblo. El especialista en Medicina General Integral es el médico que se puede necesitar en cualquier lugar. Constituye un aporte de Cuba a la salud en el mundo
The conceptual ideas about the general integral medicine specialty and the family physician were described in a historical research conducted from January 1959 through September 2009, in which the chronological sub-method and the descriptive-type content analysis of a universe of 180 Commander-in-chief Fidel Castro Ruz's speeches were used. It was concluded that Cuba faced a negative campaign to strip the country of physicians, which was overcome thanks to the formation of thousands of Cuban physicians under revolutionary ethics and the formation of physicians for the rest of the world. The functions of the physician cover the social function and the internationalist function. The family physician became the guardian of the people´s health. The general integral medicine specialist is a doctor that is required everywhere; therefore, this is a Cuban contribution to the health care worldwide
Assuntos
Humanos , Cuba , Medicina Geral/história , Médicos de Família/históriaRESUMO
Metformina es una biguanida eficaz en el control metabólico de la diabetes mellitus tipo II, no insulinodependiente cuando el control dietético falla. Dada su probada eficacia y actual accesibilidad en el mercado de medicamentos en Cuba, para ser utilizada a nivel primario de atención no solo en pacientes sintomáticos sino en la población en riesgo, se presenta este artículo cuyo propósito es actualizar a los especialistas de Medicina General Integral y Medicina Interna acerca de aspectos de interés relacionados con este medicamento, como: interacciones medicamentosas, enfermedades concomitantes, la biotransformación de la droga y los posibles efectos adversos que se pueden asociar a su uso. Se presentan consideraciones finales acerca del uso de esta droga(AU)
Metformin is an effective biguanide for the metabolic control of non-insulin dependent type 2 diabetes mellitus when the dietary control fails. Given its proven efficacy and present accessibility in the pharmaceutical market in Cuba -to be used at primary health care not only in symptomatic patients but in the population at risk-this article was presented to update the knowledge of the Family Medicine and Internal Medicine specialists about interesting aspects related to this drug, i.e, drug interactions, concomitant diseases, drug biotransformation and the possible adverse effects associated to its use. Final remarks on the use of this drug were stated(AU)
Assuntos
Humanos , Metformina/uso terapêutico , Metformina/efeitos adversos , Metformina , Diabetes Mellitus Tipo 2/tratamento farmacológico , Atenção Primária à SaúdeRESUMO
Metformina es una biguanida eficaz en el control metabólico de la diabetes mellitus tipo II, no insulinodependiente cuando el control dietético falla. Dada su probada eficacia y actual accesibilidad en el mercado de medicamentos en Cuba, para ser utilizada a nivel primario de atención no solo en pacientes sintomáticos sino en la población en riesgo, se presenta este artículo cuyo propósito es actualizar a los especialistas de Medicina General Integral y Medicina Interna acerca de aspectos de interés relacionados con este medicamento, como: interacciones medicamentosas, enfermedades concomitantes, la biotransformación de la droga y los posibles efectos adversos que se pueden asociar a su uso. Se presentan consideraciones finales acerca del uso de esta droga
Metformin is an effective biguanide for the metabolic control of non-insulin dependent type 2 diabetes mellitus when the dietary control fails. Given its proven efficacy and present accessibility in the pharmaceutical market in Cuba -to be used at primary health care not only in symptomatic patients but in the population at risk-this article was presented to update the knowledge of the Family Medicine and Internal Medicine specialists about interesting aspects related to this drug, i.e, drug interactions, concomitant diseases, drug biotransformation and the possible adverse effects associated to its use. Final remarks on the use of this drug were stated
Assuntos
Humanos , Atenção Primária à Saúde , /tratamento farmacológico , Metformina , Metformina/efeitos adversos , Metformina/uso terapêuticoRESUMO
O Brasil vem implantando o Programa de Saúde da Família, em sua atenção básica à saúde. A composição das equipes do programa tem sido questionada como insuficiente, sendo uma das críticas a ausência do pediatra. Este trabalho analisou parte da experiência do município de Campinas (SP), que implantou o programa com adaptações, entre as quais a existência de pediatra em suas 140 equipes. Utilizando metodologia qualitativa e entrevistas semi-estruturadas, foram entrevistados pediatras e médicos de família de dez equipes, indicadas pelos gestores como as de melhores resultados. O objetivo foi conhecer a visão dos mesmos sobre a atenção à saúde da criança por eles praticada, o papel de cada um e a existência do pediatra no programa. Há uma quase unanimidade de defesa da importância do pediatra na atenção básica por aumentar a resolubilidade da equipe. Porém, são apontadas críticas à sua atuação, muito focada no referencial biomédico e no consultório médico, havendo necessidade de maior envolvimento com o trabalho em equipe, os aspectos psicossociais, a família e o território. É essencial uma melhor capacitação do médico de família e do pediatra frente à complexidade da missão da atenção básica atual.
Brazil is developing a Family Health Program in the Primary Health Care. The Family Health Program's team composition has been criticized as insufficient. One of the criticisms has been about the absence of the pediatrician. This study analyzed the experience of the city of Campinas, São Paulo State, which implemented this program with adaptations specifically with the presence of the pediatrician in its 140 teams. Using qualitative methodology and semi-structured interviews, pediatricians and ten family physicians teams were interviewed. The objective was to know their visions about their practice with children's primary health care, the role of each one and about the pediatrician's presence in the team. It was almost an unanimity about the importance of the pediatrician's participation in Primary Health Care, not as a specialty, but because of the improvement of the team's resolubility. Though, the pediatrician's work was considered too focused in the biomedical paradigm and in the office. There is a need for the pediatrician to have more engagement with the psychosocial aspects, the family and territory. It is essential the improvement of the training of pediatricians and family physicians to deal with the complex mission of the primary health care of nowadays.
Assuntos
Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde da Família , Medicina de Família e Comunidade , Pediatria , Papel do Médico , Brasil , Programas Governamentais , População UrbanaRESUMO
La educación ambiental tiene particular importancia en el caso de la formación de médicos dadas las estrechas relaciones entre el deterioro del medio ambiente y las afectaciones de la salud, además por el papel educativo que deben ejercer estos profesionales en la comunidad. El presente trabajo evalúa el grado de conocimientos sobre la Dimensión Ambiental que poseen estudiantes de Medicina, profesores y médicos de familia. Para ello se procedió a aplicar a estos sujetos una encuesta que exploró la información relativa a conceptos, factores y problemas vinculados con el medio ambiente. Pudo evidenciarse un dominio parcial de la problemática ambiental lo que justificaría introducir, con un enfoque sistémico y multidisciplinario la dimensión ambiental en los planes de estudio de estos profesionales a fin de garantizar su adecuada formación en tan importante tema
The environmental education has a peculiar significance in the case of physicians training due to the close relationships between the environment deterioration and the health affections, as well as by the educational role exerted by these health professionals in the community. Present paper to assess the knowledge degree on Environmental Dimension of Medicine students, professor and family physicians. Thus, we applied in these subjects a survey exploring the information related to concepts, factors and problems linked with the environment. It was obvious a partial domain of environmental problem justifying the introduction, with a systemic and multidisciplinary approach, the environmental dimension in study plans for these professionals to guarantee its appropriate training in so important topic
Assuntos
Educação em Saúde Ambiental/métodos , Educação Médica/tendências , Conhecimentos, Atitudes e Prática em Saúde , Ecologia Humana , Médicos de Família/educaçãoRESUMO
La gingivoestomatitis herpética es una enfermedad infectocontagiosa. Aparece con mayor frecuencia en lactantes y niños menores de seis años pero también puede verse en adolescentes y adultos. Objetivo: elevar el nivel de información sobre la gingivoestomatitis herpética a través del diseño y aplicación del programa Salud para los niños. Método: se realizó una investigación de intervención cuasi experimental en el sistema y servicios de salud mediante un diseño pre y post prueba. Estuvo dirigida a los médicos de familia del policlínico José Martí y el área de salud de la clínica estomatológica Mártires de Pino Tres de Camagüey, en el período de enero a diciembre del 2007. La investigación se organizó en cinco etapas. Se confeccionó una encuesta con su respectiva escala valorativa, la que fue aplicada al inicio y final del estudio. Resultados: se diseñó el programa educativo Salud para los niños y se aplicó a los médicos de la familia. Al finalizar se realizó una evaluación a través de la encuesta. Conclusiones: el nivel de información sobre gingivoestomatitis herpética fue evaluado de regular antes de la intervención educativa, luego de aplicado el programa la totalidad de los médicos poseían un nivel de información bueno. El programa Salud para los niños generó una aceptación muy positiva, al integrar el trabajo del estomatólogo y el médico de la familia.
The herpetic gingivostomatitis is an infective-contagious disease. It appears with more frequency in infants and in children under the age of six years but also in adolescents and adults. Objective: to elevate the level of information on the herpetic gingivostomatitis through the design and application of "Health for children" program. Method: an investigation of quasi experimental intervention in the system and health services by means of a design pre and post test was performed. It was directed to family physicians of the polyclinic "José Martí" and the health area of the Odontology clinic "Mártires de Pino III" of Camagüey, from January to December of 2007. The investigation was organized in five stages. A survey was made with its respective assesment scale, which was applied at the beginning and at the end of the study. Results: the educational program "Health for children" was designed and it was applied to the family physicians. When being concluded an evaluation through the survey was carried out. Conclusions: the level of information of herpetic gingivostomatitis was evaluated of regular before the educational intervention, after having applied the program the entirety of doctors possessed a good level of information. The program "Health for children" generated a very positive acceptance, when integrating the odontologist work and the family physicians.
Assuntos
Humanos , Médicos de Família , Desenvolvimento de Programas , Estomatite HerpéticaRESUMO
Objetivo: Determinar la asociación entre los síntomas depresivos no identificados por el médico de atención primaria y la polifarmacia en pacientes mayores de 60 años. Material y métodos: Se diseñó un estudio de casos y controles con muestreo no probabilístico de casos consecutivos. Los criterios de inclusión fueron: pacientes de ambos sexos con 60 o más años de edad, con un máximo de una enfermedad, sin descompensaciones agudas, con registros confiables en sus expedientes durante los últimos 12 meses. Los criterios de exclusión fueron: deterioro cognitivo, artritis reumatoide, endocrinopatías (excepto diabetes mellitus), alcoholismo, tabaquismo, dependencia funcional, antecedentes de automedicación. Los criterios de eliminación fueron: diagnóstico previo de depresión o síntomas depresivos y hospitalización en los últimos 12 meses. Se seleccionaron como casos pacientes a quienes, por lo menos, en 5 de las 6 últimas consultas recibidas, se hayan prescrito 4 o más fármacos en forma simultánea. Se incluyeron en el grupo de los controles pacientes los a quienes al menos en 5 de las 6 últimas consultas recibidas, se haya prescrito un máximo de 3 fármacos en forma simultánea. Resultados: Participaron 200 pacientes por grupo, con edad promedio de 69 ± 6 años con los siguientes resultados: regresión logística (RM; IC95%) hipertensión arterial (6.0;3.6-10.3), diabetes mellitus 2 (3.7;2.3-5.9), síntomas depresivos (2.1;1.2-3.4), sexo femenino (1.7;1.1-2.7). Conclusiones: La presencia de hipertensión arterial, diabetes mellitus, síntomas depresivos no identificados por el médico y el sexo femenino favorecen la presencia de polifarmacia en el adulto mayor que acude a una unidad de medicina familiar.
OBJECTIVE: To determine the association between depressive symptoms not identified by the family physician and polypharmacy in patients over 60 years old. METHODS: A case-control design with non-probabilistic sampling. Inclusion criteria: > or = 60 years old both sexes, without disease or with one disease-balanced illness, and with reliable recording in chart by the last 12 month. Exclusion criteria: cognitive deterioration, obstructive chronic lung disease, cardiopathy, infarct record, alcoholism, smoking addiction and functional dependence's. Elimination criteria: depression's previous diagnoses and hospitalization during a year before the study. The cases were patients who have simultaneously received 4 o more pharmacologic prescriptions in 5 of 6 last medical visits. The controls were patients who have simultaneously received 3 o less pharmacologic prescriptions in 5 of 6 last medical visits. Depressive symptoms: grading > or = 6 (Yesavage and Brink scale). RESULTS: 200 patients per group, aged 69 +/- 6 years agreed to participate. Logistics regression (OR;CI(95%)): hypertension (6.0;3.6-10.3), diabetes mellitus type 2 (3.7;2.3-5.9), depression (2.1;1.2-3.4), and female sex (1.7;1.1-2.7). CONCLUSIONS: Hypertension, diabetes mellitus type 2, depressive symptoms not identified by the family physician, and female sex are risk factors for polypharmacy in the elderly.