Valoración del cumplimiento terapéutico por medio de programas informáticos

espanol• Introduccion: La cardiologia actual es la disciplina, dentro de la Medicina, mas tecnificada, desarrollandose programas informaticos que permiten el control domiciliario de pacientes (telemedicina) o la objetivacion in situ, para conocer si los tratamientos prescriptos se cumplen adecuadamente. En nuestra unidad existe un programa informatico capaz de analizar el dispositivo con el cual administramos el tratamiento de prostaglandinas inhaladas a los pacientes con hipertension pulmonar. • Objetivo: Mostrar nuestra experiencia con el dispositivo valorando si ha sido beneficioso para el paciente, comprobando el cumplimiento del tratamiento y si la educacion sanitaria impartida por Enfermeria, la ha recibido adecuadamente. • Metodo: Estudio descriptivo y prospectivo con los pacientes que se han beneficiado de este sistema. Se les retiro su nebulizador antiguo y se les entreno en el manejo y preparacion del dispositivo, analizando, cada vez que acudian al hospital, los eventos tanto positivos como negativos y ofreciendoles un telefono para cualquier eventualidad. • Resultados: Desde Junio del 2009 estudiamos a 50 pacientes con hipertension pulmonar y a 12 de estos pacientes les pedimos que trajeran consigo su inhalador para analizarlo, registrando la fecha, hora y eventos de todas sus administraciones, cuatro o seis al dia, con un total de 597 sesiones y con un 4.1% de eventos adversos, donde predomina la mala posicion del dispositivo por parte del paciente. • Conclusiones: En un 92% de los pacientes, a los que les hemos administrado correctamente prostaglandinas inhaladas con este dispositivo, mostraron mejoria clinica, comprobandose con el test de marcha de 6 minutos. El dispositivo de referencia que utilizamos para valorar la cumplimentacion del tratamiento ha sido util en la mayoria de nuestros pacientes. En un 8% fue necesario insistir en la educacion sanitaria, hasta asegurarse que lo utilizaban correctamente. Este trabajo pone de manifiesto la importancia de tener datos objetivos de nuestra practica clinica diaria. English• Introduction: Current cardiology is the most technified discipline among Medicine specialties. Computer programs are being developed in order to allow home patient control (telemedicine) and monitoring of adequate fulfillment of prescribed treatments. In our unit a computer program exists to analyze the device used for inhaled prostaglandin administration in patients with pulmonary hypertension. • Target: Our aim is to show our initial experience with this device, assessing whether it is beneficial or not for the patient, verifying the fulfillment of the treatment and establishing if health education given by Nursing professionals is appropriately received. • Method: We conducted a descriptive and prospective study, including those patients who had benefited from this system. Ancient nebulizers were withdrawn. Patients were trained in the handling and preparation of the new device. Whenever patients attended hospital, positive and negative events were analyzed, offering them a phone for any contingency. • Results: From June 2009 to September 2009, 50 patients with pulmonary hypertension were included. Twelve patients were asked to bring their nebulizer with them. Those nebulizers were analyzed, registering the date, hour and events of all their administrations. The number of administrations per day range from four to six, with a whole of 597 sessions and 4.1 % of adverse events, mainly due to bad positioning of the device by the patient. • Conclusions: Clinical improvement, verified by the 6 minute walk test, was shown in 92% of patients properly receiving inhaled prostaglandin treatment with this device. The reference device we used to assess the complementation of treatment was useful in most of our patients. In 8% it was necessary to insist on health education until we made sure that they were using it correctly. This study reveals the importance of having objective information about our daily clinical practice.