Quality of Life analysis of patients in chronic use of oral anticoagulant: an observational study

<p>Abstract</p> <p>Background</p> <p>Treatment with oral anticoagulant may influence the quality of life perception as it promotes changes in the patient's life, not offering an evident symptomatic relief and presenting well defined risks, such as bleeding. In this trial, the influence of chronic use of anticoagulants on the quality of life perception has been analyzed in patients assisted at the anticoagulation outpatient unit.</p> <p>Methods</p> <p>The health related quality of life was evaluated through a cross-section study with a sample composed of 72 patients seen from July 23, 2009 to September 2, 2010 at the Anticoagulation Outpatient Unit of the Federal University of Bahia's University Hospital. The study's population was composed by patients with atrial fibrillation and mechanical heart valve. The patients were submitted to two quality of life evaluation questionnaires: a generic questionnaire - the Medical Outcomes Study SF-36 Health Survey (SF36) - and a specific questionnaire - the Duke Anticoagulation Satisfaction Scale (DASS).</p> <p>Results</p> <p>The quality of life perception of the patients studied, based on both the DASS and the SF36, was positive regarding the treatment with oral anticoagulant. The SF36 presented an average score of 62.2 (± 20.0). Among the SF36 evaluated domains, the physical-emotional aspect was the most compromised one regarding life quality perception. The DASS presented an average score of 67.1 (± 18.2) and the domain presenting a greater compromise was the one related to the treatment inconveniences (annoyances, burdens and obligations). Previous hemorrhagic event, comorbidities, drug interactions with medicines that increase the anticoagulant effect, lower education level in the SF36 and younger age group influence a more negative perception of the quality of life, whereas lower education level in the DASS and the duration of treatment for more than 1 year offer a more positive perception.</p> <p>Conclusion</p> <p>Patients seen at the anticoagulation outpatient unit of the University Hospital of Federal University of Bahia/Brazil had a positive perception of the treatment. Factors such as hemorrhagic event, comorbidities, drug interactions, education level, age group and duration of treatment have an influence on the quality of life perception.</p

Factors associated with the prevalence of hypertension and control practices among elderly residents of São Paulo city, Brazil

The aim of this study was to analyze the prevalence of hypertension and control practices among the elderly. The survey analyzed data from 872 elderly people in São Paulo, Brazil, through a cluster sampling, stratified according to education and income. A Poisson multiple regression model checked for the existence of factors associated with hypertension. The prevalence of self-reported hypertension among the elderly was 46.9%. Variables associated with hypertension were self-rated health, alcohol consumption, gender, and hospitalization in the last year, regardless of age. The three most common measures taken to control hypertension, but only rarely, are oral medication, routine salt-free diet and physical activity. Lifestyle and socioeconomic status did not affect the practice of control, but knowledge about the importance of physical activity was higher among those older people with higher education and greater income. The research suggests that health policies that focus on primary care to encourage lifestyle changes among the elderly are necessary.O objetivo deste estudo foi analisar a prevalência de hipertensão e práticas de controle em idosos. Inquérito transversal analisou dados de 872 idosos de São Paulo, Brasil, por meio de uma amostra por conglomerados, estratificada segundo escolaridade e renda. O modelo de regressão múltiplo de Poisson verificou a existência de fatores associados à hipertensão. A prevalência de hipertensão referida entre os idosos foi de 46,9%. As variáveis associadas à hipertensão foram autopercepção de saúde, consumo de álcool, sexo e hospitalização no último ano, independentemente da idade. As três medidas mais adotadas para o controle da hipertensão, embora pouco praticadas, são tomar medicação oral de rotina, dieta sem sal e atividade física. O estilo de vida e a condição socioeconômica não influenciaram a prática de controle, mas o conhecimento sobre a importância da atividade física foi maior entre os idosos com mais escolaridade e renda. Fazem-se necessárias políticas de saúde com foco na atenção primária que incentivem mudanças no estilo de vida dos idosos.El objetivo de este estudio fue analizar la prevalencia de hipertensión y prácticas de control en ancianos. Un estudio transversal analizó los datos de 872 ancianos de São Paulo, Brasil, mediante una muestra por conglomerados, estratificada según la escolaridad y renta. El modelo de regresión múltiple de Poisson verificó la existencia de factores asociados a la hipertensión. La prevalencia de hipertensión referida a los ancianos fue de un 46,9%. Las variables asociadas a la hipertensión fueron: autopercepción de salud, consumo de alcohol, sexo y hospitalización durante el último año, independientemente de la edad. Las tres medidas más adoptadas para el control de la hipertensión, aunque poco practicadas, son: tomar medicación oral de rutina, dieta sin sal, y actividad física. El estilo de vida y la condición socioeconómica no influenciaron la práctica de control, sin embargo, el conocimiento sobre la importancia de la actividad física fue mayor entre los ancianos con mayor escolaridad y renta. Se necesitan políticas de salud enfocadas a la atención primaria que incentiven cambios en el estilo de vida de los ancianos.Universidade de São Paulo Faculdade de MedicinaUniversidade de São Paulo Faculdade de Saúde PúblicaUniversidade Estadual de Campinas Faculdade de Ciências MédicasUniversidade Estadual Paulista Faculdade de Medicina de BotucatuUniversidade Estadual Paulista Faculdade de Medicina de Botucat