Multimorbilidad y Prevención Cuaternaria (P4)
DOI:
https://doi.org/10.5712/rbmfc10(35)1069Palabras clave:
Salud del Anciano, Comorbilidad, Interacciones de Drogas, Medicalización, Prevención CuaternariaResumen
La multimorbilidad se convirtió en la norma para la mayoría de los pacientes que acuden a la atención primaria, y mientras que la proporción de los que tienen multimorbilidad es mayor en la edad avanzada, el número absoluto de personas con multimorbilidad es mayor en los menores de 65 años. El modelo de tratamiento de enfermedad-única, basado en el especialista focal, supone que cada enfermedad-índice es la enfermedad dominante en un sistema complejo, y que las otras comorbilidades se mantienen constantes, mientras que su manejo es centrado en una única condición. Así, las directrices de enfermedades-únicas para una persona con cinco comorbilidades crónicas, no importando cuales sean ellas, resulta en una polifarmacia, potencialmente dañosa. Este enfoque ha dado lugar a la actual “epidemia” de morbilidad y mortalidad debido a las reacciones adversas a los medicamentos, que ya superan las enfermedades-objetivo como causas de muerte. En este artículo, se destacan cuatro características de la prevención cuaternaria, que los administradores de salud deberían tener en cuenta al considerar la calidad de la atención de salud.
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