Redefiniendo la atención primaria: recomendaciones de CARABELA-AP para el manejo de enfermedades crónicas prevalentes

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN Pub Date : 2025-09-18 DOI:10.1016/j.semerg.2025.102586

J. Polo , P. Rodríguez , I. Mediavilla , A. Pérez , L. Regadera , E. Fitas , C. Moreno , A. Prado , A. Izarra , R.M. Micó-Pérez , el Comité Científico de CARABELA-AP

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引用次数: 0

Abstract

Aim

The CARABELA-AP initiative aims to optimize the comprehensive management of prevalent chronic diseases (PCDs), such as asthma, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, and heart failure, within the Primary Care (PC) setting in Spain.

Material and methods

The CARABELA methodology is structured into four phases: (1) characterization of the care process and development of quality indicators; (2) validation of results in pilot centers and identification of areas for improvement and potential solutions; (3) prioritization of improvement areas/solutions and consensus on indicators in a national meeting using the Delphi methodology; and (4) dissemination of results and implementation in other healthcare centers through the development of a guide to optimize and coordinate PCD management.

Results

The analysis conducted in 104 pilot centers allowed for the characterization and standardization of the care process for the five PCDs, from diagnosis to follow-up. Additionally, 21 areas for improvement and 37 key solutions were identified and prioritized based on their impact and ease of implementation. Among the 35 quality indicators developed, 33 were validated.

Discussion

CARABELA-AP proposes the groundwork for transforming the PC care model by strengthening multidisciplinary coordination and promoting a more efficient and sustainable management of PCDs. The structured implementation of key solutions and identified areas for improvement supports a comprehensive approach that ensures continuity of care and equitable access to treatment for these conditions. Additionally, the developed framework enables the adaptation of strategies to the local needs of the healthcare centers and facilitates ongoing monitoring of their impact through quality care indicators.

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[重新定义初级保健：流行慢性病管理的CARABELA-PC建议]。

目的：CARABELA-AP计划旨在优化西班牙初级保健（PC）环境中流行慢性病（PCDs）的综合管理，如哮喘、糖尿病、慢性阻塞性肺病、慢性肾病和心力衰竭。材料和方法：CARABELA方法分为四个阶段：(1)护理过程的表征和质量指标的制定；(2)验证试点中心的结果，确定需要改进的领域和潜在的解决方案；(3)利用德尔菲方法确定改进领域/解决方案的优先次序，并在全国会议上就指标达成共识；(4)通过制定优化和协调PCD管理的指南，在其他医疗中心传播和实施结果。结果：在104个试点中心进行的分析允许对五种慢性阻塞性肺病的护理过程进行表征和标准化，从诊断到随访。此外，还确定了21个有待改进的领域和37个关键解决方案，并根据其影响和实施难易程度确定了优先次序。在制定的35项质量指标中，有33项得到了验证。讨论：CARABELA-AP提出了通过加强多学科协调和促进更有效和可持续的PCDs管理来转变PC护理模式的基础。有组织地实施关键解决方案和确定需要改进的领域，有助于采取综合办法，确保这些疾病的护理连续性和公平获得治疗的机会。此外，制定的框架使战略能够适应医疗保健中心的当地需求，并通过优质护理指标促进对其影响的持续监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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