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Martín-Saborido C, Zarranz-Ventura J, Escobar-Barranco JJ, Garay-Aramburu G, García-Layana A, Donate-López J, Blanch C, Abraldes M. Cost-utility model of new intravitreous units vs. current patient journey model in Spain. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:619-626. [PMID: 37722561 DOI: 10.1016/j.oftale.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/06/2023] [Indexed: 09/20/2023]
Abstract
AIM To compare the effectiveness and costs of the implementation of the Intravitreal Therapy Unit Model, endorsed by the SERV, SECA, SEO and SEDISA, compared to the usual procedure. METHOD Analytical decision model that compares an UTI-type healthcare organization with 4 usual practice scenarios in Spain, in terms of quality-of-life results due to loss of visual acuity and the use of resources. The probability, cost, and quality-adjusted life years (QALYs) were estimated for each scenario proposed. A univariate sensitivity analysis was performed for each of the parameters used in the model. RESULT The model showed that from any of the initial scenarios of the usual practice, transitioning to the UTI-type implementation improves the quality of life of patients and requires lower cost. UTI-type is dominant respect usual practice. The sensitivity analysis showed that the results would not change sign with the variation of any starting variable. CONCLUSIONS Shorten suspicion-needle times is key to maintaining functional vision in patients requiring intravitreal treatment. The UTI-type model seeks the efficiency of ophthalmology services and can produce savings that vary between Є175 and Є85 per patient attended per year.
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Affiliation(s)
- C Martín-Saborido
- Escuela Nacional de Sanidad (ENS), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Educación Superior Hygiea, UDIMA, Madrid, Spain
| | - J Zarranz-Ventura
- Institut Clínic d'Oftalmologia (ICOF), Hospital Clínic, Barcelona, Spain; Institut de Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - G Garay-Aramburu
- Servicio de Oftalmología OSI Bilbao Basurto, Begiker, Instiuto de Investigaciones Sanitarias Biocruces Bizkaia, UPV-EHU, Bilbao, Spain
| | - A García-Layana
- Departamento de Oftalmología Clínica, Universidad de Navarra, Pamplona, Spain
| | - J Donate-López
- Hospital Universitario La Luz, Madrid, Spain; Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - C Blanch
- Health Economics and Evidence Strategy, Novartis Farmacéutica, Barcelona, Spain.
| | - M Abraldes
- Servicio de Oftalmología, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Instituto Oftalmológico Gómez Ulla, Santiago de Compostela, Spain
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Cabrera López F, Escobar-Barranco JJ, Ventayol P, Pérez-Alcántara F, Gómez-Baldó L, Blanch C. Cost minimization analysis of brolucizumab in the treatment of neovascular age-related macular degeneration. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:155-162. [PMID: 36371053 DOI: 10.1016/j.oftale.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 08/25/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Brolucizumab is a novel anti-vascular endothelial growth factor (anti-VEGF) drug administered in a fixed regimen of 8 or 12 weeks which, in the HAWK and HARRIER studies, was shown not to be inferior to aflibercept with respect to the best corrected visual acuity, with a less burdensome treatment regimen. The aim of the analysis was to compare the direct healthcare costs of both anti-VEGF as a treatment in patients with neovascular age-related macular degeneration. MATERIAL AND METHODS A cost minimization analysis was performed under a 25-year time horizon and considering the drug costs, administration, follow-up tests, and management of adverse events. Resource use was obtained from the related literature and validated by clinical experts. Various scenario analysis were carried out to check the robustness of the results. RESULTS Brolucizumab resulted in a lower cost per patient compared with aflibercept, considering the number of injections derived from the HAWK and HARRIER studies. This result was maintained in the different scenarios analysed, except for the number of injections of the flexible aflibercept regimen of the ARIES study, since the lower discontinuation of treatment with brolucizumab implies maintaining the treatment of more patients. Considering the same discontinuation, brolucizumab maintained the results observed in the base case of the analysis. CONCLUSIONS This study shows how the fixed administration regimen of brolucizumab can help reduce both healthcare and patients' burden.
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Affiliation(s)
- F Cabrera López
- Servicio de Oftalmología, Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Spain
| | | | - P Ventayol
- Servicio de Farmacia Hospitalaria, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | | | | | - C Blanch
- Departamento de Economía de la Salud, Novartis Farmacéutica S.A., Barcelona, Spain
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Garcia-Casanovas A, Ruiz-López PM, Blanch C, Varela Rodríguez C. [Practical considerations for implementing health outcomes measurement projects within a healthcare organization: Delphi Expert Consensus Study]. J Healthc Qual Res 2022; 37:326-334. [PMID: 35272975 DOI: 10.1016/j.jhqr.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/26/2021] [Accepted: 12/29/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Measuring health outcomes and costs per patient is an essential element of value-based healthcare (VBHC). The aim of the study was to generate expert consensus on the activities required to implement it. METHODS A two-round modified Delphi study with healthcare professionals, quality and clinical management methodologists and managers with academic and/or practical experience in outcome measurement projects. A median equal to or greater than 4 and a relative interquartile range (RIQR) equal to or greater than 25% were established as consensus criteria. RESULTS Consensus was obtained on 91% of the items (N=74/81). In terms of feasibility, the items that received the highest score and consensus were the existence of data protection guarantees (median=5; mean=4.8; RIQR=0%), the vision and motivation of healthcare professionals (median=5; mean=4.7; RIQR=20%), the existence and availability of ICT tools (or systems) for data recording (median=5; mean=4.5; RIQR=20%), and having sufficient funding to undertake the project (median=5; mean=4.2; RIQR=20%). The most highly rated factors adding complexity were the number of units or departments involved in the care process for the clinical condition (median=5; mean=4.4; RIQR=20%), having an accepted set of monitoring indicators for the condition (median=5; mean=4.4; RIQR=20%), and the involvement of several levels of care in the project (median=5; mean=4.3; RIQR=20%). CONCLUSIONS We describe practical aspects for the application of systematic outcomes measurement in routine clinical practice. These results can serve as a tool for prioritising, sizing, resource planning, and estimating implementation costs.
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Affiliation(s)
- A Garcia-Casanovas
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España.
| | - P M Ruiz-López
- Instituto de investigaciones biomédicas del Hospital Universitario 12 de Octubre (IMAS12), Madrid, España
| | - C Blanch
- Health Economics & Evidence Strategy, Departamento de acceso y relaciones con el sistema sanitario, Novartis Farmacéutica S.A., Barcelona, España
| | - C Varela Rodríguez
- Unidad de Calidad - Hospital Universitario 12 de Octubre, Madrid, España; Instituto de investigaciones biomédicas del Hospital Universitario 12 de Octubre (IMAS12), Madrid, España
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Jiménez-Morales A, Cáliz R, Aceituno S, Prades M, Blanch C. A cost-consequence analysis of the preferential use of secukinumab versus adalimumab for the treatment of psoriatic arthritis. ACTA ACUST UNITED AC 2021; 17:536-542. [PMID: 34756316 DOI: 10.1016/j.reumae.2020.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 05/13/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To assess the efficiency of secukinumab compared to adalimumab as first biologic treatment for psoriatic arthritis (PsA) from the Spanish National Health System (SNHS) perspective. METHODS A cost-consequence analysis of the cost and clinical response of two treatment strategies was conducted over a 2-year time horizon. A hypothetical cohort of 10 patients with PsA initiated treatment with secukinumab 150mg (cohort A) or adalimumab 40mg (cohort B), respectively. Patients achieving clinical response (ACR20/50/70) at week 24 continued the initial treatment, while patients with inadequate response switched to secukinumab 300mg. Pharmacological costs were calculated based on SmPC (notified ex-factory price). The lowest cost of adalimumab biosimilar was considered. Data on clinical response were extracted from the two matching-adjusted indirect comparison (MAIC) published comparing secukinumab vs adalimumab. Results were expressed as the cost difference between the two cohorts (€, 2019) and were calculated for each clinical response criteria (ACR20/50/70) and for each MAIC. Sensitivity analysis assessed the impact of potential discounts on the cost of adalimumab while maintaining the cost of secukinumab unchanged. RESULTS Depending on the MAIC used, the cost of initiating biologic treatment for PsA with secukinumab 150mg was 18-33% lower than the one estimated for adalimumab 40mg, for ACR20, 18-28% for ACR50, and 16-23% for ACR70 response rate. Sensitivity analysis showed that it would be necessary a discount of 40-60%, 40-65% and 50-75% over the adalimumab cost to compensate for the differences in efficacy observed for ACR20/50/70, respectively, depending on the MAIC used. CONCLUSION In patients with PsA, secukinumab could be considered a more efficient first-line biologic treatment compared to adalimumab, from the SNHS perspective.
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Affiliation(s)
| | - Rafael Cáliz
- Virgen de las Nieves University Hospital, Granada, Spain
| | | | | | - Carles Blanch
- Novartis Pharmaceuticals, Novartis Farmacéutica, Barcelona, Spain.
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Puig L, Ferrándiz C, Pujol RM, Vela E, Albertí-Casas C, Comellas M, Blanch C. Burden of Psoriasis in Catalonia: Epidemiology, Associated Comorbidities, Health Care Utilization, and Sick Leave. Actas Dermosifiliogr (Engl Ed) 2020; 112:425-433. [PMID: 33290733 DOI: 10.1016/j.ad.2020.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Epidemiologic and disease burden data are essential for disease control and optimal health care resource planning. The aims of this study were to estimate the epidemiologic burden of psoriasis and evaluate associated comorbidities, health care utilization, and sick leave. MATERIAL AND METHODS We collected data from the 2016 Catalan Health Survey (ESCA), the Catalan Registry of Morbidity and Utilization of Health Care Services (MUSSCAT) (2016), and the database of the Catalan Medical Evaluations Institute (ICAM) (2012-2016). RESULTS The prevalence of psoriasis in Catalonia according to 2016 ESCA data is approximately 1.8%. The MUSSCAT registry data indicate that the incidence has remained stable in recent years. The most common comorbidities associated with psoriasis are hypertension (35%) and diabetes (15%). Forty percent of patients with psoriasis have a moderate to high risk for death or high health resource utilization. Annual use of resources by psoriasis patients is high: they make a mean of 8.7 primary care visits, 2.8 outpatient visits, 0.5 emergency and day hospital visits, 0.2 mental health visits, and use 6.1 medications. Sick leave due to psoriasis or psoriatic arthritis accounted for 0.04% of all cases. CONCLUSIONS The prevalence of psoriasis in Catalonia is high at 1.8%. The disease burden is also high, both in terms of comorbidities and health care utilization.
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Affiliation(s)
- L Puig
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - C Ferrándiz
- Servicio de Dermatología, Hospital Universitari Germans Trías i Pujol (HUGiT), Badalona, España
| | - R M Pujol
- Servicio de Dermatología, Hospital del Mar, Barcelona, España
| | - E Vela
- Àrea de Sistemes d'Informació, Servei Català de la Salut, Barcelona, España
| | - C Albertí-Casas
- Subdirecció General d'Avaluacions Mėdiques, Departament de Salut, Barcelona, España
| | - M Comellas
- Outcomes'10, Espaitec 2, Universitat Jaume 1, Castelló de la Plana, España
| | - C Blanch
- Health Economics & Market Access Novartis Farmacéutica, Barcelona, España.
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Irimia P, Garrido-Cumbrera M, Santos-Lasaosa S, Braçe O, Colomina I, Blanch C, Pozo-Rosich P. Estimating the savings associated with a migraine-free life: results from the Spanish Atlas. Eur J Neurol 2020; 27:2616-2624. [PMID: 32643853 DOI: 10.1111/ene.14431] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 07/01/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Migraine is a common and costly neurological disorder. The aims of this study were to quantify the costs of chronic (CM) and episodic migraine (EM) in Spain, evaluating the impact of psychiatric comorbidities and disability, and to estimate the economic savings associated with reducing the number of migraine-days by 50%. METHODS This was an observational, cross-sectional analysis of data from migraine patients who participated in the Spanish Migraine Atlas. The participants were invited to complete a structured questionnaire including the following scales: the Headache Needs Assessment, the Hospital Anxiety and Depression Scale, and the Migraine Disability Assessment Scale (MIDAS). RESULTS A total of 475 patients were included, of whom 187 had CM (39.4%). Total costs per patient/year were: €16 578.2 ± €34 568.1 for CM and €6227.8 ± €6515.7 for EM. A higher degree of disability, according to MIDAS, significantly increased the total cost of migraine, while the presence of psychiatric comorbidity increased costs for EM patients only. A reduction of 1 migraine-day per month decreased average total costs by €744.14 per patient/year for EM and €663.20 per patient/year for CM, while a reduction in the number of migraine-days by 50% would result in economic savings of €2232.44 per patient/year (R2 = 0.927) for EM and €6631.99 per patient/year (R2 = 0.886) for CM. CONCLUSIONS The costs associated with migraine were driven by migraine frequency and the degree of disability, whereas psychiatric comorbidity only influenced the cost of EM. These results highlight the need to optimize migraine management to reduce the economic migraine burden. Future studies are needed to confirm our results.
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Affiliation(s)
- P Irimia
- Neurology Department, Clínica Universidad de Navarra, Pamplona, Spain.,Navarra's Health Research Institute (IDISNA), Pamplona, Spain.,Headache Study Group of the Spanish Neurological Society (GECSEN), Madrid, Spain
| | - M Garrido-Cumbrera
- Health and Territory Research (HTR), Universidad de Sevilla, Sevilla, Spain
| | - S Santos-Lasaosa
- Headache Study Group of the Spanish Neurological Society (GECSEN), Madrid, Spain.,Neurology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.,Instituto de Investigación Sanitaria IIS Aragón, Zaragoza, Spain
| | - O Braçe
- Health and Territory Research (HTR), Universidad de Sevilla, Sevilla, Spain
| | - I Colomina
- President of the Spanish Patient's Association of Migraine and Headache (AEMICE), Madrid, Spain
| | - C Blanch
- Market Access, Novartis, Barcelona, Spain
| | - P Pozo-Rosich
- Headache Study Group of the Spanish Neurological Society (GECSEN), Madrid, Spain.,Headache Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona, Spain.,Headache Research Group, VHIR, Universitat Autónoma de Barcelona, Barcelona, Spain
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Jiménez-Morales A, Cáliz R, Aceituno S, Prades M, Blanch C. A Cost-Consequence Analysis of the Preferential Use of Secukinumab Versus Adalimumab for the Treatment of Psoriatic Arthritis. Reumatol Clin (Engl Ed) 2020; 17:S1699-258X(20)30132-7. [PMID: 32693948 DOI: 10.1016/j.reuma.2020.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To assess the efficiency of secukinumab compared to adalimumab as first biologic treatment for psoriatic arthritis (PsA) from the Spanish National Health System (SNHS) perspective. METHODS A cost-consequence analysis of the cost and clinical response of two treatment strategies was conducted over a 2-year time horizon. A hypothetical cohort of 10 patients with PsA initiated treatment with secukinumab 150mg (cohort A) or adalimumab 40mg (cohort B), respectively. Patients achieving clinical response (ACR20/50/70) at week 24 continued the initial treatment, while patients with inadequate response switched to secukinumab 300mg. Pharmacological costs were calculated based on SmPC (notified ex-factory price). The lowest cost of adalimumab biosimilar was considered. Data on clinical response were extracted from the two matching-adjusted indirect comparison (MAIC) published comparing secukinumab vs adalimumab. Results were expressed as the cost difference between the two cohorts (€, 2019) and were calculated for each clinical response criteria (ACR20/50/70) and for each MAIC. Sensitivity analysis assessed the impact of potential discounts on the cost of adalimumab while maintaining the cost of secukinumab unchanged. RESULTS Depending on the MAIC used, the cost of initiating biologic treatment for PsA with secukinumab 150mg was 18-33% lower than the one estimated for adalimumab 40mg, for ACR20, 18-28% for ACR50, and 16-23% for ACR70 response rate. Sensitivity analysis showed that it would be necessary a discount of 40-60%, 40-65% and 50-75% over the adalimumab cost to compensate for the differences in efficacy observed for ACR20/50/70, respectively, depending on the MAIC used. CONCLUSION In patients with PsA, secukinumab could be considered a more efficient first-line biologic treatment compared to adalimumab, from the SNHS perspective.
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Affiliation(s)
| | - Rafael Cáliz
- Virgen de las Nieves University Hospital, Granada, Spain
| | | | | | - Carles Blanch
- Novartis Pharmaceuticals, Novartis Farmacéutica, Barcelona, Spain.
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Merino M, Jiménez M, Manito N, Casariego E, Ivanova Y, González‐Domínguez A, San Saturnino M, Hidalgo‐Vega Á, Blanch C. The social return on investment of a new approach to heart failure in the Spanish National Health System. ESC Heart Fail 2020; 7:130-137. [PMID: 31916416 PMCID: PMC7083495 DOI: 10.1002/ehf2.12535] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 09/12/2019] [Accepted: 09/17/2019] [Indexed: 11/11/2022] Open
Abstract
AIMS We aim to agree on a set of proposals to improve the current management of heart failure (HF) within the Spanish National Health System (SNHS) and apply the social return on investment (SROI) method to measure the social impact that these proposals would generate. METHODS AND RESULTS A multidisciplinary working team of 16 experts was set up, with representation from the main stakeholders regarding HF: medical specialists (cardiologists, internal medicine physicians, general practitioners, and geriatric physicians), nursing professionals, health management professionals, patients, and informal caregivers. This team established a set of proposals to improve the management of HF according to the main areas of HF care: emergency and hospitalization, primary care, cardiology, and internal medicine. A forecast-type SROI method, with a 1-year time frame, was applied to measure the social impact resulting from the implementation of these proposals. The required investment and social return were estimated and summarized into a ratio indicating how much social return could be generated for each euro invested. Intangible returns were included and quantified through financial proxies. The approach to improve the management of HF consisted of 28 proposals, including the implementation of a case management nurse network, standardization of operational protocols, psychological support, availability of echocardiography machines at emergency departments, stationary units and primary care, early specialist visits after hospital discharge, and cardiac rehabilitation units, among others. These proposals would benefit not only patients and their informal caregivers but also the SNHS. Regarding patients, proposals would increase their autonomy in everyday activities, decrease anxiety, increase psychological and physical well-being, improve pharmacological adherence and self-care, enhance understanding of the disease, delay disease progression, expedite medical assessment, and prevent the decrease in work productivity associated with HF management. Regarding informal caregivers, proposals would increase their quality of life; improve their social, economic, and emotional well-being; and reduce their care burden. The SNHS would benefit from shorter stays of HF patients at intensive care units and reduction of hospitalizations and admissions to emergency departments. The investment needed to implement these proposals would amount to €548m and yield a social return of €1932m, that is, €3.52 for each euro invested. CONCLUSIONS The current management of HF could be improved by a set of proposals that resulted in an overall positive social return, varying between areas of analysis. This may guide the allocation of healthcare resources and improve the quality of life of patients with HF.
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Affiliation(s)
- María Merino
- Department of Health Outcomes ResearchInstituto Max WeberMadridSpain
| | - Margarita Jiménez
- Department of Pharmacoeconomics and Market AccessInstituto Max WeberMadridSpain
| | - Nicolás Manito
- Department of Heart Failure and TransplantHospital Universitario de Bellvitge, Hospitalet de LlobregatBarcelonaSpain
| | - Emilio Casariego
- Department of Internal MedicineComplejo Hospitalario de LugoLugoSpain
| | - Yoana Ivanova
- Department of Pharmacoeconomics and Market AccessInstituto Max WeberMadridSpain
| | | | | | - Álvaro Hidalgo‐Vega
- Economy and Health Research SeminarUniversidad de Castilla‐La ManchaToledoSpain
| | - Carles Blanch
- Early Access & Health EconomicsNovartisBarcelonaSpain
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Carretero G, Moreno D, González-Domínguez A, Trigos D, Ledesma A, Sarquella E, Merino M, Blanch C. Multidisciplinary approach to psoriasis in the Spanish National Health System: A social return on investment study. Glob Reg Health Technol Assess 2020; 7:50-56. [PMID: 36627964 PMCID: PMC9677591 DOI: 10.33393/grhta.2020.2146] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 06/22/2020] [Indexed: 01/13/2023] Open
Abstract
Introduction Psoriasis is a chronic disease in which patients feel stigmatization, social rejection, and suffer from low self-esteem. There are still unmet needs that make it necessary to define a new multidisciplinary approach to provide benefits not only to patients and their families but also to the Spanish National Health System (SNHS) and society. The aim was to define a new approach to better address the unmet needs of patients with psoriasis within the SNHS and to measure its impact from a social perspective, that is, in clinical, health care, economic, and social terms. Methods Multidisciplinary experts identified, agreed on, and selected several health care interventions that were feasible for implementation in the SNHS. This process was carried out in four different areas: diagnosis, mild psoriasis, moderate psoriasis, and severe psoriasis. To estimate investment and social return, the social return on investment (SROI) method was used. Results The new approach to psoriasis management in the SNHS comprised 18 proposals. The investment needed for the implementation of this new approach would amount to €222.77 million and its return to €1,123.11 million. This would yield a SROI ratio of €5.04 for every euro invested. Conclusion The new approach to psoriasis management would yield a positive social return. The results will allow optimal strategic planning adapted to each assistance situation, to achieve a comprehensive and multidisciplinary approach.
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Affiliation(s)
| | - David Moreno
- Department of Dermatology, Virgen Macarena Hospital, Seville - Spain
| | | | - David Trigos
- Acción Psoriasis, Psoriasis Patients and Relatives Association, Barcelona - Spain
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10
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Torre-Alonso JC, Queiro R, Comellas M, Lizán L, Blanch C. Patient-reported outcomes in European spondyloarthritis patients: a systematic review of the literature. Patient Prefer Adherence 2018; 12:733-747. [PMID: 29780239 PMCID: PMC5951138 DOI: 10.2147/ppa.s162420] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE This review aims to summarize the current literature on patient-reported outcomes (PROs) in spondyloarthritis (SpA). PATIENTS AND METHODS We performed a systematic literature review to identify studies (original articles and narrative and systematic reviews) regarding PROs (health-related quality of life [HRQoL], satisfaction, preferences, adherence/compliance, and persistence) in SpA patients published in the European Union through December 2016. International databases (Medline/PubMed, Cochrane Library, ISI Web of Knowledge, Scopus) were searched using keywords in English. The methodological quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine criteria. RESULTS A total of 26 publications met the inclusion criteria. Generally, studies indicated that SpA has a negative impact on patients' HRQoL. In patients with ankylosing spondylitis, physical domains were more affected than emotional ones, whereas for psoriatic arthritis, both physical and psychological factors were strongly affected by the disease. Data indicated that biological agents (BAs) greatly contributed to improvement in HRQoL in both ankylosing spondylitis and psoriatic arthritis patients. Findings on compliance with BAs were heterogeneous. However, persistence rates exceeded 50% irrespective of the BA administered. Results on preferences indicated that most SpA patients prefer being involved in decisions regarding their treatment and that besides efficacy and safety, frequency and route of administration may influence patients' preferences for BAs. CONCLUSION Implementing management programs for SpA patients focuses on the physical, emotional, and social consequences of the disease, in addition to assessing and including patient preferences in the treatment decision-making process, could be crucial to improve patients' HRQoL and ensure their satisfaction and compliance with treatment.
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Affiliation(s)
- Juan Carlos Torre-Alonso
- Rheumatology Department, Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Monte Naranco, Oviedo, Spain
- Correspondence: Juan Carlos Torre-Alonso, Facultad de Medicina y Ciencias de la Salud, Reumatología Hospital Universitario Monte Naranco, 107 Avenida Doctores Fernández Vega, Oviedo, Asturias 33012, Spain, Tel +34 985 106 900, Email
| | - Rubén Queiro
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | | | - Luís Lizán
- Outcomes 10, Castellón de la Plana, Spain
- Medicine Department, Jaime I University, Castellón de la Plana, Spain
| | - Carles Blanch
- Health Economics & Market Access, Novartis Pharmaceuticals, Barcelona, Spain
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11
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Puig L, Notario J, Jiménez-Morales A, Moreno-Ramírez D, López-Ferrer A, Gozalbo I, Prades M, Lizán L, Blanch C. Secukinumab is the most efficient treatment for achieving clear skin in psoriatic patients: a cost-consequence study from the Spanish National Health Service. J DERMATOL TREAT 2017; 28:623-630. [DOI: 10.1080/09546634.2017.1364687] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Lluís Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jaume Notario
- Department of Dermatology, Hospital Universitari de Bellvitge, Feixa Llarga, Barcelona, Spain
| | | | - David Moreno-Ramírez
- Medical and Surgical Dermatology Unit, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Anna López-Ferrer
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | - Luis Lizán
- Outcomes SL. Castelló de la Plana, Castellón, Spain
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Obradors M, Blanch C, Comellas M, Figueras M, Lizan L. Health-related quality of life in patients with psoriasis: a systematic review of the European literature. Qual Life Res 2016; 25:2739-2754. [PMID: 27259580 DOI: 10.1007/s11136-016-1321-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 01/13/2023]
Abstract
PURPOSE To summarize the data published over the last 5 years in the European Union related to the health-related quality of life (HRQoL) of patients with psoriasis and its conditioning factors. METHODS International electronic databases and gray literature were searched to identify studies conducted on patient-reported outcomes in patients with psoriasis, published in Europe between January 1, 2009 and December 31, 2013. Bibliographic references were hand-searched. Editorials, letters, commentaries, opinion papers, and studies related to specific treatments were excluded. RESULTS A total of 46 studies met the inclusion criteria, 27 of them reporting data related to HRQoL or its conditioning factors. The publications reviewed highlighted the substantial negative impact of psoriasis on patients' HRQoL. Most of the studies that analyzed the relationship between HRQoL and sociodemographic characteristics described a relation between gender (female) and age (young patients) and poorer HRQoL. An association between HRQoL impairment and visibility of skin lesions and disease activity and severity was also established. Skin discomfort and pruritus were identified as elements that negatively influenced HRQoL. Use of biological agents had a positive impact on HRQoL and on treatment satisfaction, a better HRQoL being seen in patients treated with systemic therapies and biologics. CONCLUSIONS HRQoL has been broadly addressed in patients with psoriasis in Europe. Several disease- and patient-related factors contributed to its deterioration. Therapeutic measures with proven effectiveness in controlling disease symptoms and reducing PASI should be considered in patients with a severe disease who have a poorer HRQoL.
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Belinchón I, Rivera R, Blanch C, Comellas M, Lizán L. Adherence, satisfaction and preferences for treatment in patients with psoriasis in the European Union: a systematic review of the literature. Patient Prefer Adherence 2016; 10:2357-2367. [PMID: 27895471 PMCID: PMC5118025 DOI: 10.2147/ppa.s117006] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Adherence to treatment in patients with psoriasis is often poor. An investigation of patient preferences and satisfaction with treatment may be important, based on the expected correlation with therapy compliance. This paper aims to examine and describe the current literature on patient preferences, satisfaction and adherence to treatment for psoriasis in the European Union (EU). METHODS Electronic searches were conducted using PubMed, ISI Web of Knowledge, Scopus, Spanish databases and Google Scholar. European studies published in English or Spanish between January 1, 2009 and December 31, 2014 regarding patient-reported outcomes in psoriatic patients were included. Studies conducted in non-EU countries, letters to the editor, editorials, experts' opinions, case studies, congress proceedings, publications that did not differentiate between patients with psoriasis and psoriatic arthritis or studies related to specific treatment were excluded. RESULTS A total of 1,769 titles were identified, of which 1,636 were excluded as they were duplicates or did not provide any relevant information. After a full-text reading and application of the inclusion/exclusion criteria, 46 publications were included. This paper will describe publications on adherence (n=4), preferences (n=5) and satisfaction with treatment (n=7). Results related to health-related quality of life articles (n=30) have been published elsewhere. Adherence rates are generally low in psoriasis patients regardless of the type of treatment, severity of disease or methods used to measure adherence. Biologic therapy is associated with greater clinical improvement. There is a direct association between physician recommendations, patient preferences and several domains of treatment satisfaction. CONCLUSION The results of this review support the conclusion that adherence rates in patients with psoriasis are suboptimal and highlight the need to improve patient compliance and satisfaction with treatment. Patients' preferences should be taken into account in the treatment decision-making process in order to improve patients' clinical outcomes by ensuring satisfaction and adherence.
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Affiliation(s)
- I Belinchón
- Department of Dermatology, Hospital General Universitario de Alicante, Alicante
| | - R Rivera
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid
| | - C Blanch
- Novartis Farmacéutica S.A., Barcelona
| | | | - L Lizán
- Outcomes’10, Castellón, Spain
- Medical Department, University Jaime I, Castellón, Spain
- Correspondence: L Lizán, Outcomes’10, Espaitec 2, Universitat Jaume I, Castellón de la Plana, Castellón, Spain, Tel +34 964 83 19 98, Email
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Torres-Moreno M, Torrescasana E, Salas-Salvadó J, Blanch C. Nutritional composition and fatty acids profile in cocoa beans and chocolates with different geographical origin and processing conditions. Food Chem 2014; 166:125-132. [PMID: 25053037 DOI: 10.1016/j.foodchem.2014.05.141] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 05/08/2014] [Accepted: 05/27/2014] [Indexed: 11/28/2022]
Abstract
Nutritional composition and fatty acids (FA) profile were determined in cocoa and chocolates of different geographical origin and subject to different processing conditions. Cocoa butter was the major nutrient in cocoa beans and carbohydrates were the most important in chocolates. Cocoa composition and FA profile varied depending on geographical origin whilst in chocolates only carbohydrates and fat content varied significantly due to the effect of origin and no significant effect was observed for processing conditions. Both for cocoa and chocolates differences in FA profile were mainly explained as an effect of the geographical origin, and were not due to processing conditions in chocolate. For cocoa, differences in FA profile were found in C12:0, C14:0, C16:0, C16:1, C17:0, C17:1 and C18:0 whilst for chocolates only differences were found in C16:0, C18:0, C18:1 and C18:2. For all samples, C16:0, C18:0, C18:1 and C18:2 were quantitatively the most important FA. Ecuadorian chocolate showed a healthier FA profile having higher amounts of unsaturated FA and lower amounts of saturated FA than Ghanaian chocolate.
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Affiliation(s)
- M Torres-Moreno
- Health Sciencies and Welfare Faculty, Department of Health and Social Action, University of Vic - Central University of Catalonia, Vic, Spain.
| | - E Torrescasana
- Health Sciencies and Welfare Faculty, Department of Health and Social Action, University of Vic - Central University of Catalonia, Vic, Spain
| | - J Salas-Salvadó
- Human Nutrition Unit, Facultat de Medicina i Ciències de la Salut, IISPV, Universitat Rovira i Virgili, Reus, Spain; CIBERobn Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - C Blanch
- Food Science Research Group, University of Vic - Central University of Catalonia, Vic, Spain
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White GR, Ainsworth R, Akagi T, Alabau-Gonzalvo J, Angal-Kalinin D, Araki S, Aryshev A, Bai S, Bambade P, Bett DR, Blair G, Blanch C, Blanco O, Blaskovic-Kraljevic N, Bolzon B, Boogert S, Burrows PN, Christian G, Corner L, Davis MR, Faus-Golfe A, Fukuda M, Gao J, García-Morales H, Geffroy N, Hayano H, Heo AY, Hildreth M, Honda Y, Huang JY, Hwang WH, Iwashita Y, Jang S, Jeremie A, Kamiya Y, Karataev P, Kim ES, Kim HS, Kim SH, Kim YI, Komamiya S, Kubo K, Kume T, Kuroda S, Lam B, Lekomtsev K, Liu S, Lyapin A, Marin E, Masuzawa M, McCormick D, Naito T, Nelson J, Nevay LJ, Okugi T, Omori T, Oroku M, Park H, Park YJ, Perry C, Pfingstner J, Phinney N, Rawankar A, Renier Y, Resta-López J, Ross M, Sanuki T, Schulte D, Seryi A, Shevelev M, Shimizu H, Snuverink J, Spencer C, Suehara T, Sugahara R, Takahashi T, Tanaka R, Tauchi T, Terunuma N, Tomás R, Urakawa J, Wang D, Warden M, Wendt M, Wolski A, Woodley M, Yamaguchi Y, Yamanaka T, Yan J, Yokoya K, Zimmermann F. Experimental validation of a novel compact focusing scheme for future energy-frontier linear lepton colliders. Phys Rev Lett 2014; 112:034802. [PMID: 24484144 DOI: 10.1103/physrevlett.112.034802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Indexed: 06/03/2023]
Abstract
A novel scheme for the focusing of high-energy leptons in future linear colliders was proposed in 2001 [P. Raimondi and A. Seryi, Phys. Rev. Lett. 86, 3779 (2001)]. This scheme has many advantageous properties over previously studied focusing schemes, including being significantly shorter for a given energy and having a significantly better energy bandwidth. Experimental results from the ATF2 accelerator at KEK are presented that validate the operating principle of such a scheme by demonstrating the demagnification of a 1.3 GeV electron beam down to below 65 nm in height using an energy-scaled version of the compact focusing optics designed for the ILC collider.
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Affiliation(s)
- G R White
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025-7090, USA
| | - R Ainsworth
- John Adams Institute for Accelerator Science at Royal Holloway University of London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - T Akagi
- Department of Physics, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - J Alabau-Gonzalvo
- European Organization for Nuclear Research (CERN), CH-1211 Geneva 23, Switzerland
| | - D Angal-Kalinin
- CLRC: Daresbury Laboratory, Daresbury, Warrington, Cheshire WA4 4AD, United Kingdom
| | - S Araki
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - A Aryshev
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - S Bai
- Institute of High Energy Physics (IHEP), Chinese Academy of Sciences (CAS), Beijing, China
| | - P Bambade
- LAL, Universite Paris-Sud, CNRS/IN2P3, Orsay, France
| | - D R Bett
- John Adams Institute for Accelerator Science at University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - G Blair
- John Adams Institute for Accelerator Science at Royal Holloway University of London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom and Science and Technology Facilities Council, Polaris House, North Star Avenue, Swindon SN2 1SZ, United Kingdom
| | - C Blanch
- Universidad de Valencia - Instituto de Física Corpuscular (IFC), Edificio Institutos de Investigación, c/ Catedrático José Beltrán, 2, E-46980 Paterna, Spain
| | - O Blanco
- European Organization for Nuclear Research (CERN), CH-1211 Geneva 23, Switzerland and LAL, Universite Paris-Sud, CNRS/IN2P3, Orsay, France
| | - N Blaskovic-Kraljevic
- John Adams Institute for Accelerator Science at University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - B Bolzon
- European Organization for Nuclear Research (CERN), CH-1211 Geneva 23, Switzerland and CLRC: Daresbury Laboratory, Daresbury, Warrington, Cheshire WA4 4AD, United Kingdom and Department of Physics, Oliver Lodge Laboratory, University of Liverpool, Oxford St., Liverpool L69 3BX, United Kingdom
| | - S Boogert
- John Adams Institute for Accelerator Science at Royal Holloway University of London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - P N Burrows
- John Adams Institute for Accelerator Science at University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - G Christian
- John Adams Institute for Accelerator Science at University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - L Corner
- John Adams Institute for Accelerator Science at University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - M R Davis
- John Adams Institute for Accelerator Science at University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - A Faus-Golfe
- Universidad de Valencia - Instituto de Física Corpuscular (IFC), Edificio Institutos de Investigación, c/ Catedrático José Beltrán, 2, E-46980 Paterna, Spain
| | - M Fukuda
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - J Gao
- Institute of High Energy Physics (IHEP), Chinese Academy of Sciences (CAS), Beijing, China
| | - H García-Morales
- European Organization for Nuclear Research (CERN), CH-1211 Geneva 23, Switzerland and Universitat Politécnica de Catalunya, BarcelonaTech, C. Jordi Girona, 31. 08034 Barcelona, Spain
| | - N Geffroy
- LAPP-Universite de Savoie-CNRS/IN2P3, Annecy-le-Vieux, France
| | - H Hayano
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - A Y Heo
- Department of Physics, Kyungpook National University, 1370 San Kyuk-dong, Puk ku, Taegu 635, South Korea
| | - M Hildreth
- University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - Y Honda
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - J Y Huang
- Pohang Accelerator Laboratory, POSTECH (Pohang University of Science and Technology), San-31 Hyoja-dong, Pohang 790-784, South Korea
| | - W H Hwang
- Pohang Accelerator Laboratory, POSTECH (Pohang University of Science and Technology), San-31 Hyoja-dong, Pohang 790-784, South Korea
| | - Y Iwashita
- Institute for Chemical Research (ICR), Nuclear Science Research Facility, Kyoto University, Gokasho, Uji, Kyoto 611-0011, Japan
| | - S Jang
- Department of Physics, Kyungpook National University, 1370 San Kyuk-dong, Puk ku, Taegu 635, South Korea
| | - A Jeremie
- LAPP-Universite de Savoie-CNRS/IN2P3, Annecy-le-Vieux, France
| | - Y Kamiya
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan
| | - P Karataev
- John Adams Institute for Accelerator Science at Royal Holloway University of London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - E S Kim
- Department of Physics, Kyungpook National University, 1370 San Kyuk-dong, Puk ku, Taegu 635, South Korea
| | - H S Kim
- Department of Physics, Kyungpook National University, 1370 San Kyuk-dong, Puk ku, Taegu 635, South Korea
| | - S H Kim
- Pohang Accelerator Laboratory, POSTECH (Pohang University of Science and Technology), San-31 Hyoja-dong, Pohang 790-784, South Korea
| | - Y I Kim
- John Adams Institute for Accelerator Science at University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - S Komamiya
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan
| | - K Kubo
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - T Kume
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - S Kuroda
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - B Lam
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025-7090, USA
| | - K Lekomtsev
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - S Liu
- LAL, Universite Paris-Sud, CNRS/IN2P3, Orsay, France
| | - A Lyapin
- John Adams Institute for Accelerator Science at Royal Holloway University of London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - E Marin
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025-7090, USA
| | - M Masuzawa
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - D McCormick
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025-7090, USA
| | - T Naito
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - J Nelson
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025-7090, USA
| | - L J Nevay
- John Adams Institute for Accelerator Science at University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom and John Adams Institute for Accelerator Science at Royal Holloway University of London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - T Okugi
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - T Omori
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - M Oroku
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan
| | - H Park
- Department of Physics, Kyungpook National University, 1370 San Kyuk-dong, Puk ku, Taegu 635, South Korea
| | - Y J Park
- Pohang Accelerator Laboratory, POSTECH (Pohang University of Science and Technology), San-31 Hyoja-dong, Pohang 790-784, South Korea
| | - C Perry
- John Adams Institute for Accelerator Science at University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - J Pfingstner
- European Organization for Nuclear Research (CERN), CH-1211 Geneva 23, Switzerland
| | - N Phinney
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025-7090, USA
| | - A Rawankar
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - Y Renier
- European Organization for Nuclear Research (CERN), CH-1211 Geneva 23, Switzerland
| | - J Resta-López
- Universidad de Valencia - Instituto de Física Corpuscular (IFC), Edificio Institutos de Investigación, c/ Catedrático José Beltrán, 2, E-46980 Paterna, Spain
| | - M Ross
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025-7090, USA
| | - T Sanuki
- Tohoku University, 28 Kawauchi, Aoba-ku, Sendai, 980-8576 Japan
| | - D Schulte
- European Organization for Nuclear Research (CERN), CH-1211 Geneva 23, Switzerland
| | - A Seryi
- John Adams Institute for Accelerator Science at University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - M Shevelev
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - H Shimizu
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - J Snuverink
- John Adams Institute for Accelerator Science at Royal Holloway University of London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - C Spencer
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025-7090, USA
| | - T Suehara
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan
| | - R Sugahara
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - T Takahashi
- Department of Physics, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - R Tanaka
- Department of Physics, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - T Tauchi
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - N Terunuma
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - R Tomás
- European Organization for Nuclear Research (CERN), CH-1211 Geneva 23, Switzerland
| | - J Urakawa
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - D Wang
- Institute of High Energy Physics (IHEP), Chinese Academy of Sciences (CAS), Beijing, China
| | - M Warden
- John Adams Institute for Accelerator Science at University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - M Wendt
- European Organization for Nuclear Research (CERN), CH-1211 Geneva 23, Switzerland
| | - A Wolski
- Department of Physics, Oliver Lodge Laboratory, University of Liverpool, Oxford St., Liverpool L69 3BX, United Kingdom
| | - M Woodley
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025-7090, USA
| | - Y Yamaguchi
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan
| | - T Yamanaka
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan
| | - J Yan
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan
| | - K Yokoya
- High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - F Zimmermann
- European Organization for Nuclear Research (CERN), CH-1211 Geneva 23, Switzerland
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Blanch C, Fernández E, Martínez-Sánchez JM, Ariza C, López MJ, Moncada A, Schiaffino A, Rajmil L, Saltó E, Pascual JA, Nebot M. Impact of a multi-level intervention to prevent secondhand smoke exposure in schoolchildren: a randomized cluster community trial. Prev Med 2013; 57:585-90. [PMID: 23933268 DOI: 10.1016/j.ypmed.2013.07.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 07/18/2013] [Accepted: 07/27/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the effectiveness of a multi-level (individual, family, and school) school-based intervention to prevent the exposure to secondhand smoke (SHS) in a population of schoolchildren (12-14 years old). METHOD This was a community trial with cluster randomization of schools to an intervention and comparison group (ClinicalTrials.Gov identifier NCT01881607). The intervention targeted schoolchildren in Terrassa (Catalonia, Spain). We assessed SHS exposure in different settings and tobacco consumption by means of a questionnaire before and one year after the intervention. RESULTS We analyzed data from 1734 students with both baseline and follow-up data. The crude analysis showed that SHS exposure among students in the intervention group significantly decreased at school (-14.0%), at home (-19.9%), and on transportation (-21.8%). In the comparison group, SHS exposure significantly decreased only at home (-16.9%). After adjustment for potential confounders, the good accomplishment of the activities showed a possible trend towards a non-significant reduction in exposure at home, transportation, and leisure time. CONCLUSION While this school-based multi-level intervention had no overall effect in SHS exposure, the improvement of the activities focused on preventing SHS would be needed in order to achieve a significant decrease in the proportion of children exposed to SHS.
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Affiliation(s)
- Carles Blanch
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Global Clinical Epidemiology (DS&E), Novartis Farmacéutica, Barcelona, Spain
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Martín-Pujol A, Fernández E, Schiaffino A, Moncada A, Ariza C, Blanch C, Martínez-Sánchez JM. Tobacco smoking, exposure to second-hand smoke, and asthma and wheezing in schoolchildren: a cross-sectional study. Acta Paediatr 2013; 102:e305-9. [PMID: 23581609 DOI: 10.1111/apa.12232] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 03/08/2013] [Accepted: 03/08/2013] [Indexed: 11/29/2022]
Abstract
AIM To analyse the association between tobacco smoking, exposure to second-hand smoke (SHS) and reports of wheezing and asthma in a sample of schoolchildren. METHODS A structured questionnaire was administered to 1766 students (7th grade, aged 12-13 years) at 25 schools in Terrassa, Spain (2006). We determined the prevalence of active smoking, exposure to SHS and reports of wheezing and asthma, and their association by means of prevalence odds ratios (OR) and 95% confidence intervals (CI). RESULTS 97.5% of children were nonsmokers, 1.5% were experimental smokers and 1% were regular smokers. 41.1% of children reported exposure to SHS at home, 40.0% at school, 53.9% in their leisure time and 33.2% while using private or public transportation. Wheezing was reported by 9.2% of children, and 9.2% reported asthma. A significant association was found between smoking tobacco and wheezing: OR in experimental smokers = 3.0 (95% CI 1.2-7.7), and OR in active smokers = 4.2 (95% CI 1.4-12.5). Exposure to SHS while using transportation was associated with wheezing (OR = 1.4; 95% CI 1.0-2.0). Tobacco smoking and exposure to SHS were not associated with asthma. CONCLUSION Active and experimental smokers, and those who reported exposure to SHS while using public or private transportation, had higher likelihood of reporting wheezing. No association between active or passive smoking and asthma was observed.
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Affiliation(s)
- Anna Martín-Pujol
- Tobacco Control Unit; Cancer Control and Prevention Programme; Institut Català d'Oncologia-ICO; L'Hospitalet de Llobregat (Barcelona); Barcelona; Spain
| | | | - Anna Schiaffino
- Cancer Control and Prevention Group; Institut d'Investigació Biomèdica de Bellvitge-IDIBELL; L'Hospitalet de Llobregat (Barcelona); Barcelona; Spain
| | - Albert Moncada
- Community Health Unit; Ajuntament de Terrassa; Terrassa; Spain
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Martínez-Sánchez JM, Blanch C, Fu M, Gallus S, La Vecchia C, Fernández E. Do smoke-free policies in work and public places increase smoking in private venues?: Table 1. Tob Control 2013; 23:204-7. [DOI: 10.1136/tobaccocontrol-2012-050877] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Torres-Moreno M, Tarrega A, Torrescasana E, Blanch C. Influence of label information on dark chocolate acceptability. Appetite 2012; 58:665-71. [DOI: 10.1016/j.appet.2011.12.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 12/07/2011] [Accepted: 12/09/2011] [Indexed: 11/29/2022]
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Berlin C, Blanch C, Lewis DJ, Maladorno DD, Michel C, Petrin M, Sarp S, Close P. Are all quantitative postmarketing signal detection methods equal? Performance characteristics of logistic regression and Multi-item Gamma Poisson Shrinker. Pharmacoepidemiol Drug Saf 2011; 21:622-30. [PMID: 21994119 DOI: 10.1002/pds.2247] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 08/03/2011] [Accepted: 08/05/2011] [Indexed: 11/10/2022]
Abstract
PURPOSE The detection of safety signals with medicines is an essential activity to protect public health. Despite widespread acceptance, it is unclear whether recently applied statistical algorithms provide enhanced performance characteristics when compared with traditional systems. Novartis has adopted a novel system for automated signal detection on the basis of disproportionality methods within a safety data mining application (Empirica™ Signal System [ESS]). ESS uses two algorithms for routine analyses: empirical Bayes Multi-item Gamma Poisson Shrinker and logistic regression (LR). METHODS A model was developed comprising 14 medicines, categorized as "new" or "established." A standard was prepared on the basis of safety findings selected from traditional sources. ESS results were compared with the standard to calculate the positive predictive value (PPV), specificity, and sensitivity. PPVs of the lower one-sided 5% and 0.05% confidence limits of the Bayes geometric mean (EB05) and of the LR odds ratio (LR0005) almost coincided for all the drug-event combinations studied. RESULTS There was no obvious difference comparing the PPV of the leading Medical Dictionary for Regulatory Activities (MedDRA) terms to the PPV for all terms. The PPV of narrow MedDRA query searches was higher than that for broad searches. The widely used threshold value of EB05 = 2.0 or LR0005 = 2.0 together with more than three spontaneous reports of the drug-event combination produced balanced results for PPV, sensitivity, and specificity. CONCLUSIONS Consequently, performance characteristics were best for leading terms with narrow MedDRA query searches irrespective of applying Multi-item Gamma Poisson Shrinker or LR at a threshold value of 2.0. This research formed the basis for the configuration of ESS for signal detection at Novartis.
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McMee AT, Landon J, Funch D, Gil M, Blanch C, Walker AM. Cardiovascular Outcomes in a Large Cohort of Patients with Treated Hypertension: A Demonstration Study. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s9-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pérez K, Blanch C, Casabona J, Almeda J, Coll O. Coverage of HIV testing among pregnant women in Catalonia, Spain: a comparison of self-reporting with medical records. Eur J Public Health 2004; 14:261-6. [PMID: 15369031 DOI: 10.1093/eurpub/14.3.261] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND to estimate the coverage of HIV testing during pregnancy in Catalonia, to identify factors associated with testing during pregnancy and to assess the recording of screening in medical records and the women's awareness about being tested. METHODS A survey was carried out in 2000 among pregnant women attending hospital, with face-to-face interview 24-48 hours post-delivery, and review of the medical records. RESULTS Out of 2,132 participants, 76% were from public and 24% from private hospitals. Medical records showed that 88.3% of the participants had a HIV test (94% in public, 71% in private hospitals), while for 3.7% and 18.5% in private and public, respectively, this information was not documented. Overall, 67% of women reported having been tested for HIV during that pregnancy, and unawareness of having been tested was detected in 10.7%. Educational level and prenatal care are determinants for being tested. CONCLUSION Catalonia has a good coverage of HIV testing among childbearing women, although it is lower in private hospitals. Frequently prenatal HIV testing is not documented in medical records and women are unaware of it. Improving the prenatal care and tailoring these programmes to specific populations, like migrants or marginalized groups, will result in a better understanding of HIV prevention and in an increase in HIV testing before delivery.
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Affiliation(s)
- Katherine Pérez
- Centre for Epidemiological Studies on Aids in Catalonia, Hospital Universitari Germans Trias i Pujol, Badalona
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Casado MJ, Rovira A, Blanch C, Casabona J. [Survey of the performance of anti-HIV antibody detection tests in laboratories in Catalonia [Spain]]. Gac Sanit 2004; 18:68-71. [PMID: 14980176 DOI: 10.1157/13057982] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Quality assurance of HIV testing is essential to correctly assess the HIV epidemic. To describe the characteristics of HIV testing and identify features that could be improved, a questionnaire on the quality of HIV tests was sent to Catalan laboratories in 1998. The survey revealed variability in the procedures used by the participating laboratories when performing HIV tests. Some of the laboratories were still performing incorrect activities such as identifying HIV specimens with specific labels, extracting new specimens for a second test to confirm diagnosis, or failing to guarantee the confidentiality of the results. The criteria for HIV testing should be standardized according to the purpose of the test and the prevalence of the infection in the population analyzed. This approach would improve the quality of the results of diagnostic tests, since the overall concept of quality includes the entire process (pre-test, test and post-test).
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Affiliation(s)
- María Jesús Casado
- Centre d'Estudis Epidemiològics sobre VIH/sida de Catalunya (CEESCAT), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
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Casabona J, Romaguera A, Almeda J, Blanch C, Caylà JA, Miró JM, Colom J. [Reporting new HIV cases in Catalonia, Spain: is technical consensus feasible?]. Gac Sanit 2003; 17:75-82. [PMID: 12605750 DOI: 10.1016/s0213-9111(03)71695-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the process performed in Catalonia (Spain) to design an information system for monitoring new cases of HIV infection. METHODS A survey was used to evaluate perception of the need for notification of HIV infection by health care professionals (n = 106), as well as their opinions of the various possibilities for the implementation of the notification system. As a result of this evaluation, a specific technical report defining the objectives and technical characteristics of the new notification system was produced. The feasibility of the system in health centres was evaluated through discussions with health care professionals, health authorities and Non-Governmental Organizations, and a second survey was designed to evaluate the use of a personal identification code (PIC) from the individual health card (IHC). This process took plabe between 1998 and 2000. RESULTS A total of 84.5% of the health care professionals believed that HIV notification should be mandatory and confidential; 90.4%, were of the opinion that notification would enable identification of the epidemiological characteristics of infected individualos, and 75% believed that these individuals would have to be identified by name. Finally, 66% of the health care professionals believed that the use of the PIC from the IHC would be feasible as the personal identifier in HIV notification. A final proposal was draw up and 1 January, 2001 was set as the date to initiate the pilot phase of the new HIV notification system. CONCLUSIONS Most of the health care professionals surveyed expressed the need for notification of HIV infection, and for such notification to receive institutional endorsement. They also believed that, as with other diseases of individualized mandatory reporting, notification should be carried out with a single personal identifier. The information obtained from notification of HIV infection is essential for the optimal planning of preventive programs and the provision of health services. The main difficulties observed were that HIV infection has not been included among the diseases of mandatory reporting, as well as the low implantation of the PIC in the hospitals' clinical registries. All the sectors involved have an important role to play in creating the conditions necessary for the notification system of new cases of HIV infection to be feasible and useful.
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Affiliation(s)
- J Casabona
- Centre d'Estudis Epidemiològics sobre la Sida de Catalunya (CEESCAT), Badalona, Barcelona. España.
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Blanch C, Vall M, Matas L, Sánchez D, Casabona J. [The epidemiological surveillance of human immunodeficiency virus (HIV) infection in a hospital population of Catalonia. Collaborators in the VIHHOSP project]. Med Clin (Barc) 1998; 111:731-5. [PMID: 9922955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND AIDS is one of the most important problems of public health in our setting. The surveillance of HIV infection in sentinel population is an important alternative to the use of the AIDS cases registries, to obtain a dynamic and updated information about HIV/AIDS epidemic. The objective of this study was to determine the prevalence of HIV infection among the patients from 5 sentinel hospitals in Catalonia, Spain. PATIENTS AND METHODS Unlinked anonymous screening of serum from patients aged 15-49 from 5 sentinel hospitals in Catalonia, Spain. Samples were broken by age, sex, in-patients or out-patients and clinical specialities related to HIV/AIDS or not related. Samples were analyzed in pools of five and were tested by the OMS strategy II, for the epidemiological surveillance purposes. RESULTS HIV testing was developed in 9,524 patients, with a prevalence of 1.6% (153 samples). The overall prevalence in men was twice that of women (2.3% vs. 1.1%). Ages between 25 to 34 had the higher prevalence (3.1%). Clinical specialities related with HIV/AIDS had a prevalence twice that of non related (2.3% vs. 1.2%). CONCLUSIONS The HIV prevalence found in this population is the highest compared to similar studies performed in other western european countries. Our data confirm the pattern of HIV infection for age and sex observed in other studies in Catalonia, Spain. This is the first study of sentinel surveillance in sentinel hospitals in Spain and give us the base line which will serve as a reference to assess the evolution of HIV infection in further studies in sentinel hospital populations in Catalonia.
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Affiliation(s)
- C Blanch
- Centre d'Estudis Epidemiològics sobre la SIDA de Catalunya (CEESCAT), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona
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Blanch C, Vall M, Casabona J. [Analysis of the microbiological information derived from the sentinel laboratory network for the monitoring of the human immunodeficiency virus infection in Catalonia (1989-1995)]. Enferm Infecc Microbiol Clin 1997; 15:401-6. [PMID: 9424118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The epidemiologic information on AIDS derived exclusively from the AIDS case registry presents a series of limitations. To solve some of these epidemiologic surveillance systems of HIV infection have been designed. The information of the microbiology laboratories in which anti-HIV antibody detection tests are performed has been one of the most commonly used sources of information. MATERIAL AND METHOD The detection activity of the anti-HIV antibodies from a surveillance laboratory network in Catalonia from 1989 to 1995 was collected. RESULTS A continuous increase was observed in the number of tests performed in the network laboratories (30012 in 1989 up to 63323 in 1995) as was a significant decrease in the number of tests which were reactive (20.7% in 1989 to 6.1% in 1995). Great variability was found in the results among the different laboratories as well as in the diagnostic algorythms used. CONCLUSIONS Laboratories are an important source to take into account to perform epidemiologic surveillance of HIV infection. The collaboration among the laboratories and public health care officials allows information to be obtained that aids in better defining the characteristics of people who currently have HIV infection and in designing preventive activities directed at the needs of each community. This collaboration also allows homogeneous diagnostic algorythmns and common criteria to be established to ensure quality control.
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Affiliation(s)
- C Blanch
- Centre d'Estudis Epidemiològics sobre la VIH/sida a Catalunya (CEESCAT), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona
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Wang J, Rodés A, Blanch C, Casabona J. HIV testing history among gay/bisexual men recruited in Barcelona: evidence of high levels of risk behavior among self-reported HIV + men. Soc Sci Med 1997; 44:469-77. [PMID: 9015883 DOI: 10.1016/s0277-9536(96)00176-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
As part of the first quantitative study of men who have sex with men (MSM) and HIV/ AIDS in Spain, anonymous, self-administered questionnaires were distributed via gay/lesbian organization mailings, bathhouses, and sex shops in Barcelona. We analyzed 547 gay/bisexual men along self-reported HIV testing history-i.e. untested, previously tested HIV-, and previously tested HIV +. Eleven variables discriminated significantly between the three groups in multivariable analysis. HIV- men were over-represented in the mailing subsample. While untested men exhibited potentially protective behaviors (e.g. least likely to have had stable and casual sex partners with HIV/AIDS and to practice anal intercourse), they were also least likely to be out with their homosexuality and most likely to never use condoms when they practiced anal intercourse. HIV + men were most likely to report insertive and receptive anal intercourse with a condom and least likely to practice insertive anal intercourse without a condom in the past month, yet they were also most likely to report the highest interpersonal barriers to safer sex, recent cocaine use with sex, meeting sex partners in public restrooms, and recent episodes of STD. A potentially volatile combination of higher sexual activity (e.g. more sex partners and casual sex activity) coupled with the presence of safer sex barriers (e.g. poor scores on indices measuring safer sex disposition, elevated drug use accompanying sex) was evidenced among HIV + men. There were no statistically significant differences between the three groups for anal intercourse without a condom, but with 37.5% of this collective reporting one such episode in the past month, all groups can be considered equally risky. Against the backdrop of a 20.5% self-reported HIV prevalence, there is considerable need for enhanced prevention efforts among gay/bisexual men in general and targeted strategies among HIV + men in particular.
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Affiliation(s)
- J Wang
- AIDS Prevention and Control Program, Department de Sanitat i Seguretat Social, Generalitat de Catalunya, Barcelona, Spain
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Rodés A, Aguilera R, Blanch C, Casabona J. [Evaluation of an informative leaflet on AIDS/HIV infection aimed at primary health care professionals in Catalonia]. Aten Primaria 1996; 17:4-10. [PMID: 8742137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To assess primary care professionals' understanding and acceptance of a periodic information leaflet on HIV/AIDS. DESIGN Crossover. SETTING Primary care teams from the Institut Català de la Salut. PARTICIPANTS A random sample of 300 doctors, qualified nurses and social workers. INTERVENTION A self-administered, anonymous questionnaire returned by normal post. MEASUREMENTS AND MAIN RESULTS Questions covered the following thematic areas: clinical care of people infected by HIV/AIDS and requests for diagnostic tests for infection, perception of skills in the promotion of changes in patients' sexual behaviour and drug use, providing psychological support and guidelines for integrating HIV+ children in schools and information on social resources. 60% knew the publication. Thematic areas which aroused most interest were: psychological support for people affected, prevention of HIV infection in the health environment, clinical advice and diagnosis. 77% had received requests for diagnostic tests and 88% had attended infected people. CONCLUSIONS In spite of the low reply rate (50%) and relative variability among the professionals and the health regions they came from, this first assessment enabled us to identify specific educational needs in the care and prevention of HIV/AIDS infection in the primary care framework and also to improve the distribution methods we used.
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Affiliation(s)
- A Rodés
- Departament de Sanitat i Seguretat Social, Programa per a la Prevenció i el Control de la SIDA
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