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Signes-Costa J, Rábade-Castedo C, Jiménez-Ruiz CA. Challenges for Scientific Societies: New Tobacco-Derived Products. Arch Bronconeumol 2024; 60:265-266. [PMID: 38514347 DOI: 10.1016/j.arbres.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Jaime Signes-Costa
- Tobacco Unit, Pulmonary Department, Hospital Clínico, INCLIVA, University of Valencia, Spain.
| | - Carlos Rábade-Castedo
- Tobacco Unit, Pulmonary Department, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
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Jiménez-Ruiz CA, Rábade-Castedo C, de Granda-Orive JI. Electronic Cigarettes are Neither Effective Nor Safe for Quitting Smoking: A Critical View of the Most Recent Meta-Analyses. Arch Bronconeumol 2024; 60:195-196. [PMID: 38160162 DOI: 10.1016/j.arbres.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Affiliation(s)
| | - Carlos Rábade-Castedo
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
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Rábade-Castedo C, Zamarrón-Sanz C, Hermida-Ameijeiras Á, Abelleira-Paris R, Casal-Mouriño A, Ferreiro-Fernández L, Rodríguez-Núñez N, Ricoy-Gabaldón J, Toubes-Navarro ME, Álvarez-Dobaño JM, Valdés-Cuadrado L. Effect of an intensive tobacco cessation program on the smoker narrative: A content analysis and grounded theory. Tob Induc Dis 2024; 22:TID-22-40. [PMID: 38362270 PMCID: PMC10867740 DOI: 10.18332/tid/183607] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/28/2023] [Accepted: 02/01/2024] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION The smoker's narrative during smoking quitting provides insight into aspects not fully explored in daily clinical practice. The aim of the study was to analyze the smoker narrative using two types of methodologies: content analysis and grounded theory, before and after smoking cessation intervention, provided to the smoker in a specialized Smoking Cessation Unit accredited by the Spanish Society of Pneumology and Thoracic Surgery. METHODS A prospective observational study of current smokers included in a tobacco cessation program between 2017 and 2020 was conducted at the Smoking Cessation Unit of Santiago de Compostela Health Area, Spain. Routine clinical variables and patient narrative data were collected. A descriptive analysis of the sample, the content of the textual corpus, and a grounded theory were performed in semi-structured interviews at baseline and at follow-up at 6 months. RESULTS A total of 116 patients were included (mean age 55.6 ± 10.6 years; 56.9% male; mean nicotine dependence score 5.7 ± 1.6). Quantitative analysis of the narrative shows that the most frequent phrases and words are associated with smoking, nicotine craving, and predisposition for smoking cessation. After the intervention, phrases related to the manifestation of abstinence, response to pharmacological treatment, and self-perception of smoking cessation were predominant. In the qualitative analysis, the most frequent categories in the smoker's textual corpus were dependence, motivation, and emotionality, which decreased after the intervention (11.4%, 21.4%, and 9.9%, respectively) accompanied by increased satisfaction (19.2%) and the manifestation of abstinence (21.5%). CONCLUSIONS Motivation, nicotine dependence, and sensitivity to emotions are all closely intertwined in the current smoker narrative and can be modified as a consequence of treatment.
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Affiliation(s)
- Carlos Rábade-Castedo
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Universitario de Santiago de Compostela, Santiago de Compostela, España
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, España
| | - Carlos Zamarrón-Sanz
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - Álvaro Hermida-Ameijeiras
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, España
- Servicio de Medicina Interna, Complejo Hospitalario Universitario de Santiago de Compostela, Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - Romina Abelleira-Paris
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - Ana Casal-Mouriño
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - Lucia Ferreiro-Fernández
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Universitario de Santiago de Compostela, Santiago de Compostela, España
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, España
| | - Nuria Rodríguez-Núñez
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - Jorge Ricoy-Gabaldón
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - María Elena Toubes-Navarro
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - José Manuel Álvarez-Dobaño
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Universitario de Santiago de Compostela, Santiago de Compostela, España
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, España
| | - Luis Valdés-Cuadrado
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Universitario de Santiago de Compostela, Santiago de Compostela, España
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, España
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Rábade-Castedo C, Jiménez Ruiz CA, de Granda-Orive JI. SEPAR Guidelines for Pharmacological Treatment of Tobacco Dependence 2023: New Contributions in Daily Clinical Practice. Open Respir Arch 2024; 6:100285. [PMID: 38187888 PMCID: PMC10770605 DOI: 10.1016/j.opresp.2023.100285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Affiliation(s)
- Carlos Rábade-Castedo
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela (La Coruña), Spain
| | - Carlos A. Jiménez Ruiz
- Unidad Especializada en Tabaquismo de la Comunidad de Madrid, Hospital Clínico San Carlos, Madrid, Spain
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Jiménez Ruiz CA, Pitti-Pérez R, de Granda-Orive JI, Pastor-Esplá E, Solano-Reina S, Gorordo-Unzueta I, Mirambeaux-Villalona R, De Higes-Martínez E, Riesco-Miranda JA, Ramírez-Prieto MT, García-Río F, Rábade-Castedo C. Prevalence, Knowledge and Perceptions of Smoking and Tobacco Products and Vape Among SEPAR Members. Open Respir Arch 2023; 5:100260. [PMID: 37636991 PMCID: PMC10458292 DOI: 10.1016/j.opresp.2023.100260] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/10/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction The professional dedicated to respiratory health has an exemplary role in tobacco control, promoting smoking cessation in their patients. However, multiple circumstances cause a low implementation. Therefore, the objective of the study is to identify the consumption, knowledge and perception of tobacco and its emerging products in a representative sample of professionals involved in the treatment of respiratory patients integrated into the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). Methods Descriptive analysis of a structured online interview addressed to 5340 SEPAR members. Results In a sample of 802 respondents, more than 33% have smoked at some time and 6.6% continue to smoke. More than 66% consider smoking as a chronic disease. More than 90% consider their role model important and advise their patients to quit smoking, but less than half carry out a smoking intervention. Only 35% of them believe that the ban on smoking in health centers is always complied. More than 75% do not consider nicotine delivery devices an option for smoking cessation or harm reduction. 22% are unaware of water pipes and 29% of heated tobacco. Conclusions Professionals specialized in respiratory diseases are highly sensitized to smoking. Despite this, there are still weak points such as the insufficient implementation of smoking cessation interventions or the scant training in smoking and in new emerging products.
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Affiliation(s)
- Carlos A. Jiménez Ruiz
- Unidad Especializada en Tabaquismo de la Comunidad de Madrid, Hospital Clínico San Carlos, Madrid, Spain
| | - Ruth Pitti-Pérez
- Servicio de Neumología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | | | - Esther Pastor-Esplá
- Servicio de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | | | | | | | - Eva De Higes-Martínez
- Unidad de Neumología, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain
| | - Juan Antonio Riesco-Miranda
- Servicio de Neumología, Hospital Universitario de Cáceres, Cáceres, Spain
- Centro de Investigación en Red de enfermedades respiratorias (CIBERES), Madrid, Spain
- Instituto Universitario de Investigación Biosanitaria de Extremadura (INUBE), Spain
| | | | - Francisco García-Río
- Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Universidad Autónoma de Madrid, Spain
| | - Carlos Rábade-Castedo
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain
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Toubes-Navarro ME, Gude-Sampedro F, Álvarez-Dobaño JM, Reyes-Santias F, Rábade-Castedo C, Rodríguez-García C, Lado-Baleato Ó, Lago-Fidalgo R, Sánchez-Martínez N, Ricoy-Gabaldón J, Casal-Mouriño A, Abelleira-Paris R, Riveiro-Blanco V, Zamarrón-Sanz C, Rodríguez-Núñez N, Lama-López A, Ferreiro-Fernández L, Valdés-Cuadrado L. A pulmonary rehabilitation program reduces hospitalizations in chronic obstructive pulmonary disease patients: A cost-effectiveness study. Ann Thorac Med 2023; 18:190-198. [PMID: 38058789 PMCID: PMC10697305 DOI: 10.4103/atm.atm_70_23] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/06/2023] [Accepted: 08/23/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Although pulmonary rehabilitation (PR) is recommended in patients with chronic obstructive pulmonary disease (COPD), there is a scarcity of data demonstrating the cost-effectiveness and effectiveness of PR in reducing exacerbations. METHODS A quasi-experimental study in 200 patients with COPD was conducted to determine the number of exacerbations 1 year before and after their participation in a PR program. Quality of life was measured using the COPD assessment test and EuroQol-5D. The costs of the program and exacerbations were assessed the year before and after participation in the PR program. The incremental cost-effectiveness ratio (ICER) was estimated in terms of quality-adjusted life years (QALYs). RESULTS The number of admissions, length of hospital stay, and admissions to the emergency department decreased after participation in the PR program by 48.2%, 46.6%, and 42.5%, respectively (P < 0.001 for all). Results on quality of life tests improved significantly (P < 0.001 for the two tests). The cost of PR per patient and the cost of pre-PR and post-PR exacerbations were €1867.7 and €7895.2 and €4201.9, respectively. The PR resulted in a cost saving of €1826 (total, €365,200) per patient/year, and the gain in QALYs was+0.107. ICER was -€17,056. The total cost was <€20,000/QALY in 78% of patients. CONCLUSIONS PR contributes to reducing the number of exacerbations in patients with COPD, thereby slowing clinical deterioration. In addition, it is cost-effective in terms of QALYs.
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Affiliation(s)
| | - Francisco Gude-Sampedro
- Department of Clinical Epidemiology, University Clinical Hospital of Santiago de Compostela, Spain
| | - José Manuel Álvarez-Dobaño
- Interdisciplinary Group of research in Pulmonology, Institute of Sanitary research from Compostela, Spain
- University Clinical Hospital of Santiago de Compostela, Spain
| | - Francisco Reyes-Santias
- Department of Human Resources and General Services, University Clinical Hospital of Santiago de Compostela, Spain
| | - Carlos Rábade-Castedo
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain
| | | | - Óscar Lado-Baleato
- Research Methods Group, Health Research Institute of Santiago de Compostela, Spain
- ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela, Spain
| | - Raquel Lago-Fidalgo
- Department of Clinical Epidemiology, University Clinical Hospital of Santiago de Compostela, Spain
- Mathematics University of Santiago de Compostela, Spain
| | - Noelia Sánchez-Martínez
- Department of Clinical Epidemiology, University Clinical Hospital of Santiago de Compostela, Spain
- Mathematics University of Santiago de Compostela, Spain
| | - Jorge Ricoy-Gabaldón
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain
| | - Ana Casal-Mouriño
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain
| | - Romina Abelleira-Paris
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain
| | - Vanessa Riveiro-Blanco
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain
| | - Carlos Zamarrón-Sanz
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain
| | - Nuria Rodríguez-Núñez
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain
| | - Adriana Lama-López
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain
| | - Lucía Ferreiro-Fernández
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain
- Interdisciplinary Group of research in Pulmonology, Institute of Sanitary research from Compostela, Spain
| | - Luis Valdés-Cuadrado
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain
- Interdisciplinary Group of research in Pulmonology, Institute of Sanitary research from Compostela, Spain
- Medicine University of Santiago de Compostela, Spain
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Rábade-Castedo C, de Granda-Orive JI, Riesco-Miranda JA, De Higes-Martínez E, Ramos-Pinedo Á, Cabrera-César E, Signes-Costa Miñana J, García Rueda M, Pastor-Esplá E, Jiménez-Ruiz CA. Clinical Practice Guideline of Spanish Society of Pneumology and Thoracic Surgery (SEPAR) on Pharmacological Treatment of Tobacco Dependence 2023. Arch Bronconeumol 2023; 59:651-661. [PMID: 37567792 DOI: 10.1016/j.arbres.2023.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023]
Abstract
INTRODUCTION There are multiple systematic reviews and meta-analyses on the efficacy and safety of pharmacological treatments against nicotine dependence. However, there are few guidelines to answer frequent questions asked by a clinician treating a smoker. Therefore, the aim of this paper is to facilitate the treatment of tobacco addiction. MATERIAL AND METHODS 12 PICO questions are formulated from a GLOBAL PICO question: "Efficacy and safety of pharmacological treatment of tobacco dependence". A systematic review was carried out to answer each of the questions and recommendations were made. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system was used to grade the certainty of the estimated effects and the strength of the recommendations. RESULTS Varenicline, nicotine replacement therapy (NRT), bupropion and cytisine are more effective than placebo. Varenicline and combined nicotine therapy are superior to the other therapies. In smokers with high dependence, a combination of drugs is recommended, being more effective those associations containing varenicline. Other optimization strategies with lower efficacy consist of increasing the doses, the duration, or retreat with varenicline. In specific populations varenicline or NRT is recommended. In hospitalized, the treatment of choice is NRT. In pregnancy it is indicated to prioritize behavioral treatment. The financing of smoking cessation treatments increases the number of smokers who quit smoking. There is no scientific evidence of the efficacy of pharmacological treatment of smoking cessation in adolescents. CONCLUSIONS The answers to the 12 questions allow us to extract recommendations and algorithms for the pharmacological treatment of tobacco dependence.
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Affiliation(s)
- Carlos Rábade-Castedo
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain.
| | - José Ignacio de Granda-Orive
- Servicio de Neumología, Hospital Universitario 12 de octubre Madrid, Spain; Universidad Complutense, Madrid, Spain
| | - Juan Antonio Riesco-Miranda
- Servicio de Neumología, Hospital Universitario de Cáceres, Cáceres, Spain; Centro de Investigación en Red de enfermedades respiratorias (CIBERES), Madrid, Spain; Instituto Universitario de Investigación Biosanitaria de Extremadura (INUBE), Spain
| | - Eva De Higes-Martínez
- Unidad de Neumología, Hospital Universitario Fundación Alcorcón, Spain; Universidad Rey Juan Carlos, Madrid, Spain
| | - Ángela Ramos-Pinedo
- Unidad de Neumología, Hospital Universitario Fundación Alcorcón, Spain; Universidad Rey Juan Carlos, Madrid, Spain
| | - Eva Cabrera-César
- Servicio de Neumología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Jaime Signes-Costa Miñana
- Servicio de Neumología, Hospital Clínico Universitario de Valencia, Spain; Instituto de Investigación Sanitaria de Valencia (INCLIVA), Valencia, Spain
| | | | - Esther Pastor-Esplá
- Servicio de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Carlos A Jiménez-Ruiz
- Unidad Especializada en Tabaquismo de la Comunidad de Madrid, Hospital Clínico San Carlos, Madrid, Spain
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Rábade-Castedo C. Accessibility to smoking cessation treatment: a pending subject. Open Respiratory Archives 2023. [PMID: 37496868 PMCID: PMC10369547 DOI: 10.1016/j.opresp.2023.100240] [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: 03/16/2023] Open
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Álvarez-Dobaño JM, Atienza G, Zamarrón C, Toubes ME, Ferreiro L, Riveiro V, Casal A, Suárez-Antelo J, Rodríguez-Núñez N, Lama-López A, Rábade-Castedo C, Rodríguez-García C, Lourido-Cebreiro T, Ricoy J, Abelleira R, Golpe A, Pais B, González-Barcala FJ, Valdés L. Health outcomes: Towards the accreditation of respiratory medicine departments. Arch Bronconeumol 2021; 57:637-647. [PMID: 35702904 DOI: 10.1016/j.arbr.2021.07.007] [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: 11/11/2020] [Accepted: 01/13/2021] [Indexed: 06/15/2023]
Abstract
National health systems must ensure compliance with conditions such as equity, efficiency, quality, and transparency. Since it is the right of society to know the health outcomes of its healthcare system, our aim was to develop a proposal for the accreditation of respiratory medicine departments in terms of care, teaching, and research, measuring health outcomes using quality of care indicators. The management tools proposed in this article should be implemented to improve outcomes and help us achieve our objectives. Promoting accreditation can serve as a stimulus to improve clinical management and enable professionals to take on greater leadership roles and take action to improve outcomes in patient care.
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Affiliation(s)
- José Manuel Álvarez-Dobaño
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Gerardo Atienza
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, Spain
| | - Carlos Zamarrón
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - María Elena Toubes
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Lucía Ferreiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain.
| | - Vanessa Riveiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Ana Casal
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Juan Suárez-Antelo
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Nuria Rodríguez-Núñez
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Adriana Lama-López
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Carlos Rábade-Castedo
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Carlota Rodríguez-García
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Tamara Lourido-Cebreiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Jorge Ricoy
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Romina Abelleira
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Antonio Golpe
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Beatriz Pais
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, Spain
| | - Francisco Javier González-Barcala
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Luis Valdés
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
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Riesco-Miranda JA, Solano-Reina S, Rábade-Castedo C, de Granda-Orive JI, Pastor-Esplá E, García-Rueda M, Callejas-Gonzalez FJ, Azpeitia-Anadón Á, Mas S, Jiménez-Ruiz CA. Certified Smoking Cessation Units in Spain: High Potential for Detection of Undiagnosed Chronic Obstructive Pulmonary Disease and Profile of Newly Diagnosed Cases. Int J Chron Obstruct Pulmon Dis 2021; 16:443-450. [PMID: 33658774 PMCID: PMC7920505 DOI: 10.2147/copd.s289097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/29/2020] [Accepted: 02/07/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Smokers attending smoking cessation units (SCUs) may offer a unique opportunity for early recognition of undiagnosed chronic obstructive pulmonary disease (COPD). We aimed at assessing the impact of SCUs on the early diagnosis of COPD and describing the clinical and smoking profile of newly-diagnosed COPD cases at SCUs certified by the Spanish Society of Respiratory Diseases and Thoracic Surgery (SEPAR). PATIENTS AND METHODS A multicenter cross-sectional observational cohort study (DIPREPOQ study) was performed in eight SEPAR-certified SCUs in Spain. Adult current smokers with no previously diagnosed respiratory disease and having one o more respiratory symptoms were included. Lung functional tests were performed and previously undiagnosed COPD cases were identified and characterized based on national guidelines. RESULTS Out of 401 individuals newly attending the SCUs, 252 participants were included and 73 (28.9%) met the definition of previously undiagnosed COPD. A characterization of patients with COPD being newly recognized in SCUs showed: age (mean±SD) 61±9 years; men 59%; active work status 53.1%; functional class I/II dyspnea 82.8%, GOLD state mild/moderate/severe 57%/31%/12%; non-exacerbators 90%, CAT 14±4; emphysema in X-rays 40%. Most common co-morbidities were cardiovascular and psychiatric (anxiety and depression) ones. Usual smoking history included a lengthy smoking history (41±9 years) and a current consumption of 24±9 cigarettes/day. CONCLUSIONS AND IMPLICATIONS Consistently certified SCUs can have a substantial contribution to early diagnosis of COPD. A typical profile of newly detected cases is reported, with most patients being men at their early sixties, with mild symptoms and with high and lengthy smoking history. Our study reports a high usefulness of lung functional tests to detect undiagnosed COPD in appropriately selected participants attending SCUs at a large national scale, using a standardized methodology. This is likely to be facilitated by the certification of SCUs using well-defined requirements by national scientific societies.
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Affiliation(s)
| | | | - Carlos Rábade-Castedo
- Servicio de Neumología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - José-Ignacio de Granda-Orive
- Servicio de Neumología, Hospital Universitario Doce de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - Esther Pastor-Esplá
- Servicio de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | | | | | | | - Silvia Mas
- Universidad Pompeu Fabra, Barcelona, Spain
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Álvarez-Dobaño JM, Atienza G, Zamarrón C, Toubes ME, Ferreiro L, Riveiro V, Casal A, Suárez-Antelo J, Rodríguez-Núñez N, Lama-López A, Rábade-Castedo C, Rodríguez-García C, Lourido-Cebreiro T, Ricoy J, Abelleira R, Golpe A, Pais B, González-Barcala FJ, Valdés L. Health Outcomes: Towards the Accreditation of Respiratory Medicine Departments. Arch Bronconeumol 2021; 57:S0300-2896(21)00029-6. [PMID: 33678474 DOI: 10.1016/j.arbres.2021.01.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/04/2021] [Accepted: 01/13/2021] [Indexed: 11/22/2022]
Abstract
National health systems must ensure compliance with conditions such as equity, efficiency, quality, and transparency. Since it is the right of society to know the health outcomes of its healthcare system, our aim was to develop a proposal for the accreditation of respiratory medicine departments in terms of care, teaching, and research, measuring health outcomes using quality of care indicators. The management tools proposed in this article should be implemented to improve outcomes and help us achieve our objectives. Promoting accreditation can serve as a stimulus to improve clinical management and enable professionals to take on greater leadership roles and take action to improve outcomes in patient care.
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Affiliation(s)
- José Manuel Álvarez-Dobaño
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
| | - Gerardo Atienza
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, España
| | - Carlos Zamarrón
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - María Elena Toubes
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Lucía Ferreiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España.
| | - Vanessa Riveiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Ana Casal
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Juan Suárez-Antelo
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Nuria Rodríguez-Núñez
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Adriana Lama-López
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Carlos Rábade-Castedo
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Carlota Rodríguez-García
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Tamara Lourido-Cebreiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Jorge Ricoy
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Romina Abelleira
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Antonio Golpe
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
| | - Beatriz Pais
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, España
| | - Francisco Javier González-Barcala
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
| | - Luis Valdés
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
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García-Sanz MT, Martínez-Gestoso S, Calvo-Álvarez U, Doval-Oubiña L, Camba-Matos S, Rábade-Castedo C, Rodríguez-García C, González-Barcala FJ. Impact of Hyponatremia on COPD Exacerbation Prognosis. J Clin Med 2020; 9:jcm9020503. [PMID: 32059573 PMCID: PMC7074146 DOI: 10.3390/jcm9020503] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 12/23/2022] Open
Abstract
The most common electrolyte disorder among hospitalized patients, hyponatremia is a predictor of poor prognosis in various diseases. The aim of this study was to establish the prevalence of hyponatremia in patients admitted for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), as well as its association with poor clinical progress. Prospective observational study carried out from 1 October 2016 to 1 October 2018 in the following hospitals: Salnés in Vilagarcía de Arousa, Arquitecto Marcide in Ferrol, and the University Hospital Complex of Santiago de Compostela, Galicia, Spain, on patients admitted for AECOPD. Patient baseline treatment was identified, including hyponatremia-inducing drugs. Poor progress was defined as follows: prolonged stay, death during hospitalization, or readmission within one month after the index episode discharge. 602 patients were enrolled, 65 cases of hyponatremia (10.8%) were recorded, all of a mild nature (mean 131.6; SD 2.67). Of all the patients, 362 (60%) showed poor progress: 18 (3%) died at admission; 327 (54.3%) had a prolonged stay; and 91 (15.1%) were readmitted within one month after discharge. Patients with hyponatremia had a more frequent history of atrial fibrillation (AF) (p 0.005), pleural effusion (p 0.01), and prolonged stay (p 0.01). The factors independently associated with poor progress were hyponatremia, pneumonia, and not receiving home O2 treatment prior to admission. Hyponatremia is relatively frequent in patients admitted for AECOPD, and it has important prognostic implications, even when mild in nature.
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Affiliation(s)
- María-Teresa García-Sanz
- Emergency Department, Salnés County Hospital, 36600 Vilagarcía de Arousa, Spain; (S.M.-G.); (L.D.-O.); (S.C.-M.)
- Correspondence:
| | - Sandra Martínez-Gestoso
- Emergency Department, Salnés County Hospital, 36600 Vilagarcía de Arousa, Spain; (S.M.-G.); (L.D.-O.); (S.C.-M.)
| | - Uxío Calvo-Álvarez
- Respiratory Medicine Department, Hospital Arquitecto Marcide, 15405 Ferrol, Spain;
| | - Liliana Doval-Oubiña
- Emergency Department, Salnés County Hospital, 36600 Vilagarcía de Arousa, Spain; (S.M.-G.); (L.D.-O.); (S.C.-M.)
| | - Sandra Camba-Matos
- Emergency Department, Salnés County Hospital, 36600 Vilagarcía de Arousa, Spain; (S.M.-G.); (L.D.-O.); (S.C.-M.)
| | - Carlos Rábade-Castedo
- Respiratory Medicine Department, University Hospital Complex of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (C.R.-C.); (C.R.-G.); (F.-J.G.-B.)
| | - Carlota Rodríguez-García
- Respiratory Medicine Department, University Hospital Complex of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (C.R.-C.); (C.R.-G.); (F.-J.G.-B.)
| | - Francisco-Javier González-Barcala
- Respiratory Medicine Department, University Hospital Complex of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (C.R.-C.); (C.R.-G.); (F.-J.G.-B.)
- Medicine Department, University Hospital Complex of Santiago de Compostela, 15706 Santiago de Compostela, Spain
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