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Evaluación del tratamiento antidepresivo en pacientes con comorbilidad. El uso de la informática
Resumen
Objetivo: evaluar la calidad de la atención del paciente deprimido con comorbilidad médica e identificar áreas de mejora utilizando el expediente electrónico.
Material y métodos: estudio observacional, retrospectivo en el que se revisó la literatura para la identificación de indicadores basados en la evidencia. Con base en las notas electrónicas clínicas se calcularon las proporciones de continuidad en el tratamiento antidepresivo a 12 y 24 semanas, las tasas de respuesta y remisión en fase aguda a ocho semanas, el uso de escalas clinimétricas y de psicoterapia basada en la evidencia, así como la presencia de eventos de seguridad relacionados con los antidepresivos.
Resultados: de 100 enfermos con edad promedio de 48.7 años, 49 y 34 % recibieron tratamiento durante 12 y 24 semanas, respectivamente, con respuesta de 50 % y remisión de 28 % a las ocho semanas. A 33 % se les aplicó escalas clinimétricas y se hicieron intervenciones psicoterapéuticas en 28 % de las visitas. Un paciente presentó crisis convulsivas relacionadas con el uso de antidepresivos.
Conclusiones: la información obtenida del expediente electrónico sugiere como áreas de oportunidad de mejora, incrementar la proporción de pacientes que alcanzan remisión en la fase aguda de la enfermedad y la aplicación de escalas clinimétricas y de psicoterapia basada en la evidencia.
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