Foundation for Biosanitary Research and Innovation in Primary Care, Madrid; Primary Care Research Unit, Gerencia de Atención Primaria, Madrid; Faculty of Health, Universidad Camilo José Cela, Madrid; and Gregorio Marañón Health Research Institute, Madrid, Spain.
Foundation for Biosanitary Research and Innovation in Primary Care, Madrid; Gerencia de Atención Primaria; Instituto deInvestigación Sanitaria Hospital 12 de Octubre (imas12), Gerencia de Atención Primaria, Madrid; and Faculty of Medicine, Universidad Complutense de Madrid, Spain.
Clin Exp Rheumatol. 2023 Dec;41(12):2397-2408. doi: 10.55563/clinexprheumatol/ne3r87. Epub 2023 Aug 3.
To describe the utilisation of primary health care (PHC) services and factors associated with its use by patients diagnosed with Sjögren's syndrome (SS).
Population-based cross-sectional cohort of SS patients in Madrid, Spain (SIERMA). Sociodemographic, diagnostic, clinical and PHC service utilisation variables were studied by bivariate analyses and regression models.
A total of 4,778 SS patients were included, 65.2% classified as primary SS (pSS), while 34.8% associated with another autoimmune disease (associated SS). Mean age was 64.3 years, and 92.8% of the patients were women. A total of 87.5% used PHC services, with a mean of 19.8 consultations/year. The general practitioner was the most visited health professional, with a mean of 10.9 consultations/year, followed by the nurse, with a mean of 5.7. Characteristics associated with a greater use of PHC services in SS patients were associated SS, higher adjusted morbidity groups (AMG) risk level and older age. Additional factors included symptoms such as dry mouth, fatigue, dry vagina and joint and muscle pain; comorbidities such as atrial fibrillation, diabetes, hypertension, solid malignant neoplasms, coronary heart disease and chronic obstructive pulmonary disease; and treatments such as sterile saline solution, corticosteroids, opioids and biologic disease-modifying anti-rheumatic drugs.
Most SS patients used PHC services during the study period, and the mean number of consultations was remarkably high. Utilisation was mainly associated with AMG risk level, ageing, glandular and extra-glandular symptoms, substantial comorbidities and various treatments. An optimised design of PHC policies will facilitate early diagnosis, improved management and better quality of life for SS patients.
描述原发性保健（PHC）服务的利用情况，以及与原发性干燥综合征（SS）患者使用 PHC 服务相关的因素。
这是一项基于人群的西班牙马德里 SS 患者的横断面队列研究（SIERMA）。通过单变量分析和回归模型研究了社会人口统计学、诊断、临床和 PHC 服务利用变量。
共纳入 4778 例 SS 患者，65.2%为原发性 SS（pSS），34.8%与另一种自身免疫性疾病相关（继发性 SS）。平均年龄为 64.3 岁，92.8%的患者为女性。共有 87.5%的患者使用 PHC 服务，平均每年就诊 19.8 次。全科医生是就诊最多的卫生专业人员，平均每年就诊 10.9 次，其次是护士，平均每年就诊 5.7 次。与 SS 患者 PHC 服务利用度较高相关的特征包括继发性 SS、更高的调整后发病率组（AMG）风险水平和年龄较大。其他因素包括口干、疲劳、阴道干燥、关节和肌肉疼痛等症状；心房颤动、糖尿病、高血压、实体恶性肿瘤、冠心病和慢性阻塞性肺疾病等合并症；以及生理盐水溶液、皮质类固醇、阿片类药物和生物疾病修正抗风湿药物等治疗方法。
在研究期间，大多数 SS 患者使用了 PHC 服务，平均就诊次数非常高。利用主要与 AMG 风险水平、年龄增长、腺体和腺体外症状、大量合并症和各种治疗方法相关。优化 PHC 政策的设计将有助于 SS 患者的早期诊断、改善管理和提高生活质量。
