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Rodríguez Espinosa N, Gonzalez-Colaço Harmand M, Moro Miguel MA. [Use of antipsychotics in patients with dementia in Spain: Comparison with prescription of acetylcholinesterase inhibitors and memantine and analysis of associations]. Rev Esp Geriatr Gerontol 2024; 59:101446. [PMID: 38029634 DOI: 10.1016/j.regg.2023.101446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE We have analyzed the prevalence of antipsychotics in patients with dementia in Spain, their age distribution and the influence of treatment with IACEs and memantine on their prescription. METHOD Descriptive, retrospective and cross-sectional study of the 2017 BIFAP database in over 65 years of age with dementia. Prescriptions of antipsychotics, IACEs and memantine were collected. For antipsychotics were also collected, the duration of treatment and time from dementia diagnosis to prescription. RESULTS A total of 1,327,792 subjects were retrieved, 89,464 (6.73%) with dementia. Antipsychotics were prescribed in 31.76%; by frequency: quetiapine (58.47%), risperidone (21%) and haloperidol (19.34%). Prescriptions of IACEs and memantine were clustered in those younger than 84 years and antipsychotics in those older than 85 (P<.001). Antipsychotics were maintained for a mean of 1174.5 days. In 26.4% of cases they were prescribed alone, OR 0.61 (95% CI: 0.59-0.62), in 35.85% associated with IACEs, OR 1.26 (95% CI: 1.22-1.30) and in 42.4% with memantine, OR 1.69 (95% CI: 1.62-1.78) (P<.000). From the diagnosis of dementia, 461 days (±1576.5) elapsed when isolated drugs were prescribed; 651 days (±1574.25) associated with IACEs and 1224 (±1779) with memantine. CONCLUSIONS One third of patients with dementia were prescribed antipsychotics, mostly atypical, more frequently in those older than 85 years and for prolonged periods. IACEs and memantine were associated with the risk of antipsychotic prescription, but paradoxically, with prolonged time to onset.
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Affiliation(s)
- Norberto Rodríguez Espinosa
- Unidad de Neurología de la Conducta y Memoria, Servicio de Neurología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Tenerife, España; Departamento de Medicina, Psiquiatría y Dermatología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna/Santa Cruz de Tenerife, Tenerife, España.
| | - Magali Gonzalez-Colaço Harmand
- Unidad de Investigación, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Tenerife, España; Universidad Europea de Canarias, La Orotava/Santa Cruz de Tenerife, Tenerife, España
| | - María Adoración Moro Miguel
- Unidad de Neurología de la Conducta y Memoria, Servicio de Neurología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Tenerife, España
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García-Martín V, de Hoyos-Alonso MC, Ariza-Cardiel G, Delgado-Puebla R, García-Domingo P, Hernández-Melo E, de Haro-de Torres JL, del Cura-González I. Neuropsychiatric symptoms and subsyndromes in patients with different stages of dementia in primary care follow-up (NeDEM project): a cross-sectional study. BMC Geriatr 2022; 22:71. [PMID: 35065615 PMCID: PMC8783993 DOI: 10.1186/s12877-022-02762-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 12/24/2021] [Indexed: 02/08/2023] Open
Abstract
Abstract
Background
The objective was to describe the prevalence and intensity of neuropsychiatric symptoms (NPSs) isolated and grouped into subsyndromes in patients with dementia in primary care (PC) to analyse their distribution based on stages of dementia and the relationship between them and the intensity of symptoms.
Methods
Design: Cross-sectional study. Setting and population: Patients with dementia, not institutionalized, in a PC follow-up. Variables: Sociodemographic and clinical variables. Assessment instruments: The frequency and intensity of NPSs were measured with the Neuropsychiatric Inventory (NPI), and the stages of dementia with the Global Deterioration Scale (GDS). Statistical analysis: The number of NPSs per patient, the mean NPI value, and the prevalence and intensity of NPSs isolated and grouped into subsyndromes were calculated, as were their 95% confidence intervals (CIs). The analyses were performed on an overall basis and by GDS scores. To analyse the association between the NPI and GDS scores, multivariate analysis was performed with a generalized linear model.
Results
Overall, 98.4% (95% CI 94.5;99.8) of the patients presented some type of NPS, with an average of five symptoms per patient. The most frequent symptoms were apathy [69.8% (95% CI 61.1;77.5)], agitation [55.8% (95% CI 46.8;64.5)] and irritability [48.8% (95% CI 39.9;57.8)]. The more intense NPSs were apathy [NPI 3.2 (95% CI 2.5;3.8)] and agitation [NPI 3.2 (95% CI 2.5;4.0)]. For subsyndromes, hyperactivity predominated [86.0% (95% CI 78.8;91.5)], followed by apathy [77.5% (95% CI 69.3;84.4]). By phase of dementia, the most common isolated symptom was apathy (60.7–75.0%). Affective symptoms and irritability predominated in the initial stages, and psychotic symptoms predominated in advanced stages. The mean NPI score was 24.9 (95% CI 21.5;28.4) and increased from 15.6 (95% CI 8.2;23.1) for GDS 3 to 28.9 (95% CI 12.6;45.1) for GDS 7. Patients with in the most advanced stages of dementia presented an NPI score 7.6 (95% CI 6.8;8.3) points higher than the score for mild dementia with adjustment for the other variables.
Conclusions
A high prevalence of NPSs was found among patients with dementia treated in PC. Symptoms change and increase in intensity as the disease progresses. Scales such as the NPI allow these symptoms to be identified, which may facilitate more stage-appropriate management.
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Llanes-Álvarez C, llano JMAD, Álvarez-Navares AI, Roncero C, Pastor-Hidalgo MT, Garmendia-Leiza JR, Andrés-Alberola I, Franco-Martín MA. Hospitalization and Socio-Health Care for Dementia in Spain. J Clin Med 2020; 9:jcm9123875. [PMID: 33260542 PMCID: PMC7760198 DOI: 10.3390/jcm9123875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 11/24/2022] Open
Abstract
Dementias are brain diseases that affect long-term cognitive and behavioral functions and cause a decrease in the ability to think and remember that is severe enough to disturb daily functioning. In Spain, the number of people suffering from dementia is rising due to population ageing. Reducing admissions, many of them avoidable, would be advantageous for patients and care-providers. Understanding the correlation of admission of people with dementia and its trends in hospitalization would help us to understand the factors leading to admission. We conducted a cross-sectional study of the hospital discharge database of Castilla y León from 2005 to 2015, selecting hospitalizations for dementia. Trends in hospitalizations by year and age quartiles were studied by joinpoint regression analysis. 2807 out of 2,717,192 total hospitalizations (0.10%) were due to dementias; the main groups were degenerative dementia (1907) followed by vascular dementia (607). Dementias are not a major cause of hospitalization, but the average stay and cost are high, and many of them seem avoidable. Decreasing trends were detected in hospitalization rates for all dementias except for the group of mild cognitive impairment, which grew. An increasing–decreasing joinpoint detected in 2007 for vascular dementia and the general downward hospitalization trends for most dementias suggest that socio-health measures established since 2007 in Spain might play a key role in reducing hospitalizations.
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Affiliation(s)
- Carlos Llanes-Álvarez
- Department of Psychiatry, Complejo Asistencial de Zamora, 49022 Zamora, Spain;
- Correspondence: ; Tel.: +34-980-548-820 (ext. 48200)
| | - Jesús M. Andrés-de llano
- Department of Pediatrics, Complejo Asistencial Universitario de Palencia, 34005 Palencia, Spain;
| | - Ana I. Álvarez-Navares
- Department of Psychiatry, University of Salamanca Health Care Complex, 37007 Salamanca, Spain; (A.I.Á.-N.); (C.R.)
| | - Carlos Roncero
- Department of Psychiatry, University of Salamanca Health Care Complex, 37007 Salamanca, Spain; (A.I.Á.-N.); (C.R.)
| | | | - José R. Garmendia-Leiza
- General Direction of Information Systems, Quality and Pharmaceutical Provision at Castilla y León Health Authority, Regional Health Management, 47007 Valladolid, Spain;
| | - Irene Andrés-Alberola
- Castilla y León Health Authority, Complejo Asistencial Universitario de Palencia, 34005 Palencia, Spain;
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Perez-Cabezas V, Ruiz-Molinero C, Jimenez-Rejano JJ, Gonzalez-Medina G, Galan-Mercant A, Martin-Valero R. Continuous Positive Airway Pressure Treatment in Patients with Alzheimer's Disease: A Systematic Review. J Clin Med 2020; 9:jcm9010181. [PMID: 31936521 PMCID: PMC7019587 DOI: 10.3390/jcm9010181] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 12/23/2019] [Accepted: 01/07/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Epidemiological studies have suggested a pathophysiological relationship between obstructive sleep apnea syndrome (OSAS) and Alzheimer’s disease (AD). The aim of this study is to evaluate the treatment of obstructive sleep apnea with continuous positive airway pressure (CPAP) in AD and its relationship with neurocognitive function improvement. Methods: Systematic review conducted following PRISMA’s statements. Relevant studies were searched in MEDLINE, PEDro, SCOPUS, PsycINFO, Web of Science, CINAHL and SportDicus. Original studies in which CPAP treatment was developel in AD patients have been included. Results: 5 studies, 3 RCTs (Randomized controlled trials) and 2 pilot studies. In all RCTs the CPAP intervention was six weeks; 3 weeks of therapeutic CPAP vs. 3 weeks placebo CPAP (pCPAP) followed by 3 weeks tCPAP in patients with AD and OSA. The two pilot studies conducted a follow-up in which the impact on cognitive impairment was measured. Conclusions: CPAP treatment in AD patients decreases excessive daytime sleepiness and improves sleep quality. There are indications that cognitive deterioration function measured with the Mini Mental Scale decreases or evolves to a lesser extent in Alzheimer’s patients treated with CPAP. Caregivers observe stabilization in disease progression with integration of CPAP. More research is needed on the topic presented.
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Affiliation(s)
- Veronica Perez-Cabezas
- Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain; (V.P.-C.); (C.R.-M.); (G.G.-M.); (A.G.-M.)
| | - Carmen Ruiz-Molinero
- Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain; (V.P.-C.); (C.R.-M.); (G.G.-M.); (A.G.-M.)
| | - Jose Jesus Jimenez-Rejano
- Department of Physiotherapy, University of Seville, 41009 Seville, Spain
- Correspondence: ; Tel.: +34-676-719119; Fax: +34-956252426
| | - Gloria Gonzalez-Medina
- Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain; (V.P.-C.); (C.R.-M.); (G.G.-M.); (A.G.-M.)
| | - Alejandro Galan-Mercant
- Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain; (V.P.-C.); (C.R.-M.); (G.G.-M.); (A.G.-M.)
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Parra-Anguita L, García-Fernández FP, del-Pino-Casado R, Pancorbo-Hidalgo PL. Knowledge about the Care of People with Alzheimer's Disease of the Nursing Staff of Nursing Homes in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16244907. [PMID: 31817315 PMCID: PMC6950273 DOI: 10.3390/ijerph16244907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/03/2019] [Accepted: 12/03/2019] [Indexed: 12/19/2022]
Abstract
People with Alzheimer’s disease often live in nursing homes. Updated knowledge among the nursing staff has led to better quality of care. The aim of this study was to measure the knowledge about the care of people with Alzheimer’s disease of the nursing staff of nursing homes in Spain. A cross-sectional study was conducted in 24 nursing homes in the province of Jaén (Spain) with a sample of 361 members of staff, i.e., registered nurses (RNs), assistant nurses (ANs), and eldercare workers (EWs). The University of Jaén UJA-Alzheimer’s Care Scale was used to measure the knowledge. The knowledge was higher among the RNs (83.3% of the maximum) than among the ANs and EWs (71.6%). Work experience and updated training were associated with the knowledge score in RNs, but only the updated training in ANs and EWs. Nursing homes with less experienced nursing staff and with a small proportion of staff receiving training on dementia have a low knowledge score. The nursing staff of nursing homes in Jaén have medium to high knowledge about Alzheimer’s care. There is a wide range of variation in the knowledge score among the nursing homes. Up-to-date staff training in dementia care is the factor with the strongest association with knowledge.
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Ponjoan A, Garre-Olmo J, Blanch J, Fages E, Alves-Cabratosa L, Martí-Lluch R, Comas-Cufí M, Parramon D, Garcia-Gil M, Ramos R. Epidemiology of dementia: prevalence and incidence estimates using validated electronic health records from primary care. Clin Epidemiol 2019; 11:217-228. [PMID: 30881138 PMCID: PMC6407519 DOI: 10.2147/clep.s186590] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Purpose Updated estimates of incidence and prevalence of dementia are crucial to ensure adequate public health policy. However, most of the epidemiological studies in the population in Spain were conducted before 2010. This study assessed the validity of dementia diagnoses recorded in electronic health records contained in a large primary-care database to determine if they could be used for research purposes. Then, to update the epidemiology of dementia in Catalonia (Spain), we estimated crude and standardized prevalence and incidence rates of dementia in Catalonia in 2016. Methods The System for the Development of Research in Primary Care (SIDIAP) database contains anonymized information for >80% of the Catalan population. Validity of dementia codes in SIDIAP was assessed in patients at least 40 years old by asking general practitioners for additional evidence to support the diagnosis. Crude and standardized incidence and prevalence (95% CI) in people aged ≥65 years were estimated assuming a Poisson distribution. Results The positive predictive value of dementia diagnoses recorded in SIDIAP was estimated as 91.0% (95% CI 87.5%–94.5%). Age-and sex-standardized incidence and prevalence of dementia were 8.6/1,000 person-years (95% CI 8.0–9.3) and 5.1% (95% CI 4.5%–5.7%), respectively. Conclusion SIDIAP contains valid dementia records. We observed incidence and prevalence estimations similar to recent face-to-face studies conducted in Spain and higher than studies using electronic health data from other European populations.
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Affiliation(s)
- Anna Ponjoan
- Vascular Health Research Group (ISV-Girona), Jordi Gol Institute for Primary Care Research (IDIAPJGol), Barcelona, Catalonia, Spain, .,Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain.,Santa Clara Primary Care Health Center, Catalan Health Institute, Girona, Catalonia, Spain
| | - Josep Garre-Olmo
- Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain
| | - Jordi Blanch
- Vascular Health Research Group (ISV-Girona), Jordi Gol Institute for Primary Care Research (IDIAPJGol), Barcelona, Catalonia, Spain,
| | - Ester Fages
- Vascular Health Research Group (ISV-Girona), Jordi Gol Institute for Primary Care Research (IDIAPJGol), Barcelona, Catalonia, Spain,
| | - Lia Alves-Cabratosa
- Vascular Health Research Group (ISV-Girona), Jordi Gol Institute for Primary Care Research (IDIAPJGol), Barcelona, Catalonia, Spain,
| | - Ruth Martí-Lluch
- Vascular Health Research Group (ISV-Girona), Jordi Gol Institute for Primary Care Research (IDIAPJGol), Barcelona, Catalonia, Spain, .,Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain.,Santa Clara Primary Care Health Center, Catalan Health Institute, Girona, Catalonia, Spain
| | - Marc Comas-Cufí
- Vascular Health Research Group (ISV-Girona), Jordi Gol Institute for Primary Care Research (IDIAPJGol), Barcelona, Catalonia, Spain,
| | - Dídac Parramon
- Vascular Health Research Group (ISV-Girona), Jordi Gol Institute for Primary Care Research (IDIAPJGol), Barcelona, Catalonia, Spain, .,Autonomous University of Barcelona, Bellaterra (Cerdanyola del Vallès), Catalonia, Spain
| | - María Garcia-Gil
- Vascular Health Research Group (ISV-Girona), Jordi Gol Institute for Primary Care Research (IDIAPJGol), Barcelona, Catalonia, Spain,
| | - Rafel Ramos
- Vascular Health Research Group (ISV-Girona), Jordi Gol Institute for Primary Care Research (IDIAPJGol), Barcelona, Catalonia, Spain, .,Department of Medical Sciences, School of Medicine, Campus Salut, University of Girona, Girona, Catalonia, Spain,
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Ruano L, Araújo N, Branco M, Barreto R, Moreira S, Pais R, Cruz VT, Lunet N, Barros H. Prevalence and Causes of Cognitive Impairment and Dementia in a Population-Based Cohort From Northern Portugal. Am J Alzheimers Dis Other Demen 2019; 34:49-56. [PMID: 30514090 PMCID: PMC10852416 DOI: 10.1177/1533317518813550] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Vascular disease may play an important role in the epidemiology of dementia in countries with high stroke incidence, such as Portugal. OBJECTIVE To assess the prevalence and etiology of cognitive impairment in a population-based cohort from Portugal. METHODS Individuals ≥55 years (n = 730) from the EPIPorto cohort were assessed using the Mini-Mental State Examination and the Montreal Cognitive Assessment. Those scoring below the age-/education-adjusted cutoff points were further evaluated to identify dementia or mild cognitive impairment (MCI) and to define its most common causes. RESULTS Thirty-six cases of MCI/dementia were identified, corresponding to adjusted prevalences of 4.1% for MCI and 1.3% for dementia. The most common cause of MCI/dementia was vascular (52.8%), followed by Alzheimer's disease (36.1%). CONCLUSION These findings highlight the importance of vascular cognitive impairment in the epidemiology of dementia in Portugal and carry an important public health message regarding its prevention and management, possibly extending to other countries with a high-stroke burden.
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Affiliation(s)
- Luis Ruano
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Serviço de Neurologia, Centro Hospitalar Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - Natália Araújo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Mariana Branco
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Serviço de Neurologia, Centro Hospitalar Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - Rui Barreto
- Serviço de Neurologia, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - Sandra Moreira
- Serviço de Neurologia, Unidade de Saúde Local de Matosinhos, Matosinhos, Portugal
| | - Ricardo Pais
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Vítor Tedim Cruz
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Serviço de Neurologia, Unidade de Saúde Local de Matosinhos, Matosinhos, Portugal
| | - Nuno Lunet
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Henrique Barros
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Criado-Álvarez J, González González J, Romo Barrientos C, Mohedano Moriano A, Montero Rubio J, Pérez Veiga J. Variability and trends in the consumption of drugs for treating attention-deficit/hyperactivity disorder in Castile-La Mancha, Spain (1992–2015). NEUROLOGÍA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.nrleng.2016.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Sarabia-Cobo CM, Parás-Bravo P, Amo-Setién FJ, Alconero-Camarero AR, Sáenz-Jalón M, Torres-Manrique B, Sarabia-Lavín R, Fernández-Rodríguez A, Silio-García T, Fernández-Peña R, Paz-Zulueta M, Santibáñez-Margüello M. Validation of the Spanish Version of the ICECAP-O for Nursing Home Residents with Dementia. PLoS One 2017; 12:e0169354. [PMID: 28068375 PMCID: PMC5222189 DOI: 10.1371/journal.pone.0169354] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 12/15/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Measurement of health-related quality of life (HRQoL) is important for a chronic disease, such as dementia, which impairs the quality of life of affected patients in addition to their length of life. This is important in the context of economic evaluations when interventions do not (only) affect HRQoL and these other factors also affect overall quality of life. OBJECTIVE To validate the Spanish translation of the ICECAP-O's capability to measure Health-related quality of life in elderly with dementia who live in nursing homes. METHOD Cross-sectional study. For 217 residents living in 8 Spanish nursing homes, questionnaires were completed by nursing professionals serving as proxy respondents. We analyzed the internal consistency and other psychometric properties. We investigated the convergent validity of the ICECAP-O with other HRQoL instruments, the EQ-5D extended with a cognitive dimension (EQ-5D+C), the Alzheimer's Disease Related Quality of Life (ADRQL) measures, and the Barthel Index measure of activities of daily living (ADL). RESULTS The ICECAP-O presents satisfactory internal consistency (alpha 0.820). The factorial analysis indicated a structure of five principal dimensions that explain 66.57% of the total variance. Convergent validity between the ICECAP-O, EQ-5D+C, ADRQL, and Barthel Index scores was moderate to good (with correlations of 0.62, 0.61, and 0.68, respectively), but differed between dimensions of the instruments. Discriminant validity was confirmed by finding differences in ICECAP-O scores between subgroups based on ADL scores (0.70 low, 0.59 medium, and 0.39 high level care), dementia severity (0.72 mild, 0.63 medium, and 0.50 severe), and ages (0.59 below 75 years and 0.84 above 75 years). CONCLUSIONS This study presented the first use of a Spanish version of the ICECAP-O. The results indicate that the ICECAP-O appears to be a reliable Health-related quality of life measurement instrument showing good convergent and discriminant validity for people with dementia.
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Criado-Álvarez JJ, González González J, Romo Barrientos C, Mohedano Moriano A, Montero Rubio JC, Pérez Veiga JP. Variability and trends in the consumption of drugs for treating attention-deficit/hyperactivity disorder in Castile-La Mancha, Spain (1992-2015). Neurologia 2016; 33:S0213-4853(16)30171-2. [PMID: 27645774 DOI: 10.1016/j.nrl.2016.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 07/15/2016] [Accepted: 07/19/2016] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Attention-deficit/hyperactivity disorder (ADHD) is one of the most common behavioural disorders of childhood; its prevalence in Spain is estimated at 5-9%. Available treatments for this condition include methylphenidate, atomoxetine, and lisdexamfetamine, whose consumption increases each year. MATERIAL AND METHODS The prevalence of ADHD was estimated by calculating the defined daily dose per 1,000 population per day of each drug and the total doses (therapeutic group N06BA) between 1992 and 2015 in each of the provinces of Castile-La Mancha (Spain). Trends, joinpoints, and annual percentages of change were analysed using joinpoint regression models. RESULTS The minimum prevalence of ADHD in the population of Castile-La Mancha aged 5 to 19 was estimated at 13.22 cases per 1,000 population per day; prevalence varied across provinces (p<.05). Overall consumption has increased from 1992 to 2015, with an annual percentages of change of 10.3% and several joinpoints (2000, 2009, and 2012). methylphenidate represents 89.6% of total drug consumption, followed by lisdexamfetamine at 8%. CONCLUSIONS Analysing drug consumption enables us to estimate the distribution of ADHD patients in Castile-La Mancha. Our data show an increase in the consumption of these drugs as well as differences in drug consumption between provinces, which reflect differences in ADHD management in clinical practice.
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Affiliation(s)
- J J Criado-Álvarez
- Departamento de Ciencias Médicas, Facultad de Terapia Ocupacional, Logopedia y Enfermería, Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, España; Centro de Salud de La Pueblanueva, Gerencia de Atención Integrada de Talavera de la Reina, Servicio de Salud de Castilla-La Mancha (SESCAM).
| | - J González González
- Departamento de Ciencias Médicas, Facultad de Terapia Ocupacional, Logopedia y Enfermería, Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, España; Centro de Salud de Santa Olalla, Gerencia de Atención Integrada de Talavera de la Reina, Servicio de Salud de Castilla-La Mancha (SESCAM)
| | - C Romo Barrientos
- Servicio de Salud Mental, Gerencia de Atención Integrada de Talavera de la Reina, Servicio de Salud de Castilla-La Mancha (SESCAM)
| | - A Mohedano Moriano
- Departamento de Ciencias Médicas, Facultad de Terapia Ocupacional, Logopedia y Enfermería, Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, España
| | - J C Montero Rubio
- Servicio de Laboratorio, Instituto de Ciencias de la Salud de Castilla-La Mancha, Consejería de Sanidad de Castilla-La Mancha, Talavera de la Reina, Toledo, España
| | - J P Pérez Veiga
- Servicio de Control Farmacéutico, Área de Farmacia, Servicio de Salud de Castilla-La Mancha (SESCAM), Toledo, España
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