Evaluación de un programa de seguimiento de pacientes ancianos institucionalizados en tratamiento con anticoagulantes orales
Bibliographic record
Abstract
Valorar un programa de seguimiento interdisciplinar en el anciano institucionalizado en tratamiento con anticoagulants orales. El programa de seguimiento propuesto tiene carácter interdisciplinar e incluye la determinación de INR, una entrevista con el paciente y/o cuidador y la valoración del plan terapéutico con una periodicidad semanal. La calidad farmacoterapéutica se ha valorado mediante el porcentaje de tiempo y el porcentaje de determinaciones en rango terapéutico. La idoneidad del programa, con respecto al seguimiento tradicional, se ha estudiado a través de la diferencia de proporciones para la primera variable y a través del análisis por tablas de contingencia para la segunda. Se incluyen nueve pacientes. Seis de los nueve pacientes (67%) presentaron un aumento significativo en el porcentaje de tiempo en rango terapéutico. El 68,5% de las determinaciones de INR durante el programa de seguimiento se sitúan en rango terapéutico. El porcentaje de determinaciones de INR inferiors al rango terapéutico se redujo significativamente con respecto al seguimiento tradicional. Se han documentado 13 actuaciones por paciente. La complejidad del tratamiento anticoagulante oral, el elevado número de actuaciones realizadas junto con la baja adherencia al tratamiento en pacientes ancianos, pone de manifiesto la necesidad de instaurar programas de seguimiento que cuenten con la participación de los profesionales encargados del cuidado del paciente. To assess an interdisciplinary follow-up programme for institutionalised elderly people on oral anticoagulant treatment. The proposed follow-up treatment is of an interdisciplinary nature and includes INR, an interview with the patient and/or carer and an assessment of the treatment plan every week. The quality of drug treatment is assessed by the percentage of time and the percentage of measurements falling within the therapeutic range. The suitability of the programme in comparison to the traditional follow-up was studied in terms of the different proportions for the first variable and by analysing contingency tables for the second. Nine patients were recluted. Six patients (67%) showed a significant increase in the percentage of time they remained within the therapeutic range. 68.5% of INR measurements during the follow-up programme were within therapeutic range. The percentage of INR measurements below the therapeutic range was significantly reduced when compared to the traditional follow up. Thirteen pharmaceutical interventions were documented per patient. The complexity of oral anticoagulant treatment, the large number of interventions carried out together with elderly patients’ poor treatment compliance are evidence of the need to introduce follow-up programmes which include the professionals responsible for the patients’ care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".