Pub Date : 2026-01-13DOI: 10.1016/j.aprim.2025.103379
Paula Bellido Izquierdo , Montserrat Royo Vidal , Violeta Ramírez Arroyo , Elena Robles Díez
Nourishment is essential for human survival. However, the actual consumption pattern in enriched countries contributes to climate change and is worsening human health. Some of the factors responsible for this are the high presence of animal products in diets, the amount of food waste of the actual food system, the intensive use of fertilizers in agriculture and antibiotics in livestock, and the presence of endocrine disruptors. This way, the food system's vulnerability increases, with a bigger impact on poor people.
It is crucial for Primary Care professionals to promote a transition towards more sustainable diets, which likewise tend to be healthier. Some of the recommendations that can be done from the doctor and nurse's office are: prescribing planetary diet, teaching to read labels to choose healthier and more sustainable products, consuming seasonal fruits and vegetables, prioritizing local products, reducing food waste and avoiding foods with endocrine disruptors.
{"title":"Nutrición con visión de salud planetaria: estrategias para atención primaria","authors":"Paula Bellido Izquierdo , Montserrat Royo Vidal , Violeta Ramírez Arroyo , Elena Robles Díez","doi":"10.1016/j.aprim.2025.103379","DOIUrl":"10.1016/j.aprim.2025.103379","url":null,"abstract":"<div><div>Nourishment is essential for human survival. However, the actual consumption pattern in enriched countries contributes to climate change and is worsening human health. Some of the factors responsible for this are the high presence of animal products in diets, the amount of food waste of the actual food system, the intensive use of fertilizers in agriculture and antibiotics in livestock, and the presence of endocrine disruptors. This way, the food system's vulnerability increases, with a bigger impact on poor people.</div><div>It is crucial for Primary Care professionals to promote a transition towards more sustainable diets, which likewise tend to be healthier. Some of the recommendations that can be done from the doctor and nurse's office are: prescribing planetary diet, teaching to read labels to choose healthier and more sustainable products, consuming seasonal fruits and vegetables, prioritizing local products, reducing food waste and avoiding foods with endocrine disruptors.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 2","pages":"Article 103379"},"PeriodicalIF":1.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.aprim.2025.103332
Odylon Kleber Pereira de Souza , Millenny Lohanne da Silva Lisboa , Aline Teixeira Alves , Liana Barbaresco Gomide Matheus , Marianne Lucena da Silva , Katiane da Costa Cunha
Objective
This study aims to evaluate the clinical impacts of topical and/or oral administration of compounds rich in omega-3 fatty acids from various sources, such as oils and foods, on psoriatic lesions.
Design
A systematic review was carried out. Data sources: Searches were conducted in six databases (PubMed, Cochrane, VHL, Scopus, Embase, and Web of Science) using descriptors related to fatty acids and psoriasis.
Study selection
Inclusion criteria were studies published in the last 10 years (2013–2023) that involved patients with psoriasis and provided quantitative clinical outcome data, such as psoriasis severity scale.
Data extraction
Two independent reviewers carried out the initial screening of the titles and abstracts identified in the search. The quality of studies was evaluated using the Newcastle-Ottawa Scale, the Risk of Bias in Randomized Studies of Interventions, and the Joanna Briggs Institute critical appraisal checklist.
Results
Out of 8570 articles identified, 9 met the inclusion criteria. The quality of randomized clinical trials and observational studies varied from low to high risk of bias, according to the respective parameters of each checklist.
Conclusions
Most studies demonstrated that the topical and/or oral administration of omega-3 fatty acids from different sources significantly improved clinical parameters, as measured by severity scales and the Psoriasis Area and Severity Index (PASI).
目的：本研究旨在评估局部和/或口服各种来源（如油和食物）富含omega-3脂肪酸的化合物对银屑病病变的临床影响。设计进行了系统评价。数据来源：在六个数据库（PubMed、Cochrane、VHL、Scopus、Embase和Web of Science）中使用脂肪酸和牛皮癣相关的描述符进行检索。研究选择纳入标准是最近10年（2013-2023）发表的涉及牛皮癣患者的研究，并提供定量的临床结果数据，如牛皮癣严重程度量表。数据提取两名独立审稿人对检索中确定的标题和摘要进行初步筛选。研究质量采用纽卡斯尔-渥太华量表、干预随机研究的偏倚风险和乔安娜布里格斯研究所关键评估清单进行评估。结果在8570篇文献中，9篇符合纳入标准。随机临床试验和观察性研究的偏倚风险从低到高不等，根据每个检查表各自的参数。结论：大多数研究表明，局部和/或口服不同来源的omega-3脂肪酸可显著改善银屑病的临床参数，如严重程度量表和银屑病面积和严重程度指数（PASI）。
{"title":"Therapeutic approach with fatty acids in psoriasis: A systematic review","authors":"Odylon Kleber Pereira de Souza , Millenny Lohanne da Silva Lisboa , Aline Teixeira Alves , Liana Barbaresco Gomide Matheus , Marianne Lucena da Silva , Katiane da Costa Cunha","doi":"10.1016/j.aprim.2025.103332","DOIUrl":"10.1016/j.aprim.2025.103332","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate the clinical impacts of topical and/or oral administration of compounds rich in omega-3 fatty acids from various sources, such as oils and foods, on psoriatic lesions.</div></div><div><h3>Design</h3><div>A systematic review was carried out. Data sources: Searches were conducted in six databases (PubMed, Cochrane, VHL, Scopus, Embase, and Web of Science) using descriptors related to fatty acids and psoriasis.</div></div><div><h3>Study selection</h3><div>Inclusion criteria were studies published in the last 10 years (2013–2023) that involved patients with psoriasis and provided quantitative clinical outcome data, such as psoriasis severity scale.</div></div><div><h3>Data extraction</h3><div>Two independent reviewers carried out the initial screening of the titles and abstracts identified in the search. The quality of studies was evaluated using the Newcastle-Ottawa Scale, the Risk of Bias in Randomized Studies of Interventions, and the Joanna Briggs Institute critical appraisal checklist.</div></div><div><h3>Results</h3><div>Out of 8570 articles identified, 9 met the inclusion criteria. The quality of randomized clinical trials and observational studies varied from low to high risk of bias, according to the respective parameters of each checklist.</div></div><div><h3>Conclusions</h3><div>Most studies demonstrated that the topical and/or oral administration of omega-3 fatty acids from different sources significantly improved clinical parameters, as measured by severity scales and the Psoriasis Area and Severity Index (PASI).</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 3","pages":"Article 103332"},"PeriodicalIF":1.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-06DOI: 10.1016/j.aprim.2025.103412
Gemma Riera Arias , Aina Bao Fang Rodriguez Rubio , Marina Casadevall Arnaus , Judith Serra Corcoll , Glòria Arnau Solé , Núria Prat Gil
Objective
To evaluate the effect of an interdisciplinary group intervention in frail patients in relation to their frailty index, eating habits, quality of life and prescribed pharmacological regimen.
Design
Non-controlled, quasi-experimental longitudinal study. A pre-post intervention.
Location
Sant Hipòlit de Voltregà Primary Health Care Center, Barcelona.
Participants
Sixty-one participants were recruited who met the initial frailty diagnosis (0.20-0.35 VIG frailty index). Finally 6 participants dropped out of the intervention and 55 participants completed the study.
Intervention
Individualized intervention with psychosocial assessment, adequacy of the therapeutic plan assessment and interdisciplinary group intervention of 12 sessions to inform on the management of frailty.
Main measurements
Sociodemographic/psychosocial information was collected from the clinical history, the participant's level of frailty was assessed using the VIG-frail test, quality of life was assessed using the EuroQol questionnaire, adherence to the Mediterranean diet using the PREDIMED questionnaire and the adequacy of the therapeutic plan by measuring the decrease in medication-related incidents.
Results
Statistically significant improvements were observed in the PREDIMED Mediterranean diet adherence test (p-valor=001) and in the aspects of the EuroQol test related to the level of anxiety/depression (p-valor=037). Pharmacological incidences were reduced by 45.28%.
Conclusions
This interdisciplinary preventive intervention helps people with initial frailty to build healthy eating habits, promotes emotional well-being and reduces medication-related incidences.
目的：评价跨学科群体干预对虚弱患者虚弱指数、饮食习惯、生活质量和处方药物治疗方案的影响。设计：非对照、准实验纵向研究。前后干预。地点：Sant Hipòlit de voltreg初级保健中心，巴塞罗那。参与者：招募61名符合初始虚弱诊断（0.20-0.35 VIG虚弱指数）的参与者。最后，6名参与者退出了干预，55名参与者完成了研究。干预：个体化干预，包括心理社会评估、治疗计划评估的充分性和12次跨学科小组干预，以了解虚弱的管理。主要测量方法：从临床病史中收集社会人口学/心理社会信息，使用vg -虚弱测试评估参与者的虚弱程度，使用EuroQol问卷评估生活质量，使用PREDIMED问卷评估地中海饮食的依从性，并通过测量药物相关事件的减少来评估治疗计划的充分性。结果：在PREDIMED地中海饮食依从性测试（p-valor=001）和EuroQol测试中与焦虑/抑郁水平相关的方面（p-valor=037）观察到统计学上显著的改善。药理学发生率降低45.28%。结论：这种跨学科的预防干预可以帮助最初虚弱的人建立健康的饮食习惯，促进情绪健康，减少药物相关的发病率。
{"title":"Efecto de una intervención grupal interdisciplinar en pacientes frágiles: un estudio cuasiexperimental pre-post","authors":"Gemma Riera Arias , Aina Bao Fang Rodriguez Rubio , Marina Casadevall Arnaus , Judith Serra Corcoll , Glòria Arnau Solé , Núria Prat Gil","doi":"10.1016/j.aprim.2025.103412","DOIUrl":"10.1016/j.aprim.2025.103412","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of an interdisciplinary group intervention in frail patients in relation to their frailty index, eating habits, quality of life and prescribed pharmacological regimen.</div></div><div><h3>Design</h3><div>Non-controlled, quasi-experimental longitudinal study. A pre-post intervention.</div></div><div><h3>Location</h3><div>Sant Hipòlit de Voltregà Primary Health Care Center, Barcelona.</div></div><div><h3>Participants</h3><div>Sixty-one participants were recruited who met the initial frailty diagnosis (0.20-0.35 VIG frailty index). Finally 6 participants dropped out of the intervention and 55 participants completed the study.</div></div><div><h3>Intervention</h3><div>Individualized intervention with psychosocial assessment, adequacy of the therapeutic plan assessment and interdisciplinary group intervention of 12 sessions to inform on the management of frailty.</div></div><div><h3>Main measurements</h3><div>Sociodemographic/psychosocial information was collected from the clinical history, the participant's level of frailty was assessed using the VIG-frail test, quality of life was assessed using the EuroQol questionnaire, adherence to the Mediterranean diet using the PREDIMED questionnaire and the adequacy of the therapeutic plan by measuring the decrease in medication-related incidents.</div></div><div><h3>Results</h3><div>Statistically significant improvements were observed in the PREDIMED Mediterranean diet adherence test (p-valor=001) and in the aspects of the EuroQol test related to the level of anxiety/depression (p-valor=037). Pharmacological incidences were reduced by 45.28%.</div></div><div><h3>Conclusions</h3><div>This interdisciplinary preventive intervention helps people with initial frailty to build healthy eating habits, promotes emotional well-being and reduces medication-related incidences.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 2","pages":"Article 103412"},"PeriodicalIF":1.6,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-05DOI: 10.1016/j.aprim.2025.103413
Ana Belén Ocampo Cervantes , Robert Greif , Rafael Castro Delgado , Carmen Amalia López López , Eduardo Carrión García , Manuel Pardo Ríos
Objective
Out-of-hospital cardiac arrest is the leading cause of sudden death. Basic Life Support (BLS) training is an essential competency in Nursing. Active learning methodologies such as blended learning may improve educational outcomes.
Design
A randomized controlled trial with four parallel groups (n = 160). Participants: was conducted among first-year undergraduate nursing students. Site: At a university in the Region of Murcia, Spain. Interventions: Four methodologies were compared: traditional training, virtual reality (VR), blended learning, and a control group with no intervention. Practical competence was assessed using an 8-item checklist covering key steps in the chain of survival. Technical parameters were measured using Laerdal QCPR® manikins, including percentage of high-quality CPR, compression depth, rate, and full chest recoil. ANOVA, chi-square tests, and correlation models were applied (p < 0.05).
Results
Practical competence differed significantly between groups (p < 0.001). Main measurements: The blended and traditional groups achieved the highest scores (6.6 ± 1.7 and 6.6 ± 1.5, respectively), followed by the VR group (6.3 ± 1.5) and the control group (3.1 ± 1.5). Mean CPR quality also differed significantly (p = 0.0045), with the blended group showing the highest percentage (72.3%), followed by traditional (65.4%), VR (63.4%), and control (46.9%). Regarding compression depth (p = 0.0011), the blended and VR groups achieved similar results (6.1 cm), outperforming the traditional (5.5 cm) and control (4.8 cm) groups. Perceived usability of the VR system was high (78/100).
Conclusions
Blended learning showed overall better performance in most variables analyzed, with higher CPR quality and equal or superior results in practical competence and compression depth compared to the traditional and immersive models. These findings support its effectiveness as a teaching strategy for acquiring BLS competencies.
{"title":"Aprendizaje combinado frente a realidad virtual y métodos tradicionales en la formación en reanimación cardiopulmonar: un ensayo aleatorizado en estudiantes universitarios","authors":"Ana Belén Ocampo Cervantes , Robert Greif , Rafael Castro Delgado , Carmen Amalia López López , Eduardo Carrión García , Manuel Pardo Ríos","doi":"10.1016/j.aprim.2025.103413","DOIUrl":"10.1016/j.aprim.2025.103413","url":null,"abstract":"<div><h3>Objective</h3><div>Out-of-hospital cardiac arrest is the leading cause of sudden death. Basic Life Support (BLS) training is an essential competency in Nursing. Active learning methodologies such as blended learning may improve educational outcomes.</div></div><div><h3>Design</h3><div>A randomized controlled trial with four parallel groups (n<!--> <!-->=<!--> <!-->160). Participants: was conducted among first-year undergraduate nursing students. Site: At a university in the Region of Murcia, Spain. Interventions: Four methodologies were compared: traditional training, virtual reality (VR), blended learning, and a control group with no intervention. Practical competence was assessed using an 8-item checklist covering key steps in the chain of survival. Technical parameters were measured using Laerdal QCPR® manikins, including percentage of high-quality CPR, compression depth, rate, and full chest recoil. ANOVA, chi-square tests, and correlation models were applied (p<!--> <!--><<!--> <!-->0.05).</div></div><div><h3>Results</h3><div>Practical competence differed significantly between groups (p<!--> <!--><<!--> <!-->0.001). Main measurements: The blended and traditional groups achieved the highest scores (6.6<!--> <!-->±<!--> <!-->1.7 and 6.6<!--> <!-->±<!--> <!-->1.5, respectively), followed by the VR group (6.3<!--> <!-->±<!--> <!-->1.5) and the control group (3.1<!--> <!-->±<!--> <!-->1.5). Mean CPR quality also differed significantly (p<!--> <!-->=<!--> <!-->0.0045), with the blended group showing the highest percentage (72.3%), followed by traditional (65.4%), VR (63.4%), and control (46.9%). Regarding compression depth (p<!--> <!-->=<!--> <!-->0.0011), the blended and VR groups achieved similar results (6.1<!--> <!-->cm), outperforming the traditional (5.5<!--> <!-->cm) and control (4.8<!--> <!-->cm) groups. Perceived usability of the VR system was high (78/100).</div></div><div><h3>Conclusions</h3><div>Blended learning showed overall better performance in most variables analyzed, with higher CPR quality and equal or superior results in practical competence and compression depth compared to the traditional and immersive models. These findings support its effectiveness as a teaching strategy for acquiring BLS competencies.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 2","pages":"Article 103413"},"PeriodicalIF":1.6,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.aprim.2025.103401
Manoel Felipe Nunes da Rocha , Mirtys Vivianne Pedroza Lopes , Juliana de Castro Nunes Pereira , Sayane Marlla Silva Leite Montenegro
Objectives
This study aims to evaluate the National Immunization Program (NIP) of a city in the interior of Pernambuco in the light of Donabedian's triad.
Methods
An epidemiological, descriptive and observational study focused on analyzing data from 2019 to 2024 from the city of Calçado – PE. It seeks to understand the efficiency of the National Immunization Program (NIP), guided by the question of how to qualify the NIP in logistics and execution of immunobiologicals. The NIP Information System and SISAB were used to collect data. The evaluation is based on the structure, processes and results of vaccine care. The data was analyzed using SPSS software.
Results
Calçado has over 11,000 inhabitants and 100% Family Health Strategy (ESF) coverage. The Primary Health Care (PHC) network has five Basic Health Units (BHU) and two support points in rural areas. Each UBS has vaccination rooms and is coordinated by a health team organized according to Ministry of Health guidelines. The infrastructure of the UBS is inconsistent in relation to the expected standards, with challenges in vaccination rooms and temperature control of vaccines. No new protocols have been created in the last five years. Supervision is carried out on a monthly basis, and the team faces challenges in terms of training and the population's adherence to vaccination.
Conclusion
Vaccination coverage in Calçado is monitored, but there is a lack of structured interaction between the NIP and the teams. Epidemiological surveillance is carried out, and educational actions are promoted, but there is a lack of formal feedback from the population that can help improve services. The study provides a clear view of the NIP's performance in the municipality, allowing us to discuss the quality of the health care offered.
{"title":"Evaluation of the National Immunization Program in a city in the interior of Pernambuco in the light of Donabedian's triad","authors":"Manoel Felipe Nunes da Rocha , Mirtys Vivianne Pedroza Lopes , Juliana de Castro Nunes Pereira , Sayane Marlla Silva Leite Montenegro","doi":"10.1016/j.aprim.2025.103401","DOIUrl":"10.1016/j.aprim.2025.103401","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to evaluate the National Immunization Program (NIP) of a city in the interior of Pernambuco in the light of Donabedian's triad.</div></div><div><h3>Methods</h3><div>An epidemiological, descriptive and observational study focused on analyzing data from 2019 to 2024 from the city of Calçado – PE. It seeks to understand the efficiency of the National Immunization Program (NIP), guided by the question of how to qualify the NIP in logistics and execution of immunobiologicals. The NIP Information System and SISAB were used to collect data. The evaluation is based on the structure, processes and results of vaccine care. The data was analyzed using SPSS software.</div></div><div><h3>Results</h3><div>Calçado has over 11,000 inhabitants and 100% Family Health Strategy (ESF) coverage. The Primary Health Care (PHC) network has five Basic Health Units (BHU) and two support points in rural areas. Each UBS has vaccination rooms and is coordinated by a health team organized according to Ministry of Health guidelines. The infrastructure of the UBS is inconsistent in relation to the expected standards, with challenges in vaccination rooms and temperature control of vaccines. No new protocols have been created in the last five years. Supervision is carried out on a monthly basis, and the team faces challenges in terms of training and the population's adherence to vaccination.</div></div><div><h3>Conclusion</h3><div>Vaccination coverage in Calçado is monitored, but there is a lack of structured interaction between the NIP and the teams. Epidemiological surveillance is carried out, and educational actions are promoted, but there is a lack of formal feedback from the population that can help improve services. The study provides a clear view of the NIP's performance in the municipality, allowing us to discuss the quality of the health care offered.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103401"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.aprim.2025.103402
Irantzu Bengoa-Urrengoechea , Isabel Aguilar-Palacio , Diana Valero-Errazu , María José Rabanaque , Mª José Gómez-Poyato , Mª Antonia Sánchez-Calavera , Sara Malo
Objective
To gain insight into the experiences of healthcare managers and professionals during the COVID-19 pandemic, with the aim of identifying barriers and facilitators to healthcare access for chronic patients.
Location
Aragon Health System (SALUD), Aragon, Spain.
Participants
21 managers and 16 healthcare professionals (nurses and doctors) selected using convenience and snowball sampling.
Methods
A qualitative research design involving semi-structured interviews and communicative focus groups based on a communicative methodology was employed. Perceptions were collected regarding barriers to access, the quality of care, digitalisation, territorial inequality, the availability and management of resources, as well as positive experiences and lessons learned.
Results
Three main barriers were identified that hindered equitable access to care, especially for vulnerable patients: the digital divide, rural-urban inequality, and system overload. Among the facilitating factors, digitalisation and interdisciplinary collaboration were found to improve efficiency and coordination between levels of care. The experiences gathered revealed discrepancies between organisational decisions and clinical outcomes, particularly in the care of chronic patients.
Conclusions
The pandemic revealed both structural weaknesses in the health system and opportunities for improvement. Positive innovations must be consolidated through an equitable approach that is tailored to the needs of vulnerable patients.
{"title":"Barreras y elementos facilitadores en el acceso a la atención sanitaria durante la pandemia de COVID-19: valoración de gestores y profesionales sanitarios","authors":"Irantzu Bengoa-Urrengoechea , Isabel Aguilar-Palacio , Diana Valero-Errazu , María José Rabanaque , Mª José Gómez-Poyato , Mª Antonia Sánchez-Calavera , Sara Malo","doi":"10.1016/j.aprim.2025.103402","DOIUrl":"10.1016/j.aprim.2025.103402","url":null,"abstract":"<div><h3>Objective</h3><div>To gain insight into the experiences of healthcare managers and professionals during the COVID-19 pandemic, with the aim of identifying barriers and facilitators to healthcare access for chronic patients.</div></div><div><h3>Location</h3><div>Aragon Health System (SALUD), Aragon, Spain.</div></div><div><h3>Participants</h3><div>21 managers and 16 healthcare professionals (nurses and doctors) selected using convenience and snowball sampling.</div></div><div><h3>Methods</h3><div>A qualitative research design involving semi-structured interviews and communicative focus groups based on a communicative methodology was employed. Perceptions were collected regarding barriers to access, the quality of care, digitalisation, territorial inequality, the availability and management of resources, as well as positive experiences and lessons learned.</div></div><div><h3>Results</h3><div>Three main barriers were identified that hindered equitable access to care, especially for vulnerable patients: the digital divide, rural-urban inequality, and system overload. Among the facilitating factors, digitalisation and interdisciplinary collaboration were found to improve efficiency and coordination between levels of care. The experiences gathered revealed discrepancies between organisational decisions and clinical outcomes, particularly in the care of chronic patients.</div></div><div><h3>Conclusions</h3><div>The pandemic revealed both structural weaknesses in the health system and opportunities for improvement. Positive innovations must be consolidated through an equitable approach that is tailored to the needs of vulnerable patients.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103402"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.aprim.2025.103399
Maria Miñana-Castellanos , Maria Ramon Granés , Berta Fernández Camins , Elena Navas Méndez , Joan Barrot de la Puente , Carolina Lapena Estella
Objectives
To describe the population with type 2 diabetes mellitus (T2DM) meeting frailty criteria and assess their management based on clinical guidelines (CGL). Patient characteristics, prescribed treatments, adherence to recommendations, and overtreatment prevalence were analyzed.
Design
Cross-sectional observational study using retrospective data.
Setting
SIDIAP database (primary care records, Catalonia, Spain).
Participants
594,777 T2DM patients; other diabetes types were excluded.
Main measures
Sociodemographic, clinical, and treatment characteristics were assessed. Frailty was defined using consensus criteria as the presence of one or more major criteria or two or more minor criteria. Major criteria were defined as a Charlson index >4, a Barthel index < 60, weight status alterations, and cognitive impairment. Minor criteria included age >75 years, MEDEA U4 or U5, established cardiovascular disease, and chronic kidney disease. Medications were classified as indicated or not recommended, based on CGL. Not recommended treatments included insulin and sulfonylureas due to their hypoglycemia risk. Glycemic control (HbA1c) and inappropriate treatments in frail patients were examined. Overtreatment was defined as use of not recommended treatments in patients with correct metabolic control (HbA1c < 7%).
Results
A total of 22.8% of individuals with T2DM met clinical criteria for frailty. Sulfonylureas were the second most frequently prescribed class of glucose-lowering agents after metformin across all groups. Among frail patients, 14% were treated with therapies not recommended by clinical guidelines, primarily insulin (39.4%) and sulfonylureas (29.2%). Overtreatment was observed in over 20% of frail individuals.
Conclusions
Almost 1 every 4 people with T2DM meet frailty criteria. Low adherence to guidelines and a high prevalence of inappropriate treatments and overtreatment were observed. These findings emphasize the need for increased awareness and better guideline implementation to improve care for this vulnerable population.
{"title":"Manejo de la diabetes mellitus tipo 2 en personas con fragilidad en la práctica clínica real","authors":"Maria Miñana-Castellanos , Maria Ramon Granés , Berta Fernández Camins , Elena Navas Méndez , Joan Barrot de la Puente , Carolina Lapena Estella","doi":"10.1016/j.aprim.2025.103399","DOIUrl":"10.1016/j.aprim.2025.103399","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the population with type 2 diabetes mellitus (T2DM) meeting frailty criteria and assess their management based on clinical guidelines (CGL). Patient characteristics, prescribed treatments, adherence to recommendations, and overtreatment prevalence were analyzed.</div></div><div><h3>Design</h3><div>Cross-sectional observational study using retrospective data.</div></div><div><h3>Setting</h3><div>SIDIAP database (primary care records, Catalonia, Spain).</div></div><div><h3>Participants</h3><div>594,777 T2DM patients; other diabetes types were excluded.</div></div><div><h3>Main measures</h3><div>Sociodemographic, clinical, and treatment characteristics were assessed. Frailty was defined using consensus criteria as the presence of one or more major criteria or two or more minor criteria. Major criteria were defined as a Charlson index<!--> <!-->>4, a Barthel index <<!--> <!-->60, weight status alterations, and cognitive impairment. Minor criteria included age<!--> <!-->>75 years, MEDEA U4 or U5, established cardiovascular disease, and chronic kidney disease. Medications were classified as indicated or not recommended, based on CGL. Not recommended treatments included insulin and sulfonylureas due to their hypoglycemia risk. Glycemic control (HbA1c) and inappropriate treatments in frail patients were examined. Overtreatment was defined as use of not recommended treatments in patients with correct metabolic control (HbA1c<!--> <!--><<!--> <!-->7%).</div></div><div><h3>Results</h3><div>A total of 22.8% of individuals with T2DM met clinical criteria for frailty. Sulfonylureas were the second most frequently prescribed class of glucose-lowering agents after metformin across all groups. Among frail patients, 14% were treated with therapies not recommended by clinical guidelines, primarily insulin (39.4%) and sulfonylureas (29.2%). Overtreatment was observed in over 20% of frail individuals.</div></div><div><h3>Conclusions</h3><div>Almost 1 every 4 people with T2DM meet frailty criteria. Low adherence to guidelines and a high prevalence of inappropriate treatments and overtreatment were observed. These findings emphasize the need for increased awareness and better guideline implementation to improve care for this vulnerable population.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103399"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Global change —including biodiversity loss, land-use alterations and climate change— is reshaping the epidemiology of infectious diseases. These factors facilitate the emergence of new pathogens, interspecies transmission, and the geographical expansion of vectors and reservoirs. Vector-borne diseases such as dengue, malaria and West Nile fever are increasing in both incidence and distribution. Similarly, water- and food-borne diseases (e.g. salmonellosis, cholera) are becoming more frequent, driven by extreme weather events, poor water and sanitation infrastructure, and changes in aquatic ecosystems. In Europe and Spain, autochthonous outbreaks and the re-emergence of previously controlled diseases have been documented. The “One Health” and “Planetary Health” approaches —integrating human, animal and environmental health— are essential, alongside stronger epidemiological surveillance and the adaptation of health systems to this evolving scenario.
{"title":"Impacto del cambio global en la epidemiología de enfermedades infecciosas","authors":"Alejandra Pérez Pérez , Javier Arranz Izquierdo , Miriam Navarro Beltrá","doi":"10.1016/j.aprim.2025.103375","DOIUrl":"10.1016/j.aprim.2025.103375","url":null,"abstract":"<div><div>Global change —including biodiversity loss, land-use alterations and climate change— is reshaping the epidemiology of infectious diseases. These factors facilitate the emergence of new pathogens, interspecies transmission, and the geographical expansion of vectors and reservoirs. Vector-borne diseases such as dengue, malaria and West Nile fever are increasing in both incidence and distribution. Similarly, water- and food-borne diseases (e.g. salmonellosis, cholera) are becoming more frequent, driven by extreme weather events, poor water and sanitation infrastructure, and changes in aquatic ecosystems. In Europe and Spain, autochthonous outbreaks and the re-emergence of previously controlled diseases have been documented. The “One Health” and “Planetary Health” approaches —integrating human, animal and environmental health— are essential, alongside stronger epidemiological surveillance and the adaptation of health systems to this evolving scenario.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103375"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.aprim.2025.103339
Ana González-Díaz , Juan Gómez-Salgado , Nora Suleiman-Martos , José Luis Gómez-Urquiza
{"title":"Más que jugar: el valor terapéutico del juego en la atención integral infantil desde atención primaria","authors":"Ana González-Díaz , Juan Gómez-Salgado , Nora Suleiman-Martos , José Luis Gómez-Urquiza","doi":"10.1016/j.aprim.2025.103339","DOIUrl":"10.1016/j.aprim.2025.103339","url":null,"abstract":"","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103339"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.aprim.2025.103386
M. Elisa Torres Tejera , María Cristina Almécija Pérez , Marcia Guitián Domínguez , Miriam Navarro Beltrá
Climate change is not only affecting the planet, it is also profoundly impacting our mental health. In these times, talking about how anxiety, stress and other emotional problems are growing due to the consequences of climate change, from distress over natural disasters to sadness over the loss of our ecosystems, is something that has become necessary. Several studies are already putting the spotlight on these effects, showing how millions of people, especially young people, feel worry, uncertainty and even hopelessness about the future. They are also exploring ways to address these problems by connecting people's well-being with care for the planet. In addition, it underscores the importance of public policy including this approach to protect our mental health in the midst of the climate crisis.
{"title":"El impacto silencioso del cambio climático en nuestra salud mental: ansiedad y estrés en un mundo en transformación","authors":"M. Elisa Torres Tejera , María Cristina Almécija Pérez , Marcia Guitián Domínguez , Miriam Navarro Beltrá","doi":"10.1016/j.aprim.2025.103386","DOIUrl":"10.1016/j.aprim.2025.103386","url":null,"abstract":"<div><div>Climate change is not only affecting the planet, it is also profoundly impacting our mental health. In these times, talking about how anxiety, stress and other emotional problems are growing due to the consequences of climate change, from distress over natural disasters to sadness over the loss of our ecosystems, is something that has become necessary. Several studies are already putting the spotlight on these effects, showing how millions of people, especially young people, feel worry, uncertainty and even hopelessness about the future. They are also exploring ways to address these problems by connecting people's well-being with care for the planet. In addition, it underscores the importance of public policy including this approach to protect our mental health in the midst of the climate crisis.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103386"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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