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Objectives: To analyze the effectiveness of a multicomponent treatment for smoking cessation carried out in primary care and to evaluate the evolution of the consumption of tobacco that the people who participated had, more than 5 years after the end of the treatment., Design: Longitudinal study of 307 participants in a multicomponent program in group format of tobacco cessation., Emplacement: Santander (Spain) Primary Care Health Center., Participants: Smokers from the basic health zone who wanted to quit smoking between 2006 and 2012 and requested help., Interventions: Multicomponent treatment of 5face-to-face sessions and follow-up for up to 12 months., Primary Measurements: The activity was evaluated in 263 participants more than 5years after the end of treatment. The results of continuous and punctual withdrawal were obtained by self-declaration and the data recorded in the medical record. The punctual was also validated with co-oximetry., Results: After a year 42.7% of participants declared continuous abstinence. From 5 to 12 years later, the continuous declared abstinence further than 12 months was 40.7%. They did not smoke again since the end of the treatment 66 people; 68.0% of those who relapsed made new attempts and 45.5% of them requested help to quit smoking., Conclusions: The proposed multi-component treatment is effective. Abstinence at 12 months predicts long-term maintenance and participating in disabling groups favors further attempts in case of relapse and the request for help to quit smoking., (Copyright © 2023 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To determine the unexpected return rate to the Primary Care Emergency Service of elderly patients over 65 years old within the following 72h of a previous visit, as well as to determine the clinical and assistance requirements of these patients., Procedure: Retrospective and observational epidemiologic study., Location: Cotolino's Primary Care Emergency Service in Cantabria, Spain., Participants: 1940 elderly patients over 65 years old were included. These patients returned to the Primary Care Emergency Service in 2016., Main Data for the Study: The dependent variable was the return rate to the Primary Care Emergency Service. The independent variables were socio-demographic characteristics, health details and medical assistance information. All data was collected from the Primary Care Emergency Service Management Office database. All variables were analysed applying Pearson's chi-squared test and Fisher's exact test, with statistical significance P≤.05., Results: The rate of unexpected return was 2.3%. The average age was 77.4 years old (standard deviation (SD): 8.4), of which the 37.6% were male. The most frequent range of age was from 75 to 84 years old, with males being the predominant group. A history of polymedication was detected in 54.4% of the cases, as well as a medium cardiovascular risk within this group. Nursing professionals attended the 42.2% of these return cases (P<.001). Patients with dysnea (P=.015), scheduled care or scheduled injection returned with a higher frequency (P<.001). It was as well noticed a higher frequency of return for subsequent attention during the months of December and January (P<.001)., Conclusions: The rate of unexpected return is low. The main causes why elderly patients returned to the service requiring urgent assistance were issues categorised as unspecific general health indicators and/or respiratory system illnesses. Our proposal is to develop specific protocols combining the work from both Geriatrics and Gerontology professionals, in order to improve the support to this group of population at every Primary Care Emergency Service., (Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To describe the use and perception of the need for assistive devices and identify their relationship with instruments to measure dependence and caregiver burden., Design: Cross-sectional study., Location: Primary Health Care in the southern area of Pontevedra., Participants: A total of 112 informal caregivers providing care to 125 dependent persons., Key Measurements: Through a personal interview, data was collected on the use and perception of the need for these devices. In addition, sociodemographic data and information on the time dedicated to daily care, caregiver burden, the Dependency Rating Scale, and the DEP-6D dependency indicator were obtained. A contrast mean was used to identify whether there are significant differences in these indicators, depending on whether or not they use the facilitator devices. A logistic regression was performed to identify those variables most associated with not having a need covered., Results: More than half (60%: 95% CI; 50.9-68.7) of dependent persons have unmet needs for these devices. These needs are mainly associated with a low family income, a high degree of dependence, and better health of the caregiver; although in extreme situations of greater dependence and worse health of the caregiver these deficiencies are smoothed out., Conclusions: There is a strong association between the level of dependence and the use of these devices. However, there is a high percentage of the sample that do not have the products that they need, which are associated with the socioeconomic situation of the household as well as with the characteristics of the dependent person and the caregiver., (Copyright © 2019 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To assess the efficacy of the ProMIC, multidisciplinary program for patients admitted at hospital because of heart failure (HF) programme, in reducing the HF-related readmission rate., Desing: Quasi-experimental research with control group., Settings: Twelve primary health care centres and 3 hospitals from the Basque Country., Participants: Aged 40 years old or above patients admitted for HF with a New York Heart Association functional class II to IV., Interventions: Patients in the intervention group carried out the ProMIC programme, a structured clinical intervention based on clinical guidelines and on the chronic care model. Control group received usual care., Main Measurements: The rate of readmission for HF and health-related quality of life RESULTS: One hundred fifty five patients were included in ProMIC group and 129 in control group. 45 rehospitalisation due to heart failure happened in ProMIC versus 75 in control group (adjusted hazard ratio=0.59, CI 95%: 0.36-0.98; P=.049). There were significant differences in specific quality of life al 6 months. No significant differences were found in rehospitalisation due to all causes, due to cardiovascular causes, visits to emergency room, mortality, the combined variable of these events, the functional capacity or quality of life at 12 months of follow up., Conclusions: ProMIC reduces significantly heart failure rehospitalisation and improve quality of life al 6 months of follow up. No significant differences were found in the rests of variables., (Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To estimate the prevalence of infection with non-vaccinable high risk genotypes of human papillomavirus (HPV)., Design: Cross-sectional study., Location: Seven randomly selected health centres in Cantabria (Northern Spain)., Participants: All women with an evaluable vaginal smear (n=3,359) between 2010 and 2011., Main Measures: The variables collected were cytological diagnosis, PCR results, and family planning method. The vaginal smear results were classified with the Bethesda system. The classification by Muñoz et al. was used for typing as oncogenic risk HPV. Proportions and odds ratio (OR) were estimated with corresponding confidence intervals at 95% (95% CI)., Results: The prevalence of HPV infection was 2.71% (95% CI: 2.15 to 3.27). The prevalence of high oncogenic risk HPV genotypes was 2.26%; (95% CI: 1.75 to 2.78). The most frequent genotype was 16 (28.89%). More than half of the women were positive for one of the non-vaccinable high risk genotypes: 51 (18.89%) and 58 (13.33%) and 68 (12.22%) or 31 (11.11%). At least two non-vaccinable high-risk genotypes co-existed in 23.33% of women. Younger women (≤30 years) had twice the risk of any HPV infection: OR 2.01 (95% CI: 1.02 to 3.96); and were twice as likely to use condoms compared to hormonal contraceptives, OR 2.09 (95% CI: 1.64 to 2.67)., Conclusions: According to the high percentage of non-vaccinable high oncogenic risk HPV types, there should be a re-think of the prevention strategy in the population, who may have a false sense of protection., (Copyright © 2015 Elsevier España, S.L.U. All rights reserved.)

Objective: To identify items to design a questionnaire to assess IADL in the elderly in the community., Design: Delphi study., Location: Community setting, primary health care., Participants: Fifty seven multidisciplinary experts (family doctors, geriatricians, physiotherapists, social workers, male nurses) who are members of the Spanish Society of Family and Community Medicine or the Spanish Geriatrics and Gerontology Society., Methods: Three consecutive questions sent via e-mail or fax. First: what items you would take into account in a questionnaire to assess IADL in the elderly? Second: out of the groupings select 10 you consider to be of special relevance? Third: among the 14 more most selected items, select, by scoring from 1 to 10, the ones you consider more important? In the end we obtained the 10 items to include in the questionnaire according to their scores., Results: Thirty experts answered the 3 mailings. The 53 initial proposals were grouped into 24 items. In the end we obtained the following selection (from higher to lower score): dealing with medication, use of the telephone, housework, handling money, walking outside the home, security measures and risk avoidance, shopping, dealing with doors and keys, transport use, and means of social contact., Conclusions: Only 2 items could have gender influence (in contrast to other questionnaires), as "shopping" does not refer only to the household ones and "housework" also includes activities carried out by males. The most important items are "dealing with medication" (due to the high prevalence of problems and clinical outcomes) and "the use of the telephone" (survival item).