Background: Adherence to treatment, a public health issue, is of particular importance in chronic disease therapies. Primary care practices offer ideal venues for the effective care and management of these conditions. The aim of this study is to assess adherence to treatment and related-factors among patients with chronic conditions in primary care settings. Methods: A cross-sectional study was conducted among 299 adult patients with ≥1 chronic condition(s) and prescribed medication in primary healthcare centers of Spain. The Morisky-Green-Levine questionnaire was used to assess medication adherence via face-to-face interviews. Crude and adjusted multivariable logistic regression models were used to analyze factors associated with adherence using the Multidimensional Model proposed by the World Health Organization — social and economic, healthcare team and system-related, condition-related, therapy-related, and patient-related factors. Results: The proportion of adherent patients to treatment was 55.5%. Older age (adjusted odds ratio 1.31 per 10-year increment, 95% CI 1.01–1.70), lower number of pharmacies used for medication refills (0.65, 95% CI 0.47–0.90), having received complete treatment information (3.89, 95% CI 2.09–7.21), having adequate knowledge about medication regimen (4.17, 95% CI 2.23–7.80), and self-perception of a good quality of life (2.17, 95% CI 1.18–4.02) were independent factors associated with adherence. Conclusions: Adherence to treatment for chronic conditions remained low in primary care. Optimal achievement of appropriate levels of adherence through tailored multifaceted interventions will require attention to the multidimensional factors found in this study, particularly those related to patients’ education and their information needs.

The aim of this study was to assess the relation between perceived social support and personal autonomy of individuals with intellectual disabilities and Health-Related Quality of Life. A cross-sectional study with a multicentre sample was carried out including 162 institutionalized individuals with intellectual disability. The measurement tool was a structured questionnaire with sociodemographic variables, and three scales: Functional Independence Measure(FIM) scale, Duke-UNC Functional Social Support Questionnaire, and SF-36 Health Survey, which were completed during an individual/family interview. The perception of received social support is high on all 11 items of the Duke-UNC questionnaire, with an average of 3.45 for item-1 and 4.85 for item-11, which represents a total perceived support of an average 47.98 points (±SD7.30) (normal support). The Mental-Health component is rated worse than Physical-Health (67.41 vs. 71.74). The average rates for the different dimensions range from 57.34 points for Social-Functioning (the lowest rating) to 79.61 points for Bodily-Pain (highest rating). A multiple linear regression analysis reveals that the dimensions of Physical-Functioning (p < 0.001), Role-Physical (p = 0.016) and Bodily-Pain (p = 0.022), which are elements of the Physical-Health component, are independent predictive variables with the Degree of Autonomy (FIM) as a dependent variable. Social-Support (Duke-UNC) as a dependent variable is determined by the dimensions of Vitality (p = 0.014), Role-Emotional (p = 0.001) and Mental-Health (p < 0.001), which are part of the Mental-Health component and act as independent predictive variables. Individuals with intellectual disability and a higher degree of personal autonomy determined by institutional and family support report better Health and Quality of Life.

To perform a systematic review to analyze the association between occupational exposure to wood dust and cancer. A systematic literature search of entries made in the MEDLINE-PubMed database between 1957 and 2013 was conducted to identify studies that had assessed the relationship between occupational exposure to wood dust and different types of cancer. A meta-analysis of selected case-control and cohort studies was subsequently performed. A total of 114 studies were identified and 70 were selected for review. Of these, 42 studies focused on the relationship between wood dust and nasal cancer (n = 22), lung cancer (n = 11), and other types of cancer (n = 9). Low-to-moderate quality evidence that wood dust acts as a carcinogen was obtained, and a stronger association between wood dust and nasal adenocarcinoma was observed. A lesser association between wood dust exposure and lung cancer was also observed. Several studies suggested that there is a relationship between wood dust and the onset of other cancers, although there was no evidence to establish an association. A meta-analysis that included four case-controls studies showed that workers exposed to wood dust exhibited higher rates of nasal adenocarcinoma than other workers (odds ratio = 10.28; 95% confidence interval: 5.92 and 17.85; P<0,0001), although a large degree of heterogeneity was found. Low-to-moderate quality evidence supports a causal association between cancer and occupational exposure to wood dust, and this association was stronger for nasal adenocarcinoma than for lung cancer. There was no evidence of an association between wood dust exposure and the other cancers examined.