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Comparative Study
. 2004 Jun 15;34(1):26-31.
doi: 10.1016/s0212-6567(04)79447-0.

[Care by a primary care team for patients with eating behaviour disorders: identifying possibilities for improvement]

[Article in Spanish]
M E Aguilar Hurtado  1 , J Sagredo Pérez, G Heras Salvat, J C Estévez Muñoz, M L Linares López, E Peña Rodríguez
Affiliations
Comparative Study

[Care by a primary care team for patients with eating behaviour disorders: identifying possibilities for improvement]

[Article in Spanish]
M E Aguilar Hurtado et al. Aten Primaria. .

Abstract
in English, Spanish

Objectives: Principal: to find opportunities for improvement in the care of patients with eating behaviour disorders (EBD). Secondary: a) to ascertain the profile of patients diagnosed with EBD at our health centre; b) to find out whether the handling of patients is in line with the guidelines stipulated in the bibliography as "good quality", and c) to find out whether we conduct EBD early-detection activities among adolescents.

Design: Transversal, descriptive study.

Setting: Urban health centre in Madrid. Ten family medicine clinics and 2 paediatrics ones.

Patients: Objectives 1 and 2: patients diagnosed with EBD by our primary care team (PCT) (n=13). Objective 3: randomised sample of 136 patients between 12 and 17 years old.

Measurements and results: Thirteen patients, all women, were diagnosed with EBD. Their mean age was 21 (SD, 3.87). The most common EBD were: anorexia nervosa (46.15%) and undefined disorders (30.77%); 92.30% were diagnosed in primary care. The most common detail giving rise to suspected EBD in the clinic was family members seeking help (46.15%). At the time of study, 38.46% evolved favourably, 30.77% were cured and 30.77% were chronically ill. After diagnosis, the activity most complied with was attending a minimum of four times a year (90.9%); the least complied with were a report from the mental health services (22.2%) and weight monitoring (42.9%). Early detection was appraised in a sample of 123 females and 13 males, with an average age of 15 (SD, 2.07); 50% were evaluated for their nutrition, and 10.3% for their self-esteem.

Conclusions: The most common EBD in the patients diagnosed by our PCT was anorexia nervosa. Most of those ill were diagnosed in primary care. During their treatment, few patients had their weight monitored and communication with mental health departments could be improved. Few early detection tests among adolescents, in particular appraisal of their self-esteem, were conducted.

Objetivos: Principal: buscar oportunidades de mejora en la atención a los pacientes con trastornos del comportamiento alimentario (TCA). Secundarios: a) averiguar el perfil de los pacientes diagnosticados de TCA pertenecientes a nuestro centro de salud; b) investigar si el manejo de los pacientes se ajusta a las pautas establecidas en la bibliografía como de buena calidad, y c) descubrir si realizamos actividades de detección precoz de los TCA en la población adolescente

Diseño: Estudio descriptivo, transversal

Emplazamiento: Centro de salud urbano de Madrid. Diez consultas de medicina de familia y 2 de pediatría

Pacientes: Objetivos 1 y 2: pacientes diagnosticados de TCA de nuestro EAP (n = 13). Objetivo 3: muestra aleatoria de 136 pacientes de 12–17 años de edad

Mediciones y resultados: Pacientes diagnosticados de TCA: 13, todos mujeres. Edad media, 21 años (DE, 3,87). TCA más frecuentes: anorexia nerviosa (46,15%) y trastornos no especificados (30,77%). Diagnóstico en atención primaria en el 92,30%. Dato de sospecha clínica más frecuente: búsqueda de ayuda por parte de los familiares (46,15%). En el momento del estudio el 38,46% tenía una evolución favorable, el 30,77% se había curado y el 30,77% presentaba cronicidad. En el manejo de los pacientes tras el diagnóstico, la actividad de mejor cumplimiento fue la realización de un mínimo de 4 visitas programadas cada año (90,9%), y las de peor cumplimiento: presencia de informe de los servicios de salud mental (22,2%) y seguimiento del peso (42,9%). La detección precoz se evaluó en una muestra de 123 mujeres y 13 varones con una edad media de 15 años (DE, 2,07). Se realizó valoración nutricional en el 50% y en el 10,3% valoración de la autoestima

Conclusiones: El TCA más frecuente en las pacientes diagnosticadas de TCA en nuestro EAP es la anorexia nerviosa. La mayoría de las enfermas fue diagnosticada en atención primaria. Respecto a su tratamiento, se ha realizado seguimiento del peso a pocos pacientes y se puede mejorar la comunicación con salud mental. Se realizan pocas actividades de detección precoz en los adolescentes, sobre todo en el caso de la valoración de la autoestima

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