目的:评估是否出现了诸如SARS-COV-2大流行引起的危机情况,加上初级保健中采用的组织变革,影响了40至74岁患者心血管预防活动的实施。
方法:在初级保健中进行为期三年(2019-2022年)的回顾性多中心描述性研究。
方法:马德里北方援助局初级保健的35个保健中心。
方法:1008名40至74岁的男性和女性均被诊断为高血压,糖尿病和/或血脂异常。
方法:从计算机化的临床病史分析的变量是生活方式活动(烟草的消费,酒精,地中海饮食和运动的消耗)考虑4个参数中的3个最佳;检查数据(血压记录)和分析记录(血糖,hbA1c,总胆固醇,HDL,LDL)考虑5个参数中的4个最优。差异分析了基于大流行前的差异(2019年3月15日-2020年3月14日),大流行(03/15/2020-03/14/2021),和过渡(2022年3月15日至2022年3月14日)。
方法:MCNemar\'s检验,以比较研究期间之间的主要变量。
结果:收集来自1008名患者的数据。在大流行前,对生活方式进行预防活动的登记为180名患者(17.9%)(IC95%:0,155-0,204),29例患者(2.9%)(IC95%:0,019-0,041)处于大流行阶段,55例患者(5.5%)(IC95%:0,041-0,070)处于过渡阶段(p<0.05)。在大流行前,393名患者(39%)(IC95%:0,360-0,421)进行了探索,133名患者13,2%(IC95%:0,112-0,154)在大流行中,和218名患者(21,6%)(IC95%:0,191-0,243)在过渡(p<0.05)。分析记录为33名患者(3.3%)(IC955:0,023-0,046),10例患者(1%)(IC95%:0,005-0,018)和23例患者(2.3%)(IC95%:0,015-0,034)在每个阶段分别有一个(P<0.05)。
结论:关于生活方式的活动,体检,作为心血管预防策略的一部分的实验室测试在流行病前期很少,在大流行期间急剧下降,在第一层次的护理。
OBJECTIVE: To assess whether the appearance of a crisis situation such as the one caused by the SARS-COV-2 pandemic, together with the organizational changes adopted in Primary Care, have influenced the implementation of cardiovascular preventive activities in patients aged 40 to 74 years.
METHODS: Retrospective multicenter descriptive study for three years (2019-2022) in Primary Care.
METHODS: 35 health centers of the Primary Care of the Northern Assistance Directorate of Madrid.
METHODS: 1008 patients of both sexes between 40 and 74 years with diagnosed of hypertension, Diabetes Mellitus and/or dyslipidemia.
METHODS: The variables analyzed from the computerized clinical history were lifestyle activities (consumption of tobacco, alcohol, consumption of Mediterranean diet and exercise) considering 3 of the 4 parameters optimal; examination data (blood pressure record) and analytical record (glycemia, hbA1c, total cholesterol, HDL, LDL)considering 4 of the 5 parameters optimal. Differences are analyzed between based pre-pandemic (03/15/2019-03/14/2020), pandemic (03/15/2020-03/14/2021), and transition (03/15/2022-03/14/2022).
METHODS: MC Nemar\'s test to compare the main variables between the study periods.
RESULTS: Data from 1008 patients are collected. The registration of preventive activities on lifestyle was 180 patients (17.9%) (IC95%: 0,155-0,204) in pre-pandemic, 29 patients (2.9%) (IC 95%: 0,019-0,041) in pandemic and 55 patients (5.5%) (IC 95%: 0,041-0,070) in the transition stage (p < 0.05). Exploration was registered in 393 patients (39%) (IC95%: 0,360-0,421) in the pre-pandemic, 133 patients 13,2% (IC 95%: 0,112-0,154) in the pandemic, and 218 patients (21,6%) (IC 95%: 0,191-0,243) in the transition (p < 0.05). The analytical record was 33 patients (3.3%) (IC955: 0,023-0,046), 10 patients (1%) (IC95%: 0,005-0,018) and 23 patients (2.3%) (IC95%: 0,015-0,034) respectively in each phase with one (P < 0.05).
CONCLUSIONS: Activities on lifestyle, physical examination, and laboratory test as part of the cardiovascular prevention strategy are scarce in the prepandemic period and decrease drastically during the pandemic, at the first level of care.