Educate the patient after a heart attack reduces by 30% visits to the health center.

-The objective is to involve patients in control of their disease and encourage more active and individualized by the medical staff and nursing track

-the care of chronic patients with cardiovascular such as obesity, high cholesterol or diabetes risk factors, constitutes one of the most frequent primary care consultation reasons

Alicante, March 2012.- among patients who have suffered a heart attack, those who have received information about their illness better control risk factors, enjoy better quality of life and need considerably less to attend the doctor’s. The Proprese program proves (1), an initiative carried out in health of the community of Valencia. day centres past data for the participating centres in Alicante in the IV National Congress of health care were presented to the chronic patient until the past Saturday 10th of March was held in this cityorganized by the Spanish society of internal medicine (SEMI) and the Spanish society of family and community (semFYC), medicine together with the Ministry of health of Valencia, the patronage of ESTEVE and the collaboration of MSD, carbides medical, Sanofi and Telefónica

the Proprese aims to optimize and improve control of the cardiovascular risk factors in patients with myocardial infarction through a educational intervention. Specifically according to the data collected throughout 2010, the authors of this paper conclude that with this intervention are achieved to reduce visits to the health centre in 30%, from average per patient from 13,04 visits in 2009 to 8,16 at 2010.

The progressive ageing of the population and the increase in cardiovascular diabetes, obesity and hypertension risk factors have motivated that myocardial infarction is increasingly common in people older than 65 years. While improving treatments is directly responsible for a decline in deaths from this cause, the truth is that, in every day, the control of risk factors that we see in the primary care consultations is far from the desirable ”, warns Dr. Esther RuescasCoordinator of the Proprese program. Undoubtedly the data presented are good example that through appropriate therapeutic education and track active and individualized by doctors can be a more effective and efficient use of healthcare ”, adds Dr. Ruescas.

These chronic patients tend to be further polimedicados. Have seen that in many cases not knowing well the usefulness of prescribed drugs they tend to downplay the oversights, with the risk of a poor compliance with medication. Why is the key to improve the level of information: the more know about their illness, may better control and more quality of life ”, says this expert. Therefore the Proprese program has included, as well as training sessions for doctors and nurses, four educational sessions with patients in which year each of them knew the parameters that determine the degree of control of their disease and established next to the doctor what was the goal to achieve and the degree of commitment that debEd take to achieve it.

In this way, you get, according to Dr. Ruescas, Dr. involve the patient in the control and management of their disease. The idea is to know what to do but above all why do. Thus becomes aware that the progression of his disease will depend in many cases of its commitment to the proposals of treatment that will make healthcare professionals, which always have at your side to help you ”.

Characteristics and results of the programme Proprese

El Proprese program has included 78 patients who had suffered a heart attack, aged between 46-85 years and 74.1 per cent of whom were boys. In all of them, during the year of educational intervention, 2010, relevant changes in different parameters for the year 2009 were observed. Thus for example, the adoption of healthy lifestyle habits improved significantly, and in the case of the practice of exercise compliance percentage went from a 61.5% to 74.6% in the diet of 59% to 71.7% or analysed habit decreased from 20.3% to 11.9%.

Dr. Ruescas also underlines that the prescription of drugs with proven efficacy and benefit in the treatment of cardiovascular diseases has improved. On many occasions, used therapies did not conform to the purpose that it was intended to achieve, for example, in reducing high cholesterol levels. It is necessary to establish the appropriate dose of the drug to the patient’s needs well because that way Gets an important benefit on parameters such as cholesterol, hemoglobin and blood glucose. Results that if kept improve turn the figures of survival, re-admissions or reinfartos of these patients ”, indicates this expert. This was the case of Statins (lipid lowering of wide use treatments) which went from being correctly prescribed in 78% of patients become a 94.5%.

Work of the family doctor in the chronic patient care

The position of primary care and the family physician as gateway to the health system and the fact that, at least once per year, 70% of the population go through your health care center facilitates the implementation of preventive activities as taking blood pressure regularlymeasure levels of blood cholesterol, control blood sugar in patients at risk for diabetes, etc. In fact, the care of chronic patients with risk factors, such as obesity, high cholesterol, hypertension, diabetes, smoking, etc., is one of the reasons for more common in primary care consultation. The family physician has a key role not only in the early detection of patients with high cardiovascular risk and in the promotion of healthy lifestyle habits, but also, as a referring physician and in coordination with other specialties, in the achievement of the objectives of therapeutic control and in the reduction of complications. For its proximity to the patient is often the first to diagnose and initiate appropriate treatment or attend the patient when occurs any cardiovascular complication ”, concludes this expert.

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1. Program Coordinator Proprese: e. Ruescas (2), a. Navarro (2), M. Gaubert (3), M. Núñez (4), l. Cruz (3), e. López

(1) Centro de Salud. Alicante-Pla. (Alicante)

(2) Health Center. Alicante-Cabo Huertas. (Alicante)

(3) Health Center. Campello. (Alicante)

(4) Address of nursing. Department of San Juan de Alicante. (Alicante)