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Resumen: Objetivo: Analizar la implantación e identificar y describir las actividades comunitarias (AC) desarrolladas durante 2018-2022, en Atención Primaria (AP) del área sanitaria de Santiago de Compostela y Barbanza. Adicionalmente, se determinarán las barreras y facilitadores para su desarrollo. Diseño: Estudio observacional, transversal. Emplazamiento: El estudio se realizó en Galicia, una comunidad autónoma situada al noroeste de España, abarcando los 74 centros de salud del área sanitaria, que forman parte de la red pública del sistema sanitario español. Participantes: Se invitó a participar a todos los coordinadores de enfermería, así como a jefes de servicio y aquellos profesionales de AP con mayor conocimiento sobre las AC desarrolladas. Mediciones principales: Mediante entrevista telefónica, se cumplimentó un cuestionario heteroadministrado sobre las características, barreras y facilitadores de las AC. Resultados: Se identificaron un total de 95 AC. La mayoría fueron de carácter puntual (72,6%), de una única sesión (67,4%), con participación pasiva de los asistentes (100%) y escasa colaboración intersectorial (9,5%). El 76,8% de las AC no fueron evaluadas y surgieron por iniciativa de los profesionales de AP. Se identificó la flexibilización de las agendas de los profesionales de AP como factor clave para lograr la implantación de las AC en AP. Conclusiones: Para lograr una implementación efectiva de las AC es crucial una mayor implicación institucional que facilite la flexibilización de las agendas de AP, la evaluación de las AC, la incorporación de profesionales con formación específica en atención comunitaria, así como una mayor colaboración con los agentes de la comunidad. Abstract: Objective: To analyse the implementation and identify and describe the community activities (CA) developed during 2018–2022, in the Primary Health Care (PHC) of the health area of Santiago de Compostela y Barbanza. In addition, the barriers and facilitators for its development will be determined. Design: Observational, cross-sectional study. Setting: The study was conducted in Galicia, an autonomous community located in northwestern Spain, covering the 74 health centres in the health area, which are part of the public network of the Spanish health system. Participants: All nursing coordinators were invited to participate, as well as heads of service and those PHC professionals with greater knowledge of the CA developed. Main measurements: A hetero-administered questionnaire on the characteristics, barriers and facilitators of CA was completed by means of a telephone interview. Results: A total of 95 CA were identified. Most were one-time activities (72.6%), single-session (67.4%), with passive participation of the attendees (100%) and little cross-sectoral collaboration (9.5%). 76.8% of the CA were not evaluated and arose on the initiative of PHC professionals. The flexibility of PHC professionals’ agendas was identified as a key factor in achieving the implementation of CA in PHC. Conclusions: In order to achieve an effective implementation of CA, greater institutional involvement is crucial to facilitate the flexibility of PHC agendas, the evaluation of CA, the incorporation of professionals with specific training in community care, as well as greater collaboration with community agents.

Abstract Background Dentist play an important role in misuse of antibiotics. Identification of the dental activities linked to the misuse of antibiotics is important for improving dentists’ prescribing quality. The aim of the study was to quantify the magnitude of inappropriate antibiotic prescribing by dentists in Spain and identify the characteristics, knowledge and attitudes that influence prescribing quality. Material and methods We conducted a cross-sectional, questionnaire-based study on dentists in Spain, assessing prescribing quality (dependent variable) on the basis of their responses about the prescription of antibiotics in 14 clinical situations. As the independent variables, we assessed professional characteristics and attitudes (lack of knowledge, fear, complacency, scheduling problems, and economic benefit) measured on a Likert scale. Odds Ratios (OR) (95%CI) were calculated using logistic regression. Results A total of 878 participants were included in the analysis. Half of all dentists displayed inappropriate antibiotic prescribing habits in more than 28.6% (10/14) of the clinical situations posed (interquartile range 57–79%). Prescribing quality increased when resistance was perceived as a public health problem (OR 0.88, 95% CI: 0.79–0.97), and decreased in response to fear (OR 1.12, 95% CI:1.07–1.18) or the pursuit of economic benefit (OR 1.07, 95% CI 1.01–1.14). Having over 30 years’ experience (OR 4.58, 95% CI:1.80–12.48) and/or practising in the field of prosthodontics as opposed to endodontics (OR 2.65, 95% CI:1.26–5.71) were associated with worse prescribing quality. Conclusions Antibiotics are the most commonly prescribed drugs in dentistry, and in many cases this prescription is inappropriate. Our findings shows that modifiable factors influence prescribing quality among dentists in Spain. These may be use for designing educational and training programmes for dentists.

Background: Antibiotic resistance is one of the most pressing public health problems. Health authorities, patients, and health professionals, including dentists, are all involved in its development. COVID-19 pandemic restrictions on dental care may have had repercussions on antibiotic prescribing by dentists. The aim of this study was to assess the impact of the COVID-19 pandemic on antibiotic prescribing by dentists, and to review antibiotic consumption according to the WHO Access, Watch, Reserve classification. We conducted a natural, before-and-after, quasi-experimental study, using antibiotic prescription data covering the period from January 2017 to May 2021. A segmented regression analysis with interrupted time series data was used to analyse the differences between the numbers of defined daily doses (DDD) of antibiotics prescribed monthly. The outcomes showed an immediate significant decrease in overall antibiotic prescribing by primary-care dentists during lockdown, followed by a non-significant upward trend for the next year. This same pattern was, likewise, observed for Access and Watch antibiotics. COVID-19 pandemic restrictions on dental care influenced the prescription of antibiotics. During confinement, an initial decrease was observed, this trend changed when in person consultations were recovered. It might be beneficial to analyse the prescription of antibiotics using the WHO AWaRe classification, in order to monitor their appropriate use.

Community health promotion activities are a useful tool for a proactive approach to healthy lifestyles. However, the implementation of these types of activities at health centers is not standardized. The aim of this review was to analyse the characteristics of community activities undertaken in the primary care setting and substantiate available evidence on their health impact. We conducted a bibliographic review until November 15th, 2023 in the TRIPDATABASE, MEDLINE, EMBASE, and DIALNET databases. We included original papers on interventions, community activities, and actions and/or social prescriptions which had been implemented in a Primary Care setting, included a group approach in at least one session, and described some type of evaluation of the intervention applied. Studies targeted at professionals and those without involvement of the primary care team were excluded. The search identified 1912 potential studies. We included a total of 30 studies, comprising 11 randomized clinical trials, 14 quasi-experimental studies, 1 cohort study, and 4 qualitative studies. The issues most frequently addressed in community activities were healthy habits, physical activity, cardiovascular diseases and diabetes. Community activities can improve the physical and psychological environment of their participants, as well as their level of knowledge about the issues addressed. That said, however, implementation of these types of interventions is not uniform. The existence of a professional community-activity liaison officer at health centers, who would help integrate the health system with the community sector, could serve to standardize implementation and maximize the health impact of these types of interventions.