Atencion primaria
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To evaluate the effectiveness of interventions aimed at improving the quality and outcome of chronic disease management. ⋯ In order to improve quality and effectiveness of chronic disease management, it is necessary to take a systematic view including proactive health care systems and patients taking an active role in managing their disease. These programmes should combine, at the least, organizational strategies, design of clinical practice and patient self-management.
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To describe how patients with back pain are usually handled at a health centre. ⋯ Clinical evaluation of patients with back pain is still inadequate in our centre, and x-rays are requested without adherence to formal or explicit criteria. We prescribe more NSAIDs than paracetamol for therapy.
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To describe the quality of professional life (QPL) as perceived by primary care workers and to measure the organizational climate (OC). To identify the influence of OC on QPL and the variables that explain this relationship. ⋯ OC influences QPL, especially in motivation and managerial support. Commitment enhances motivation and perception of demands. Where there is better cohesion and team-work, the manager s support is also rated more highly.
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To assess the quality and relevance of adverse drug reactions (ADRs) published as Letters to the Editor (LE) in Spanish medical journals. ⋯ ADRs constitute an important part of LE in the journals studied. The causal relationship is acceptable, the documentation quality is high, with few unknown reactions and ADRs to recently marketed drugs. Relevance is generally low, although greater in Medicina Clínica.