1
|
Cobo-Calvo Á, Gómez-Ballesteros R, Orviz A, Díaz Sánchez M, Boyero S, Aguado-Valcarcel M, Sepúlveda M, Rebollo P, López-Laiz P, Maurino J, Téllez Lara N. Therapeutic inertia in the management of neuromyelitis optica spectrum disorder. Front Neurol 2024; 15:1341473. [PMID: 38450077 PMCID: PMC10915282 DOI: 10.3389/fneur.2024.1341473] [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: 11/20/2023] [Accepted: 02/02/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction and objective Limited information is available on how neurologists make therapeutic decisions in neuromyelitis optica spectrum disorder (NMOSD), especially when new treatments with different mechanisms of action, administration, and safety profile are being approved. Decision-making can be complex under this uncertainty and may lead to therapeutic inertia (TI), which refers to lack of treatment initiation or intensification when therapeutic goals are not met. The study aim was to assess neurologists' TI in NMOSD. Methods An online, cross-sectional study was conducted in collaboration with the Spanish Society of Neurology. Neurologists answered a survey composed of demographic characteristics, professional background, and behavioral traits. TI was defined as the lack of initiation or intensification with high-efficacy treatments when there is evidence of disease activity and was assessed through five NMOSD aquaporin-4 positive (AQP4+) simulated case scenarios. A multivariate logistic regression analysis was used to determine the association between neurologists' characteristics and TI. Results A total of 78 neurologists were included (median interquartile range [IQR] age: 36.0 [29.0-46.0] years, 55.1% male, median [IQR] experience managing demyelinating conditions was 5.2 [3.0-11.1] years). The majority of participants were general neurologists (59.0%) attending a median (IQR) of 5.0 NMOSD patients (3.0-12.0) annually. Thirty participants (38.5%) were classified as having TI. Working in a low complexity hospital and giving high importance to patient's tolerability/safety when choosing a treatment were predictors of TI. Conclusion TI is a common phenomenon among neurologists managing NMOSD AQP4+. Identifying TI and implementing specific intervention strategies may be critical to improving therapeutic decisions and patient care.
Collapse
Affiliation(s)
- Álvaro Cobo-Calvo
- Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d’Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Aida Orviz
- Department of Neurology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - María Díaz Sánchez
- Department of Neurology, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Sabas Boyero
- Department of Neurology, Hospital Universitario Cruces, Bilbao, Spain
| | | | - María Sepúlveda
- Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | | | | | - Nieves Téllez Lara
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| |
Collapse
|
2
|
Rebollo P, García-López S, Povedano M, Cattinari MG, Martínez-Moreno M, Terrancle Á, Cabello-Moruno R, Vázquez-Costa JF. Design and Validation of a Clinical Outcome Measure for Adolescents and Adult Patients with Spinal Muscular Atrophy: SMA Life Study Protocol. Neurol Ther 2024; 13:233-249. [PMID: 38180726 PMCID: PMC10787721 DOI: 10.1007/s40120-023-00571-9] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/22/2023] [Indexed: 01/06/2024] Open
Abstract
INTRODUCTION The objective of this study is to develop a clinical tool for the evaluation and follow-up of adolescent and adult patients with 5q spinal muscular atrophy (SMA) and to design its validation. METHODS This prospective, non-interventional study will be carried out at five centres in Spain and will include patients aged 16 years or older with a confirmed diagnosis of 5q SMA (biallelic mutation of the survival motor neuron 1 [SMN1] gene). A panel of experts made up of neurologists, physiatrists and Spanish patients' association (FundAME), participated in the design of the clinical tool. Physicians will administer the tool at three time points (baseline, 12 months and 24 months). Additionally, data from other questionnaires and scales will be collected. Once recruitment is achieved, an interim statistical analysis will be performed to assess its psychometric properties by applying Rasch analysis and classical statistical tests. RESULTS The tool will consist of up to 53 items to assess functional status from a clinical perspective in seven key dimensions (bulbar, respiratory, axial, lower, upper, fatigability and other symptoms), which will be collected together with objective clinical measures (body mass index, forced vital capacity, pinch strength and 6-minute walk test). CONCLUSIONS The validation of this tool will facilitate the clinical evaluation of adult and adolescent patients with SMA and the quantification of their response to new treatments in both clinical practice and research.
Collapse
Affiliation(s)
| | | | - Mónica Povedano
- Unidad Funcional de Motoneurona (UFMN), Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Mercedes Martínez-Moreno
- Sección de Rehabilitación Infantil, Servicio de Medicina Física y Rehabilitación, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Juan F Vázquez-Costa
- Department of Medicine, University of Valencia, Valencia, Spain.
- ALS Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Avenida Fernando Abril Martorell 106, 46026, Valencia, Spain.
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain.
| |
Collapse
|
3
|
Olmedo M, Asensio Ú, García L, Rebollo P, Ricote I, Cardenas G, Marcos C. 35P Drug treatment management of advanced ALK-positive non-small cell lung cancer in Spain: A real-world cross-sectional analysis. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00289-7] [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: 04/04/2023]
|
4
|
Vázquez-Costa JF, Branas-Pampillón M, Medina-Cantillo J, Povedano M, Pitarch-Castellano I, López-Lobato M, Fernández-Ramos JA, Lafuente-Hidalgo M, Rojas-García R, Caballero-Caballero JM, Málaga I, Eirís-Puñal J, De Lemus M, Cattinari MG, Cabello-Moruno R, Díaz-Abós P, Sánchez-Menéndez V, Rebollo P, Maurino J, Madruga-Garrido M. Validation of a Set of Instruments to Assess Patient- and Caregiver-Oriented Measurements in Spinal Muscular Atrophy: Results of the SMA-TOOL Study. Neurol Ther 2023; 12:89-105. [PMID: 36269538 PMCID: PMC9837344 DOI: 10.1007/s40120-022-00411-2] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/04/2022] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Outcome measures traditionally used in spinal muscular atrophy (SMA) clinical trials are inadequate to assess the full range of disease severity. The aim of this study was to assess the psychometric properties of a set of existing questionnaires and new items, gathering information on the impact of SMA from the patient and caregiver perspectives. METHODS This was a multicenter, prospective, noninterventional study including patients with a confirmed diagnosis of 5q-autosomal-recessive SMA aged 8 years and above, or their parents (if aged between 2 and 8 years). The set of outcome measurements included the SMA Independence Scale (SMAIS) patient and caregiver versions, the Neuro-QoL Fatigue Computer Adaptive Test (CAT), the Neuro-QoL Pain Short Form-Pediatric Pain, the PROMIS adult Pain Interference CAT, and new items developed by Fundación Atrofia Muscular España: perceived fatigability, breathing and voice, sleep and rest, and vulnerability. Reliability, construct validity, discriminant validity, and sensitivity to change (4 months from baseline) were measured. RESULTS A total of 113 patients were included (59.3% 2-17 years old, 59.3% male, and 50.4% with SMA type II). Patients required moderate assistance [mean patient and caregiver SMAIS (SD) scores were 31.1 (12.8) and 7.6 (11.1), respectively]. Perceived fatigability was the most impacted domain, followed by vulnerability. Cronbach's alpha coefficient for perceived fatigability, breathing and voice, and vulnerability total scores were 0.92, 0.88, and 0.85, respectively. The exploratory factor analysis identified the main factors considered in the design, except in the sleep and rest domain. All questionnaires were able to discriminate between the Clinical Global Impression-Severity scores and SMA types. Sensitivity to change was only found for the SMAIS caregiver version and vulnerability items. CONCLUSIONS This set of outcome measures showed adequate reliability, construct validity, and discriminant validity and may constitute a valuable option to measure symptom severity in patients with SMA.
Collapse
Affiliation(s)
- Juan F Vázquez-Costa
- Neuromuscular Unit, Department of Neurology, Hospital Universitari I Politècnic La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | | | - Julita Medina-Cantillo
- Rehabilitation and Physical Unit Department, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Mónica Povedano
- Department of Neurology, IDIBELL, Hospital de Bellvitge, Barcelona, Spain
| | | | - Mercedes López-Lobato
- Neuromuscular Research Unit, Department of Pediatric Neurology, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Seville, Spain
| | | | - Miguel Lafuente-Hidalgo
- Child Neurology Unit, Department of Pediatrics, Hospital Universitario Miguel Servet, Saragossa, Spain
| | - Ricard Rojas-García
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | | | - Ignacio Málaga
- Child Neurology Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Jesús Eirís-Puñal
- Department of Pediatric Neurology, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Mencía De Lemus
- Fundacion Atrofia Muscular Espinal España (FundAME), Madrid, Spain
| | | | - Rosana Cabello-Moruno
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain
| | - Paola Díaz-Abós
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain
| | | | | | - Jorge Maurino
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain
| | | |
Collapse
|
5
|
Almonacid C, Fitas E, Sánchez-Covisa J, Gutiérrez H, Rebollo P. Geographical differences in the use of oral corticosteroids in patients with severe asthma in Spain: heat map based on existing databases analyses. BMC Pulm Med 2023; 23:3. [PMID: 36600236 PMCID: PMC9812540 DOI: 10.1186/s12890-022-02295-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 03/04/2022] [Accepted: 12/22/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Although there are currently alternative treatments to the long-term use of oral corticosteroids (OCS) in severe asthma, recent studies show excessive use depending on geography and differences in medical practice. The objective of the study was to describe the differences in OCS use for severe asthma across the Spanish geography. METHODS This is a real-world study using existing databases (year 2019): longitudinal patient database (EMR), based on electronic medical records, and database of pharmacological consumption (Sell-in) in basic healthcare areas. With EMR, the percentage of OCS prescriptions corresponding to patients with severe asthma (ICD-9 "asthma" and prescription of biological treatment and/or high dose of inhaled corticosteroids/long-acting inhaled β2 agonists) was calculated. This percentage was transferred to the OCS consumption of each basic healthcare area as reported in the Sell-in database and a national heat map was created. The estimation of OCS use in patients with severe asthma per 100,000 inhabitants for each region was calculated by grouping basic healthcare areas and the mean OCS use per patient for different regions in Spain was also estimated. RESULTS Patients with severe asthma in Spain were mostly female (69.6%), with a mean age (SD) of 57.6 years (18.01). Median time (Pc25-Pc75) since asthma diagnosis was 83.1 months (34.65-131.56). Of all patients with OCS prescriptions in 2019 identified in EMR, 4.4% corresponded to patients with severe asthma. Regions with the highest OCS use were Asturias, Andalucía, and Galicia, whereas those with the lowest use were Navarra, Baleares, Madrid and País Vasco. The mean OCS use per patient with severe asthma in 2019 throughout Spain was 1099.85 mg per patient, ranging from 782.99 mg in Navarra to 1432.64 in Asturias. CONCLUSIONS There are geographical differences between Spanish regions with respect to the use of OCS in patients with severe asthma. The national mean consumption of OCS per patient with severe asthma and year is above the limits that indicate good asthma control.
Collapse
Affiliation(s)
- Carlos Almonacid
- grid.418888.50000 0004 1766 1075Pulmonology Unit, Complejo Hospitalario de Toledo, Av. del Río Guadiana, 45007 Toledo, Spain
| | | | | | | | | |
Collapse
|
6
|
Fortea J, García-Arcelay E, Terrancle Á, Gálvez B, Díez-Carreras V, Rebollo P, Maurino J, Garcia-Ribas G. Attitudes of Neurologists Toward the Use of Biomarkers in the Diagnosis of Early Alzheimer's Disease. J Alzheimers Dis 2023; 93:275-282. [PMID: 36970902 DOI: 10.3233/jad-221160] [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] [Indexed: 05/09/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) biomarkers reflect key elements of pathophysiology and improve the diagnostic process. However, their use in routine clinical practice is still limited. OBJECTIVE We aimed to assess neurologists' barriers and enablers to early AD diagnosis using core AD biomarkers. METHODS We conducted an online study in collaboration with the Spanish Society of Neurology. Neurologists answered a survey exploring their attitudes towards AD diagnosis using biomarkers in mild cognitive impairment (MCI) or mild AD dementia. Multivariate logistic regression analyses were conducted to determine the association between neurologists' characteristics and diagnostic attitudes. RESULTS We included 188 neurologists with a mean age (SD) of 40.6 (11.3) years, 52.7% male. Most participants had access to AD biomarkers, mainly in cerebrospinal fluid (CSF) (89.9%,#x0025;, n = 169). The majority of participants (95.2%,#x0025;, n = 179) considered CSF biomarkers useful for an etiological diagnosis in MCI. However, 85.6% of respondents (n = 161) used them in less than 60% of their MCI patients in routine clinical practice. Facilitating patients and their families to plan for the future was the most frequent enabler for the use of biomarkers. Short consultation time and practicalities associated with the programming of a lumbar puncture were the most common barriers. A younger neurologist age (p = 0.010) and a higher number of patients managed weekly (p = 0.036) were positively associated with the use of biomarkers. CONCLUSION Most neurologists had a favorable attitude to the use of biomarkers, especially in MCI patients. Improvements in resources and consultation time may increase their use in routine clinical practice.
Collapse
Affiliation(s)
- Juan Fortea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Center of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | | | | | - Blanca Gálvez
- Medical Department, Roche Diagnostics, Barcelona, Spain
| | | | | | | | | |
Collapse
|
7
|
Povedano M, Vázquez-Costa J, Pitarch I, López-Lobato M, Medina J, Fernández-Ramos J, Lafuente-Hidalgo M, Rojas-García R, Caballero-Caballero J, Málaga I, Eirís J, De Lemus M, Cattinari M, Madruga-Garrido M, Branas M, Cabello-Moruno R, Díaz-Abós P, Terrancle A, Maurino J, Rebollo P. VP.55 Fatigue, pain, breathing, voice, fatigability, sleep, rest and vulnerability as meaningful outcomes in SMA care: the patients´ and caregivers' voice. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.209] [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: 11/05/2022]
|
8
|
Díaz-Guzmán J, Freixa-Pamias R, García-Alegría J, Pérez Cabeza AI, Roldán-Rabadán I, Antolin-Fontes B, Rebollo P, Llorac A, Genís-Gironés M, Escobar-Cervantes C. Epidemiology of atrial fibrillation-related ischemic stroke and its association with DOAC uptake in Spain: first national population-based study 2005 to 2018. Rev Esp Cardiol (Engl Ed) 2022; 75:496-505. [PMID: 34518112 DOI: 10.1016/j.rec.2021.07.009] [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: 03/13/2021] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION AND OBJECTIVES The incidence and prevalence of atrial fibrillation (AF), a major risk factor for stroke, has increased substantially in the past few years. However, several studies have reported a decline in AF-related stroke rates associated with higher uptake of direct oral anticoagulants (DOACs). This ecological study evaluated the association between DOAC uptake in Spain and the incidence rate (IR) of AF-related ischemic stroke. METHODS Data were obtained from the Registry of Activity of Specialized Healthcare of the Spanish Ministry of Health (RAE-MDS). AF-related ischemic strokes were identified using International Classification of Diseases codes. IR were age-standardized and adjusted to the 2013 European standard population. Poisson regression models were used to identify the association between DOAC uptake and AF-related ischemic stroke in patients aged ≥ 65 years. RESULTS Before the use of DOACs, the adjusted IR of AF-related ischemic stroke increased steadily from 2005 (IR=2.20 per 100 000 person/y) to 2012 (IR=2.67). Upon DOAC uptake in Spain from 2012 onwards for AF-related ischemic stroke prevention, the IR remained constant or decreased slightly (IR in 2018=2.66). Poisson regression showed that DOAC uptake was a significant predictor for the rate of AF-related ischemic stroke in patients older than 65 years (IRR=0.995; 95%CI, 0.995-0.996). CONCLUSIONS This study shows an association between DOAC use and a reduced incidence of AF-related ischemic stroke. While this association is based on aggregate data and cannot demonstrate causality, these findings suggest that higher DOAC uptake could improve health outcomes in AF patients in Spain.
Collapse
Affiliation(s)
- Jaime Díaz-Guzmán
- Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - Román Freixa-Pamias
- Servicio de Cardiología, Complex Hospitalari Moisès Broggi, Sant Joan Despí, Barcelona, Spain
| | | | - Alejandro-Isidoro Pérez Cabeza
- Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Inmaculada Roldán-Rabadán
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Instituto de Investigación del Hospital Universitario La Paz (IdiPaz), Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Aleix Llorac
- Departamento de Market Access, Bayer Hispania S.L., Sant Joan Despí, Barcelona, Spain
| | - Mar Genís-Gironés
- Departamento Médico, Bayer Hispania S.L., Sant Joan Despí, Barcelona, Spain
| | - Carlos Escobar-Cervantes
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Instituto de Investigación del Hospital Universitario La Paz (IdiPaz), Hospital Universitario La Paz, Madrid, Spain
| |
Collapse
|
9
|
Díaz-Guzmán J, Freixa-Pamias R, García-Alegría J, Pérez Cabeza AI, Roldán-Rabadán I, Antolin-Fontes B, Rebollo P, Llorac A, Genís-Gironés M, Escobar-Cervantes C. Epidemiología del ictus cardioembólico y su asociación con la penetración de los ACOD en España: primer estudio poblacional 2005-2018. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2021.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
10
|
Castro-Domínguez F, Vargas-Negrín F, Pérez C, Gutiérrez-Prieto H, Rebollo P. Unmet Needs in the Osteoarthritis Chronic Moderate to Severe Pain Management in Spain: A Real Word Data Study. Rheumatol Ther 2021; 8:1113-1127. [PMID: 34109548 PMCID: PMC8380598 DOI: 10.1007/s40744-021-00327-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/25/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Patients with moderate or severe pain due to osteoarthritis (OAP) usually undergo pharmacological treatment with NSAIDs and/or opioids. Many of them do not get adequate pain relief because of intolerances, contraindications and the ineffectiveness of these treatments. The main objective of the present study was to quantify the group of OAP patients who are inadequately treated for their pain in routine clinical practice in Spain and to describe the prescription flow of these patients. METHODS This was a non-interventional, retrospective cohort study conducted using the IQVIA's electronic medical records database in Spain. Patients with osteoarthritis (OA), aged ≥ 15 years and receiving any pain treatment during 12 out of 24 months between 1 October 2017 and 30 September 2019 were studied. Assumptions were made to identify patients with contraindication or intolerance to NSAIDs or opioids and those who failed NSAID or opioid therapy. RESULTS Out of 136,556 patients with OA, 29,886 had moderate-to-severe pain, which extrapolated to the general population in Spain represents 1,541,286 OAP patients. Mean age (SD) of OAP patients was 75 (12.8) years, and 73.8% were female; 52.8% were treated with NSAIDs and/or weak opioids. There were were 16,748 OAP patients (56.08%) (extrapolated figure 838,620) with one or more conditions associated with being inadequately treated (contraindication, intolerance or failed NSAID and/or opioid therapy). In most OAP patients (91%) pain treatment was initiated by the general practitioner (GP) alone. Considering overall successive therapy lines, after the first prescription, pain drugs were prescribed by a GP in 61% of the cases, by a specialist in 20% and by both in 18%. CONCLUSION More than half of the patients with OA in Spain have unsatisfactory pain control. Pain drugs are mainly prescribed by GPs, and specialists (traumatologists, rheumatologists, physiatrists and pain management specialists) are not very involved in the management of OAP patients.
Collapse
Affiliation(s)
- Francisco Castro-Domínguez
- Rheumatology Unit, Teknon Medical Center, Quirónsalud Group, Barcelona, Spain
- Rheumatology Unit, University Hospital "Sagrat Cor", Quirónsalud Group, Barcelona, Spain
- SER Working Group in Osteoarthritis, Spanish Society of Rheumatology, Madrid, Spain
| | | | | | | | - Pablo Rebollo
- IQVIA, C/ Juan Esplandiu 11, 6º, 28007, Madrid, Spain.
| |
Collapse
|
11
|
Azanza JR, Grau S, Vázquez L, Rebollo P, Peral C, López-Ibáñez de Aldecoa A, López-Gómez V. The cost-effectiveness of isavuconazole compared to voriconazole, the standard of care in the treatment of patients with invasive mould diseases, prior to differential pathogen diagnosis in Spain. Mycoses 2020; 64:66-77. [PMID: 32989796 PMCID: PMC7894146 DOI: 10.1111/myc.13189] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 12/29/2022]
Abstract
Background Invasive mould diseases are associated with high morbidity, mortality and economic impact. Its treatment is often started prior to differential pathogen diagnosis. Isavuconazole is approved for treatment of invasive aspergillosis (IA) and invasive mucormycosis (IM) when amphotericin‐B is not indicated. Objectives To estimate the cost‐effectiveness of isavuconazole vs voriconazole for the treatment of adult patients with possible IA prior to differential pathogen diagnosis, in Spain. Methods A decision tree analysis was performed using the Spanish Healthcare System perspective. Among all patients with possible IA, it was considered that 7.81% actually had IM. Costs for laboratory analysis, management of adverse events, hospitalisation and drugs per patient, deaths and long‐term effects in life years (LYs) and quality‐adjusted LYs (QALYs) were considered. Efficacy data were obtained from clinical trials and utilities from the literature. Deterministic and probabilistic sensitivity analyses (PSA) were conducted. Results In patients with possible IA and when compared to voricanozole, isavuconazole showed an incremental cost of 4758.53€, besides an incremental effectiveness of +0.49 LYs and +0.41 QALYs per patient. The Incremental Cost Effectiveness Ratio was 9622.52€ per LY gained and 11,734.79€ per QALY gained. The higher cost of isavuconazole was due to drug acquisition. Main parameters influencing results were mortality, treatment duration and hospitalisation days. The PSA results showed that isavuconazole has a probability of being cost‐effective of 67.34%, being dominant in 24.00% of cases. Conclusions Isavuconazole is a cost‐effective treatment compared to voriconazole for patients with possible IA for a willingness to pay threshold of 25,000€ per additional QALY.
Collapse
Affiliation(s)
- José Ramón Azanza
- Clinical Pharmacology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Santiago Grau
- Pharmacy Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lourdes Vázquez
- Hematology Department, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | | | - Carmen Peral
- Pharmacoeconomics Department, Pfizer, Madrid, Spain
| | | | | |
Collapse
|
12
|
Arlandis S, Franco A, Mora AM, Rebollo P. Validation of the Spanish version of the Bladder Pain/Interstitial Cystitis-Symptom Score (BPIC-SS) questionnaire. A useful tool for the diagnosis of bladder pain syndrome. Actas Urol Esp 2018; 42:457-464. [PMID: 29650471 DOI: 10.1016/j.acuro.2018.01.008] [Citation(s) in RCA: 2] [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: 11/07/2017] [Revised: 12/29/2017] [Accepted: 01/03/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Validation of the Spanish version of the Bladder Pain/Interstitial Cystitis-Symptom Score (BPIC-SS) questionnaire to evaluate its utility for the diagnosis of Bladder Pain Syndrome (BPS) patients in the Female and Urodynamics Urology Functional Units in Spain. MATERIAL AND METHODS The Spanish adaptation of the BPIC-SS questionnaire was evaluated in 243 BPS patients. EQ-5D-5L, Patient Perception of Bladder Condition (PPBC) and global impression questionnaire (CGI-S) were collected. Consistency, test-retest reliability in patients without clinical changes at 15 days, criterion validity and sensitivity to change were assessed in BPS patients with clinical changes at 6 months. The cut-off point for discriminating BPS patients from other similar pathologies (Hyperactive Bladder or other urinary pathologies) was analysed using ROC curve. RESULTS Mean (SD) BPIC-SS score (0-38) was 16.2 (12.0) points. Cronbach's alpha was 0.92 and intraclass coefficient correlation (ICC) was 0.82, ranging from 0.5-0.9 per item. Convergent validity determined a Spearman correlation of 0.63 with PPBC and -0.40 with EQ-5D-5L Visual Analogue Scale (VAS) and the effect size obtained in patients who improved their clinical status was 1.9. A score greater than or equal to 12 points in the BPIC-SS has been established as the best cut-off point for the diagnosis of BPS (87.5% sensitivity and 91.9% specificity). CONCLUSIONS The Spanish version of the BPIC-SS is a valid and reliable instrument for the diagnosis and follow-up of patients with BPS in Spain.
Collapse
Affiliation(s)
- S Arlandis
- Hospital Universitario y Politécnico La Fe, Valencia, España.
| | - A Franco
- Hospital Universitario Clínic, Barcelona, España
| | - A M Mora
- Departamento Médico, Astellas Pharma S.A., Madrid, España
| | - P Rebollo
- Health Economics & Outcomes Research. Real-World Evidence Solutions. QuintilesIMS, Barcelona, España
| |
Collapse
|
13
|
Martínez-Ginés ML, García-Domínguez JM, Forero L, Canal N, Rebollo P, Prefasi D, Honan CA, Maurino J. Spanish validation of a specific measure to assess work-related problems in people with multiple sclerosis: The Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ-23). Mult Scler Relat Disord 2018; 22:115-119. [DOI: 10.1016/j.msard.2018.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/02/2018] [Indexed: 01/30/2023]
|
14
|
Simmons D, Jelsma JGM, Galjaard S, Devlieger R, van Assche A, Jans G, Corcoy R, Adelantado JM, Dunne F, Desoye G, Harreiter J, Kautzky-Willer A, Damm P, Mathiesen ER, Jensen DM, Andersen LL, Lapolla A, Dalfra M, Bertolotto A, Wender-Ozegowska E, Zawiejska A, Hill D, Rebollo P, Snoek FJ, van Poppel MNM. Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus: The DALI Lifestyle Pilot. Diabetes Care 2015; 38:1650-6. [PMID: 26112044 DOI: 10.2337/dc15-0360] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [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: 02/18/2015] [Accepted: 05/12/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Ways to prevent gestational diabetes mellitus (GDM) remain unproven. We compared the impact of three lifestyle interventions (healthy eating [HE], physical activity [PA], and both HE and PA [HE+PA]) on GDM risk in a pilot multicenter randomized trial. RESEARCH DESIGN AND METHODS Pregnant women at risk for GDM (BMI ≥29 kg/m2) from nine European countries were invited to undertake a 75-g oral glucose tolerance test before 20 weeks' gestation. Those without GDM were randomized to HE, PA, or HE+PA. Women received five face-to-face and four optional telephone coaching sessions, based on the principles of motivational interviewing. A gestational weight gain (GWG) <5 kg was targeted. Coaches received standardized training and an intervention toolkit. Primary outcome measures were GWG, fasting glucose, and insulin sensitivity (HOMA) at 35-37 weeks. RESULTS Among the 150 trial participants, 32% developed GDM by 35-37 weeks and 20% achieved GWG <5 kg. HE women had less GWG (-2.6 kg [95% CI -4.9, -0.2]; P = 0.03) and lower fasting glucose (-0.3 mmol/L [-0.4, -0.1]; P = 0.01) than those in the PA group at 24-28 weeks. HOMA was comparable. No significant differences between HE+PA and the other groups were observed. CONCLUSIONS An antenatal HE intervention is associated with less GWG and lower fasting glucose compared with PA alone. These findings require a larger trial for confirmation but support the use of early HE interventions in obese pregnant women.
Collapse
Affiliation(s)
- David Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, U.K. University of Western Sydney, Campbelltown, NSW, Australia
| | - Judith G M Jelsma
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Sander Galjaard
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Andre van Assche
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Goele Jans
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Rosa Corcoy
- Institut de Recerca de l´Hospital de la Santa Creu i Sant Pau, Barcelona, Spain CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan M Adelantado
- Institut de Recerca de l´Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medizinische Universitaet Graz, Graz, Austria
| | - Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | | | | | - Ewa Wender-Ozegowska
- Department of Obstetrics and Women's Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Zawiejska
- Department of Obstetrics and Women's Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - David Hill
- Recherche en Santé Lawson SA, Bronschhofen, Switzerland
| | | | - Frank J Snoek
- Department of Medical Psychology, VU University Medical Center and Academic Medical Center, Amsterdam, the Netherlands
| | - Mireille N M van Poppel
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| |
Collapse
|
15
|
Cassadó J, Espuña-Pons M, Díaz-Cuervo H, Rebollo P. How can we measure bladder volumes in women with advanced pelvic organ prolapse? Ultrasound Obstet Gynecol 2015; 46:233-238. [PMID: 25270769 DOI: 10.1002/uog.14678] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 05/14/2014] [Revised: 09/01/2014] [Accepted: 09/19/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To compare bladder volumes determined by three different formulae using measurements obtained from two-dimensional translabial ultrasound (2D-US), with true bladder volumes, in women with advanced pelvic organ prolapse (POP). METHODS This was a prospective observational multicenter study of consecutive women on the waiting list for prolapse surgery in 24 gynecology departments. All women had a symptomatic genital prolapse Stage 2 or higher according to the Pelvic Organ Prolapse Quantification System (POP-Q). Bladder volumes were calculated before and after spontaneous voiding by 2D-US, and true bladder volumes were determined by micturition and catheterization. Volumes determined by US were calculated using three formulae (Haylen, Dietz and Dicuio). Correlation was calculated between the volume determined by US measurement before micturition and the true volume, and also between the volume determined by US measurements after micturition and the true volume. Correlations (Spearman's rho) and concordance (intraclass correlation coefficient (ICC)) were estimated for each of the three formulae considered. RESULTS One-hundred and eighty-six women with POP were included in the study. A total of 349 bladder volumes (186 before micturition and 163 after micturition) were obtained. Good correlation (rho, 0.818-0.849) and concordance (ICC, 0.827-0.898) were found between total measured volume (volume of spontaneous bladder voiding + volume obtained from catheterization) and the volume determined by US using the three different formulae, as well as between the post-void residual volume measured by catheterization and the post-void volume calculated by US using the three formulae (rho, 0.739-0.777; ICC, 0.840-0.877). CONCLUSIONS Bladder volumes in women with advanced POP can be measured easily by 2D-US. Volumes determined using the three different formulae show good correlations and concordance with true bladder volume.
Collapse
Affiliation(s)
- J Cassadó
- Hospital Universitari Mutua Terrassa, Terrassa, Spain
| | - M Espuña-Pons
- Hospital Clinic, Universidad de Barcelona, Barcelona, Spain
| | | | | |
Collapse
|
16
|
Escribano P, Del PR, Cuervo J, Rebollo P, Alvarez MP, Espinós B, Vieta A, López-Gude MJ, Cortina J. Management Of Chronic Thromboembolic Pulmonary Hypertension: Clinical And Reported Outcomes From A Referral Hospital In Spain. Value Health 2014; 17:A476. [PMID: 27201377 DOI: 10.1016/j.jval.2014.08.1365] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- P Escribano
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Pozo R Del
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | | | - A Vieta
- Bayer Hispania, Barcelona, Spain
| | | | - J Cortina
- Hospital Universitario 12 de Octubre, Madrid, Spain
| |
Collapse
|
17
|
Castejón N, Arenas MD, Rebollo P, Sellés GF, Delgado CP, Gil González MT, Gutierrez RP, Reichert GJ. Restless Leg Syndrome Detection in Hemodialysis. Value Health 2014; 17:A391. [PMID: 27200900 DOI: 10.1016/j.jval.2014.08.859] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - M D Arenas
- Hospital Vithas Perpetuo Socorro, Alicante, Spain
| | | | | | | | | | | | | |
Collapse
|
18
|
Rebollo P, Arenas MD, Castejón N, Reichert GJ, Delgado CP, Gutierrez RP, Gil GMT. Pain Incidence and Analgesic Consumption During Haemodialysis Sessions: Impact on Health-Related Quality Of Life. Value Health 2014; 17:A521-A522. [PMID: 27201632 DOI: 10.1016/j.jval.2014.08.1631] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - M D Arenas
- Hospital Vithas Perpetuo Socorro, Alicante, Spain
| | | | | | | | | | | |
Collapse
|
19
|
Castejón N, Harrington M, Campillo-Álvarez Á, Rebollo P. Patient Driven Questionnaire Development, Item Feedback from Users of A Patient Network. Value Health 2014; 17:A574. [PMID: 27201922 DOI: 10.1016/j.jval.2014.08.1928] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
20
|
Gutiérrez-Hernández P, Rebollo P. Preference for erectile dysfunction treatments: Assessment by means of consumers preference analysis techniques. Actas Urol Esp 2014; 38:319-26. [PMID: 24332530 DOI: 10.1016/j.acuro.2013.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 11/04/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Patient preference for erectile dysfunction (ED) treatments is of great importance for satisfaction and adherence. We have assessed the usefulness of the main technique for assessing consumer preferences (conjoint analysis) to analyze preferences towards these treatments. We also assessed the influence of age, frequency of sexual intercourse, co-morbidities, ED severity or having testosterone deficiency syndrome (TDS). MATERIAL AND METHOD Observational, cross-sectional, multicenter study in 626 men aged ≥18 years that had recently taken at least two different PDE5i, one being vardenafil orodispersible (ODT). Seven selected features of ED treatments were tested. Different series of scenarios (cards) were created by combining these features: two series of 4 features (9 cards), another one series of 7 (16 cards). Short series were tested in Primary Care, and the long series in Urology/Andrology offices. Influences were tested by rank ordered logistic regression analysis. RESULTS The feature «administration form» was consistently given the most relative importance; the ODT form was given the greatest utility. Consensus towards the most and least preferred treatment was achieved only in one of the short series tested. Only severity of TDS symptoms, or having the most frequent symptoms, influenced treatment preference. Influence was mild. CONCLUSIONS Conjoint analysis is a valid method for assessing preferences for ED treatments. A short series of highly selected attributes is advisable. Easiness and convenience of administration are of great importance for users. TDS symptomatology mildly affects preference.
Collapse
|
21
|
Espuña-Pons M, Fillol M, Pascual MA, Rebollo P, Mora AM. Pelvic floor symptoms and severity of pelvic organ prolapse in women seeking care for pelvic floor problems. Eur J Obstet Gynecol Reprod Biol 2014; 177:141-5. [PMID: 24784712 DOI: 10.1016/j.ejogrb.2014.03.050] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 02/10/2014] [Accepted: 03/31/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to estimate whether POP severity is related to lower urinary tract symptoms (LUTS) and symptoms of sexual difficulties, when evaluated with validated questionnaires. STUDY DESIGN Multicentric cross-sectional study of 521 women seeking care for PFD in 35 specialized urogynecological clinics. Patients answered the EPIQ to detect symptoms of PFD. The severity of urinary incontinence and the OAB symptoms were measured by ICIQ-UI SF and BSAQ. POP anatomic severity was measured by the anatomic stage of each compartment, determined in pelvic examination in accordance with the IUGA-ICS terminology. A maximum POP stage (M-POP-S) was assigned to each patient: Group A, patients with no POP (stage 0-I); group B, M-POP-S stage II; and group C, M-POP-S stage III-IV. RESULTS Pelvic examination demonstrated anatomic POP in 224 patients (stage from II to IV). 288 women (56.25%) were classified in group A (no prolapse); 102 (19.92%) group B (stage II); and 122 (28.83%) group C (stage III-IV). Several associations were found between studied variables and M-POP-S (age<55 years, menopause, number of vaginal deliveries, symptom of vaginal bulge, feeling of a bulge makes it difficult to have sexual relations, symptoms of stress urinary incontinence, nocturia and voiding difficulties), but the only variables independently associated were age, symptom of vaginal bulge and difficulty in having sexual relations due to feeling of a bulge. CONCLUSIONS In patients seeking care for PFD, LUTS are not independently associated to the prolapse stage.
Collapse
|
22
|
Alegret JM, Viñolas X, Arias MA, Martínez-Rubio A, Rebollo P, Ràfols C, Martínez-Sande JL. New oral anticoagulants vs vitamin K antagonists: benefits for health-related quality of life in patients with atrial fibrillation. Int J Med Sci 2014; 11:680-4. [PMID: 24843316 PMCID: PMC4025166 DOI: 10.7150/ijms.8916] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 04/01/2014] [Indexed: 11/19/2022] Open
Abstract
New oral anticoagulants (NOAC) have demonstrated their efficacy as an alternative to vitamin K antagonists (VKA) in the prophylaxis of cardioembolic events in patients with atrial fibrillation (AF). However, evidence on the benefits of NOAC in health-related quality of life (HRQoL) is lacking.We evaluated changes in HRQoL related to oral anticoagulation therapy employing a specific questionnaire in a cohort of 416 patients with AF undergoing electrical cardioversion. In terms of HRQoL, we observed a progressive adaptation to treatment with VKA; satisfaction with NOAC remained constant. Older age, higher left ventricular ejection fraction and NOAC were associated with better HRQoL.
Collapse
Affiliation(s)
- Josep M Alegret
- 1. Grup de Recerca Cardiovascular, Hospital Universitari de Sant Joan, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | | | | | | | | | - Carles Ràfols
- 6. Medical Department, Bayer HealthCare, Barcelona, Spain
| | | |
Collapse
|
23
|
Jimenez-Cidre MA, Lopez-Fando L, Esteban-Fuertes M, Prieto-Chaparro L, Llorens-Martinez FJ, Salinas-Casado J, Castro-Diaz D, Müller-Arteaga C, Adot-Zurbano JM, Rodriguez-Escobar F, Gutierrez C, Arlandis-Guzman S, Bonillo-Garcia MA, Madurga-Patuel B, Leva-Vallejo M, Franco de Castro A, Peri-Cusi L, Conejero-Sugrañes J, Jimenez-Calvo J, Rebollo P, Mora A. The 3-day bladder diary is a feasible, reliable and valid tool to evaluate the lower urinary tract symptoms in women. Neurourol Urodyn 2013; 34:128-32. [DOI: 10.1002/nau.22530] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 10/21/2013] [Indexed: 11/09/2022]
Affiliation(s)
| | - Luis Lopez-Fando
- Department of Urology; Hospital Universitario Ramón y Cajal; Madrid Spain
| | | | | | | | | | - David Castro-Diaz
- Department of Urology; Hospital Universitario de Canarias; Santa Cruz de Tenerife Spain
| | | | | | | | | | | | | | | | | | | | - Lluis Peri-Cusi
- Department of Urology; Hospital Clinic i Provincial; Barcelona Spain
| | | | | | | | - Ana Mora
- Medical Department; Astellas Pharma; Madrid Spain
| |
Collapse
|
24
|
Jelsma JGM, van Poppel MNM, Galjaard S, Desoye G, Corcoy R, Devlieger R, van Assche A, Timmerman D, Jans G, Harreiter J, Kautzky-Willer A, Damm P, Mathiesen ER, Jensen DM, Andersen L, Dunne F, Lapolla A, Di Cianni G, Bertolotto A, Wender-Oegowska E, Zawiejska A, Blumska K, Hill D, Rebollo P, Snoek FJ, Simmons D. DALI: Vitamin D and lifestyle intervention for gestational diabetes mellitus (GDM) prevention: an European multicentre, randomised trial - study protocol. BMC Pregnancy Childbirth 2013; 13:142. [PMID: 23829946 PMCID: PMC3710199 DOI: 10.1186/1471-2393-13-142] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 07/01/2013] [Indexed: 02/06/2023] Open
Abstract
Background Gestational diabetes mellitus (GDM) is an increasing problem world-wide. Lifestyle interventions and/or vitamin D supplementation might help prevent GDM in some women. Methods/design Pregnant women at risk of GDM (BMI≥29 (kg/m2)) from 9 European countries will be invited to participate and consent obtained before 19+6 weeks of gestation. After giving informed consent, women without GDM will be included (based on IADPSG criteria: fasting glucose<5.1mmol; 1 hour glucose <10.0 mmol; 2 hour glucose <8.5 mmol) and randomized to one of the 8 intervention arms using a 2×(2×2) factorial design: (1) healthy eating (HE), 2) physical activity (PA), 3) HE+PA, 4) control, 5) HE+PA+vitamin D, 6) HE+PA+placebo, 7) vitamin D alone, 8) placebo alone), pre-stratified for each site. In total, 880 women will be included with 110 women allocated to each arm. Between entry and 35 weeks of gestation, women allocated to a lifestyle intervention will receive 5 face-to-face, and 4 telephone coaching sessions, based on the principles of motivational interviewing. The lifestyle intervention includes a discussion about the risks of GDM, a weight gain target <5kg and either 7 healthy eating ‘messages’ and/or 5 physical activity ‘messages’ depending on randomization. Fidelity is monitored by the use of a personal digital assistance (PDA) system. Participants randomized to the vitamin D intervention receive either 1600 IU vitamin D or placebo for daily intake until delivery. Data is collected at baseline measurement, at 24–28 weeks, 35–37 weeks of gestation and after delivery. Primary outcome measures are gestational weight gain, fasting glucose and insulin sensitivity, with a range of obstetric secondary outcome measures including birth weight. Discussion DALI is a unique Europe-wide randomised controlled trial, which will gain insight into preventive measures against the development of GDM in overweight and obese women. Trial registration ISRCTN70595832
Collapse
Affiliation(s)
- Judith G M Jelsma
- Department of Public and Occupational Health, EMGO+-Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081BT Amsterdam, the Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Julián-Mauro JC, Cuervo J, Rebollo P, Callejo D. Employment status and indirect costs in patients with renal failure: differences between different modalities of renal replacement therapy. Nefrologia 2013; 33:333-341. [PMID: 23712223 DOI: 10.3265/nefrologia.pre2012.dec.11767] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2012] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND There are evidences of a different employment status between patients undergoing different modalities of renal replacement therapy (RRT). OBJECTIVES The present study aims to compare the indirect costs associated to morbidity in the following RRT alternatives: hemodialysis in a specialized center (HD), automated peritoneal dialysis (APD), continuous ambulatory dialysis (CAPD), and renal transplant (TX). METHODS An analysis on indirect costs was implemented following the Human Capital Theory. In total, 243 patients in working age were included (32 CAPD, 46 APD, 83 HD and 82 TX) from 8 hospitals. The potentially productive years of life lost (PPYL), the costs of lost labor productivity (LLPc) for the year 2009 and the total cost of PPYL (PPYLtc) until age of retirement were estimated. All the estimations were adjusted by age, sex rates. Non-parametric analysis (a bootstrap confidence intervals of differences in costs calculated following the simple bias-corrected percentile method -1,000 estimates-) was computed to highlight differences in costs. RESULTS No significant differences were found in age or sex between groups. LLPc-2009- in HD (6,547€-95% CI: 5,727€-7,366€) was significantly higher (p<.001) than TX (5,079€-95% CI: 4,127€-6,030€) or APD (4,359€-95% CI: 3,064€-5,655€) but not CAPD (5,785€-95% CI: 4,302€-7,269€). PPYLs were: HD 12.58 years-95% CI: 10.42-14.73; TX 10.05-95% CI: 7.45-12.65; APD 6.09-95% CI: 3.43-8.74; CAPD 10.69-95% CI: 6.14-15.23. PPYLtc was higher in HD than in TX, APD or CAPD in all the provided scenarios. CONCLUSIONS TX and, specially, APD are the modalities of RRT with the lowest impact on indirect costs due to morbidity showing higher rates of employment than HD and requiring less disability benefits.
Collapse
|
26
|
Villa G, Sánchez-Álvarez E, Cuervo J, Fernández-Ortiz L, Rebollo P, Ortega F. Cost-effectiveness analysis of timely dialysis referral after renal transplant failure in Spain. BMC Health Serv Res 2012; 12:257. [PMID: 22897891 PMCID: PMC3465227 DOI: 10.1186/1472-6963-12-257] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 08/06/2012] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A cost-effectiveness analysis of timely dialysis referral after renal transplant failure was undertaken from the perspective of the Public Administration. The current Spanish situation, where all the patients undergoing graft function loss are referred back to dialysis in a late manner, was compared to an ideal scenario where all the patients are timely referred. METHODS A Markov model was developed in which six health states were defined: hemodialysis, peritoneal dialysis, kidney transplantation, late referral hemodialysis, late referral peritoneal dialysis and death. The model carried out a simulation of the progression of renal disease for a hypothetical cohort of 1,000 patients aged 40, who were observed in a lifetime temporal horizon of 45 years. In depth sensitivity analyses were performed in order to ensure the robustness of the results obtained. RESULTS Considering a discount rate of 3 %, timely referral showed an incremental cost of 211 €, compared to late referral. This cost increase was however a consequence of the incremental survival observed. The incremental effectiveness was 0.0087 quality-adjusted life years (QALY). When comparing both scenarios, an incremental cost-effectiveness ratio of 24,390 €/QALY was obtained, meaning that timely dialysis referral might be an efficient alternative if a willingness-to-pay threshold of 45,000 €/QALY is considered. This result proved to be independent of the proportion of late referral patients observed. The acceptance probability of timely referral was 61.90 %, while late referral was acceptable in 38.10 % of the simulations. If we however restrict the analysis to those situations not involving any loss of effectiveness, the acceptance probability of timely referral was 70.10 %, increasing twofold that of late referral (29.90 %). CONCLUSIONS Timely dialysis referral after graft function loss might be an efficient alternative in Spain, improving both patients' survival rates and health-related quality of life at an affordable cost. Spanish Public Health authorities might therefore promote the inclusion of specific recommendations for this group of patients within the existing clinical guidelines.
Collapse
Affiliation(s)
- Guillermo Villa
- BAP LA-SER Outcomes, LA-SER Group, Azcárraga, 12 A, 33010, Oviedo, Asturias, Spain
- Department of Medicine, Universidad de Oviedo, Oviedo, Spain
| | | | - Jesús Cuervo
- BAP LA-SER Outcomes, LA-SER Group, Azcárraga, 12 A, 33010, Oviedo, Asturias, Spain
| | | | - Pablo Rebollo
- BAP LA-SER Outcomes, LA-SER Group, Azcárraga, 12 A, 33010, Oviedo, Asturias, Spain
| | - Francisco Ortega
- Department of Medicine, Universidad de Oviedo, Oviedo, Spain
- Department of Nephrology, Hospital Universitario Central de Asturias, Oviedo, Spain
| |
Collapse
|
27
|
Vellinga A, Zawiejska A, Harreiter J, Buckley B, Di Cianni G, Lapolla A, Corcoy R, Simmons D, Adelantado JM, Damm P, Desoye G, Devlieger R, Hill D, Kautzky-Willer A, Klemetti M, Mathiesen E, Rebollo P, Snoek F, Tikkanen M, Timmerman D, van Assche A, van Poppel M, Wender-Oegowska E, Dunne F. Associations of Body Mass Index (Maternal BMI) and Gestational Diabetes Mellitus with Neonatal and Maternal Pregnancy Outcomes in a Multicentre European Database (Diabetes and Pregnancy Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention). ISRN Obes 2012; 2012:424010. [PMID: 24527262 PMCID: PMC3914269 DOI: 10.5402/2012/424010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 04/04/2012] [Indexed: 11/23/2022]
Abstract
Objective. Assess the impact of Gestational Diabetes Mellitus (GDM) and obesity on neonatal and maternal pregnancy outcomes. Methods. Cross-sectional data (3343 pregnancies) from seven European centres were included in a multilevel analysis of the association between GDM/obesity and caesarean section, macrosomia and neonatal morbidities. Results. Comparison of databases identified reporting differences between countries due to the inclusion of true population based samples or pregnancies from specialised tertiary centres, resulting in higher prevalences of GDM for some countries. The analysis showed that obesity and GDM were independent risk factors of perinatal complications. Only BMI had a dose-dependent effect on the risk of macrosomia and caesarean section. Both obesity (BMI > 30 kg/m2) and GDM were independent risk factors of neonatal morbidities. Conclusions. Obesity and GDM were independent risk factors of perinatal complications. The effect of the worldwide obesity and diabetes epidemic is extending to the next generation.
Collapse
Affiliation(s)
- Akke Vellinga
- School of Medicine, Clinical Science Institute, National University of Ireland, Galway, Ireland
| | - A Zawiejska
- Akademia Medyczna im Karola Marcinkowskiego, 60-512 Poznan, Poland
| | - J Harreiter
- Department of Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - B Buckley
- School of Medicine, Clinical Science Institute, National University of Ireland, Galway, Ireland
| | - G Di Cianni
- Dipartimento di Endocrinologia e Malattie del Metabolismo, Università di Pisa, 56126 Pisa, Italy
| | - A Lapolla
- Dipartimento Scienze Mediche e Chirurgiche, Università degli Studi di Padova, 35122 Padova, Italy
| | - R Corcoy
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - D Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - J M Adelantado
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - P Damm
- Department of Obstetrics, Rigshospitalet, University Hospital of Copenhagen, 2100 Copenhagen, Denmark
| | - G Desoye
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria
| | - R Devlieger
- University Hospitals Leuven, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - D Hill
- Recherche en Sante Lawson, 9552 Bronschhofen, Switzerland
| | - A Kautzky-Willer
- Department of Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - M Klemetti
- Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, 00029 Helsinki, Finland
| | - E Mathiesen
- Department of Obstetrics, Rigshospitalet, University Hospital of Copenhagen, 2100 Copenhagen, Denmark
| | - P Rebollo
- BAP Health Outcomes Research, S.L, 33010 Oviedo, Spain
| | - F Snoek
- Department of Public and Occupational Health, EMGO Institute, VU University Medical Center Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - M Tikkanen
- Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, 00029 Helsinki, Finland
| | - D Timmerman
- University Hospitals Leuven, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - A van Assche
- University Hospitals Leuven, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - M van Poppel
- Department of Public and Occupational Health, EMGO Institute, VU University Medical Center Amsterdam, 1007 MB Amsterdam, The Netherlands
| | | | - F Dunne
- School of Medicine, Clinical Science Institute, National University of Ireland, Galway, Ireland
| |
Collapse
|
28
|
Parra E, Arenas MD, Alonso M, Martínez MF, Gamen A, Balda S, Rebollo P, Martínez T, Álvarez-Ude F. Outcomes weighting for comprehensive haemodialysis centre assessment. Nefrologia 2012; 32:659-663. [PMID: 23013953 DOI: 10.3265/nefrologia.pre2012.jun.11426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2012] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND At present, there is no adequate system available for evaluating dialysis centres. OBJECTIVES To construct an overall haemodialysis results weighting system, acceptable to the different stakeholders involved which allows the comparison of centres using a compound marker. METHOD The Quality Management Work Group of the Spanish Society of Nephrology (WG) established a set of preselected indicators. A Focus Group, independent of the WG, was established. It was made up of nine individuals: three patients, three clinicians and three clinical managers, who assessed these indicators using an approved methodology and established the selected indicators. Finally, the indicators were weighted through three weighting stages, each separated by two debate periods, which involved the distribution of 100 points between each variable, according to the personal assessment and the debate sustained. RESULTS The clinical results included: haemodialysis doses, anaemia, plasma calcium and phosphorus, type of vascular access, and hospitalisation days. The weighting given to each variable following the third weighting process, expressed as an average of all the factors, was as follows: clinical results 38.9; annual mortality 25.0; satisfaction with the centre 12.2; health-related quality of life 15.6; and cost 8.3 (total 100). CONCLUSIONS The weighting structure covers relevant and overall results and includes the opinion of all stakeholders involved; all of which will increase its acceptability and widespread use and contribute to the analysis of the value produced by the centres and the improvement of the results.
Collapse
Affiliation(s)
- Eduardo Parra
- Servicio de Nefrología, Hospital Reina Sofía de Tudela, Tudela, Navarra, Spain.
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Villa G, Fernández-Ortiz L, Cuervo J, Rebollo P, Selgas R, González T, Arrieta J. Cost-effectiveness analysis of the Spanish renal replacement therapy program. Perit Dial Int 2011; 32:192-9. [PMID: 21965620 DOI: 10.3747/pdi.2011.00037] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND We undertook a cost-effectiveness analysis of the Spanish Renal Replacement Therapy (RRT) program for end-stage renal disease patients from a societal perspective. The current Spanish situation was compared with several hypothetical scenarios. METHODS A Markov chain model was used as a foundation for simulations of the Spanish RRT program in three temporal horizons (5, 10, and 15 years). The current situation (scenario 1) was compared with three different scenarios: increased proportion of overall scheduled (planned) incident patients (scenario 2); constant proportion of overall scheduled incident patients, but increased proportion of scheduled incident patients on peritoneal dialysis (PD), resulting in a lower proportion of scheduled incident patients on hemodialysis (HD) (scenario 3); and increased overall proportion of scheduled incident patients together with increased scheduled incidence of patients on PD (scenario 4). RESULTS The incremental cost-effectiveness ratios (ICERs) of scenarios 2, 3, and 4, when compared with scenario 1, were estimated to be, respectively, -€83 150, -€354 977, and -€235 886 per incremental quality-adjusted life year (ΔQALY), evidencing both moderate cost savings and slight effectiveness gains. The net health benefits that would accrue to society were estimated to be, respectively, 0.0045, 0.0211, and 0.0219 ΔQALYs considering a willingness-to-pay threshold of €35 000/ΔQALY. CONCLUSIONS Scenario 1, the current Spanish situation, was dominated by all the proposed scenarios. Interestingly, scenarios 3 and 4 showed the best results in terms of cost-effectiveness. From a cost-effectiveness perspective, an increase in the overall scheduled incidence of RRT, and particularly that of PD, should be promoted.
Collapse
Affiliation(s)
- Guillermo Villa
- BAP Health Outcomes Research1 and Department of Medicine, Universidad de Oviedo, Oviedo, Spain.
| | | | | | | | | | | | | |
Collapse
|
30
|
Grau S, Rebollo P, Cuervo J, Gil-Parrado S. [Pharmacoeconomic assessment of daptomycin as first-line therapy for bacteraemia and complicated skin and skin structure infections caused by gram-positive pathogens in Spain]. Rev Esp Quimioter 2011; 24:154-163. [PMID: 21947099] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To assess the efficiency of daptomycin as firstline therapy (D) versus daptomycin as salvage therapy after vancomycin (V→D ) or linezolid (L→D) failure in gram-positive bacteraemia and complicated skin and skin-structure infections (cSSTIs). METHODS Cost-effectiveness analysis of 161 bacteraemia and 84 cSSTIs patients comparing the above mentioned therapeutic alternatives was performed using the data from 27 Spanish hospitals involved in the EUCORE study. Direct medical costs were considered. Patients were observed from the first antibiotic dose for infection until either the end of daptomycin therapy or exitus. A multivariate Monte Carlo probabilistic sensitivity analysis was applied for costs (lognormal distribution) and effectiveness (normal distribution). RESULTS In terms of effectiveness there were no statistical differences between groups but referring total costs per patient, there were significant differences. Sensitivity analysis confirmed that D dominates over L→D between 44.2%-62.1% of simulations in bacteraemia and between 48.2%-67.5% in cSSTIs. In comparison to V→D, D dominance was detected in 29.2%-33.2% of simulations in bacteraemia and between 48.2%-59.3% in cSSTIs. CONCLUSIONS Daptomycin as first-line therapy dominates over daptomycin as salvage therapy after linezolid failure both in bacteraemia and cSSTIs. Comparing daptomycin as first-line therapy with its use after vancomycin failure, in cSSTIs the former is dominant. In bacteremia daptomycin as first line therapy is as effective as daptomycin as salvage therapy after vancomycin failure and implies lower costs.
Collapse
Affiliation(s)
- S Grau
- Departamento de Farmacia del Hospital del Mar. Universitat Autònoma de Barcelona, Spain.
| | | | | | | |
Collapse
|
31
|
Montejo AL, Correas-Lauffer J, Mauriño J, Villa G, Rebollo P, Díez T, Cordero L. Estimation of a multiattribute utility function for the Spanish version of the TooL questionnaire. Value Health 2011; 14:564-570. [PMID: 21669381 DOI: 10.1016/j.jval.2010.11.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 09/26/2010] [Accepted: 11/10/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To estimate and assess the psychometric properties of a multiattribute utility function (MAUF) for the Spanish version of the Tolerability and Quality of Life (TooL questionnaire). METHODS Balanced data on 243 patients diagnosed with schizophrenia or bipolar disorder were gathered. In addition to the demographic and clinical variables and the usual generic health-related quality of life (HRQoL) questionnaires (EuroQol-5D [EQ-5D] and Short Form-6D [SF-6D]), instruments considered included the Spanish versions of the Positive and Negative Symptoms of Schizophrenia Scale (PANSS), Young Mania Rating Scale (YMRS), Montgomery-Asberg Depression Rating Scale (MADRS), Udvalg for Kliniske Undersogelser (UKU), and Clinical Global Impression Severity (CGIS) scale. MAUF parameters estimation involved a number of visual analogue scale (VAS) and time trade-off (TTO) ratings that proved difficult to be performed by the patients. After checking for inconsistencies in patient responses, the original sample was reduced to a still balanced subsample of 70 individuals. A multiplicative-form MAUF was estimated following the standard methodology. RESULTS Good convergent validity was demonstrated because utility estimates from the MAUF presented strong correlations with utilities from the generic HRQoL instruments included: SF-6D (0.66, P < 0.01), EQ-5D (0.69, P < 0.01), and moderate correlations with the rest of instruments considered: PANSS (-0.27, P = 0.10), YMRS (-0.30, P = 0.08), MADRS (-0.48, P < 0.01), UKU (-0.35, P < 0.01). Criterion validity was also met because differences in mean utilities by clinical severity were found (P < 0.01). Utilities from the MAUF covered a wider range of health states [0.04,1.00] than those from the SF-6D [0.53,1.00] and EQ-5D [0.23,0.96]. CONCLUSIONS Utilities from the MAUF showed good psychometric properties, serving as a complement to generic health utilities. If misapplied, however, utilities from this instrument might favor the positive evaluation of drugs showing fewer associated side effects.
Collapse
Affiliation(s)
- Angel Luis Montejo
- Department of Psychiatry, Hospital Universitario de Salamanca, Salamanca, Spain
| | | | | | | | | | | | | |
Collapse
|
32
|
Villa G, Rodríguez-Carmona A, Fernández-Ortiz L, Cuervo J, Rebollo P, Otero A, Arrieta J. Cost analysis of the Spanish renal replacement therapy programme. Nephrol Dial Transplant 2011; 26:3709-14. [PMID: 21427072 DOI: 10.1093/ndt/gfr088] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A cost analysis of the Spanish Renal Replacement Therapy (RRT) programme in the year 2010, for end-stage renal disease (ESRD) patients, was performed from the perspective of the Public Administration. METHODS The costs associated with each RRT modality [hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation (Tx)] were analysed. The Spanish ESRD incidence and prevalence figures in the year 2010 were forecasted in order to enable the calculation of an aggregate cost for each modality. Costs were mainly computed based on a review of the existing literature and of the Official Bulletins of the Spanish Autonomous Communities. Data from Oblikue Consulting eSalud health care costs database and from several Spanish public sources were also employed. RESULTS In the year 2010, the forecasted incidence figures for HD, PD and Tx were 5409, 822 and 2317 patients, respectively. The forecasted prevalence figures were 22,582, 2420 and 24,761 patients, respectively. The average annual per-patient costs (incidence and prevalence) were €2651 and €37,968 (HD), €1808 and €25,826 (PD) and €38,313 and €6283 (Tx). Indirect costs amounted to €8929 (HD), €7429 (PD) and €5483 (Tx). The economic impact of the Spanish RRT programme on the Public Administration budget was estimated at ~€1829 million (indirect costs included): €1327 (HD), €109 (PD) and €393 (Tx) million. CONCLUSIONS HD accounted for >70% of the aggregate costs of the Spanish RRT programme in 2010. From a costs minimization perspective, it would be preferable if the number of incident and prevalent patients in PD were increased.
Collapse
Affiliation(s)
- Guillermo Villa
- Department of Health Outcomes Research, BAP Health Outcomes Research, Oviedo, Spain.
| | | | | | | | | | | | | |
Collapse
|
33
|
Montejo AL, Lauffer JC, Cuervo J, Rebollo P, Cordero L, Diez T, Maurino J. Validation of a specific measure to assess health-related quality of life in patients with schizophrenia and bipolar disorder: the 'Tolerability and quality of life' (TOOL) questionnaire. Ann Gen Psychiatry 2011; 10:6. [PMID: 21396102 PMCID: PMC3062605 DOI: 10.1186/1744-859x-10-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Accepted: 03/11/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perception of quality of life may differ depending on the perspective. The aim of the study was to assess the psychometric properties of the Spanish version of the 'TOlerability and quality Of Life' (TOOL) questionnaire, a specific self-rated instrument to evaluate the impact of side effects of antipsychotic drugs on health-related quality of life (HRQoL). The questionnaire consists of eight items answered on a four-point Likert scale. METHODS A psychometric study was conducted with clinically stable outpatients with schizophrenia and bipolar disorder under antipsychotic treatment. The translation and cultural adaptation of the questionnaire was performed according to international standards. Internal consistency using the Cronbach α coefficient and test-retest reliability using the intraclass correlation coefficient (ICC) was used to assess the reliability of the instrument. Patients completed generic and specific measures of quality of life and clinical severity. RESULTS A total of 238 patients were analysed, with a mean age of 42 years (SD 10.9). The mean completion time was 4.9 min (SD 4.4). Internal consistency and intraclass correlation coefficient were adequate (Cronbach α = 0.757 and ICC = 0.90). Factorial analysis showed a unidimensional structure (a single eigenvalue >1, accounting for 39.1% of variance). Significant Spearman's rank correlations between the TOOL and both generic and specific measures were found. The questionnaire was able to discriminate among the Clinical Global Impression - Severity scores (Mann-Whitney U test, P < 0.001). CONCLUSIONS The TOOL questionnaire shows appropriate feasibility, reliability, and discriminative performance as a patient-reported outcome. TOOL constitutes a valuable addition to measure the impact of adverse events of antipsychotic drugs from the patient perspective.
Collapse
Affiliation(s)
- Angel L Montejo
- Neuroscience Area, AstraZeneca Medical Department, Madrid, Spain.
| | | | | | | | | | | | | |
Collapse
|
34
|
Rebollo P, Castejón I, Cuervo J, Villa G, García-Cueto E, Díaz-Cuervo H, Zardaín PC, Muñiz J, Alonso J. Validation of a computer-adaptive test to evaluate generic health-related quality of life. Health Qual Life Outcomes 2010; 8:147. [PMID: 21129169 PMCID: PMC3022567 DOI: 10.1186/1477-7525-8-147] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Accepted: 12/03/2010] [Indexed: 11/10/2022] Open
Abstract
Background Health Related Quality of Life (HRQoL) is a relevant variable in the evaluation of health outcomes. Questionnaires based on Classical Test Theory typically require a large number of items to evaluate HRQoL. Computer Adaptive Testing (CAT) can be used to reduce tests length while maintaining and, in some cases, improving accuracy. This study aimed at validating a CAT based on Item Response Theory (IRT) for evaluation of generic HRQoL: the CAT-Health instrument. Methods Cross-sectional study of subjects aged over 18 attending Primary Care Centres for any reason. CAT-Health was administered along with the SF-12 Health Survey. Age, gender and a checklist of chronic conditions were also collected. CAT-Health was evaluated considering: 1) feasibility: completion time and test length; 2) content range coverage, Item Exposure Rate (IER) and test precision; and 3) construct validity: differences in the CAT-Health scores according to clinical variables and correlations between both questionnaires. Results 396 subjects answered CAT-Health and SF-12, 67.2% females, mean age (SD) 48.6 (17.7) years. 36.9% did not report any chronic condition. Median completion time for CAT-Health was 81 seconds (IQ range = 59-118) and it increased with age (p < 0.001). The median number of items administered was 8 (IQ range = 6-10). Neither ceiling nor floor effects were found for the score. None of the items in the pool had an IER of 100% and it was over 5% for 27.1% of the items. Test Information Function (TIF) peaked between levels -1 and 0 of HRQoL. Statistically significant differences were observed in the CAT-Health scores according to the number and type of conditions. Conclusions Although domain-specific CATs exist for various areas of HRQoL, CAT-Health is one of the first IRT-based CATs designed to evaluate generic HRQoL and it has proven feasible, valid and efficient, when administered to a broad sample of individuals attending primary care settings.
Collapse
|
35
|
Rebollo P, Cuervo J, Villa G, Barreda MJ, Tranche S, Sánchez-Baragaño MA, Prieto MÁ. [Development and validation of a generic questionnaire for evaluating satisfaction in patients with chronic disease: the SAT-Q Questionnaire]. Aten Primaria 2010; 42:612-9. [PMID: 20304529 PMCID: PMC7024501 DOI: 10.1016/j.aprim.2009.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 11/11/2009] [Revised: 12/10/2009] [Accepted: 12/10/2009] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To develop and validate a brief general questionnaire to assess satisfaction in patients with chronic disease. DESIGN epidemiological, observational, multicentre cross-sectional study. LOCATION 4 Primary Health Care Centers from the IV Health Area in the Principality of Asturias. SUBJECTS A total of 202 patients diagnosed with chronic illness who were following a pharmacological regimen for at least one year. METHODS An extensive literature review was conducted to create an initial item pool of 61 questions regarding patient satisfaction. Then, a forward-backward translation into Spanish was carried out. Next, both the expert (n=8) and patient (n=30) panels led to a new version of 34 items (concerning satisfaction with medication and satisfaction with health service). Finally, scale item reduction (item-total correlation and exploratory factorial analysis -EFA-) and psychometrical validation (feasibility, reliability and criterion validity) of the SAT-Q- were evaluated. Both the SAT-Q and the SF-12 (to assess patient health related quality of life) were applied. RESULTS Item reduction analysis resulted in 18 items: general satisfaction with medication (3), adverse-events (3), oversights (2), effectiveness (3), convenience (4) and Health services (3). Internal consistency (Cronbach α) and Intraclass Correlation Coefficients were moderate-high. Moreover, significant positive correlations between SAT-Q scores and SF-12 Physical and Mental Summary Components were found (with the exception of oversights). CONCLUSIONS A brief questionnaire for measuring satisfaction in chronic patients has been developed and preliminary validated.
Collapse
|
36
|
Arenas MD, Rebollo P, Malek T, Moledous A, Gil MT, Alvarez-Ude F, Morales A, Cotilla E. A comparative study of 2 new phosphate binders (sevelamer and lanthanum carbonate) in routine clinical practice. J Nephrol 2010; 23:683-692. [PMID: 20540040] [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] [Accepted: 11/27/2009] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Lack of adherence may influence the efficiency of phosphate binders. Our clinical hypothesis was that if lanthanum carbonate (LC) might offer some advantage over sevelamer (S), that that would be in those patients in whom serum phosphate (P) levels were not controlled by S or in those requiring high doses of it, presuming that therapeutic compliance with S could be inadequate. The aim of this study was to compare the cost-consequences of changing from S to LC. METHODS This was a prospective comparative before-after interventional study. Fifty-one hemodialysis patients prescribed a large number of tablets of S (≥ 9 tablets/day) and/or had serum phosphorus (P) levels >5.5 mg/dL were changed from S to LC; 68 patients who did not meet those criteria served as controls. RESULTS Mean daily number of total phosphate binder tablets was reduced after the introduction of LC (13.9 ± 5.5 at time 0 vs. 7.7 ± 4.6 at 12 months; p<0.001). LC was suspended in 14 patients (31.1%), due to a wish to return to the previous medication (S). Percentage compliance with the objectives recommended by the NFK-KDOQI guidelines improved after the change (patients with P <5.5 mg/dL: 46.9% at month 0 and 72.5% at month 12; p<0.01). The incremental cost of changing from S (month 0) to LC (month 12) was -107.8 monthly, considering only the costs of phosphate binders. LC reached the P objective at a lower cost (euro 582.2 vs. euro 1,038.5; -44%; p<0.01). CONCLUSIONS A complete change from S to LC in these particular kinds of patients significantly decreased the cost of treatment while also improving the achievement of NFK-KDOQI guideline objectives for mineral metabolism.
Collapse
Affiliation(s)
- María Dolores Arenas
- Department of Nephrology, Hospital Perpetuo Socorro, Plaza Dr. Gomez Ulla 15, Alicante, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Martínez-Agulló E, Ruiz-Cerdá J, Arlandis S, Rebollo P, Pérez M, Chaves J. Análisis del síndrome de vejiga hiperactiva y de la incontinencia urinaria en mujeres laboralmente activas entre 25-64 años: Estudio EPICC. Actas Urol Esp 2010. [DOI: 10.4321/s0210-48062010000700008] [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: 11/11/2022]
|
38
|
Martínez-Agulló E, Ruiz-Cerdá JL, Arlandis S, Rebollo P, Pérez M, Chaves J. [Analysis of overactive bladder and urinary incontinence in working women aged between 25 and 64 years. EPICC study]. Actas Urol Esp 2010; 34:618-624. [PMID: 20540879] [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: 05/29/2023]
Abstract
INTRODUCTION Urinary symptoms Overactive Bladder (OAB) and Urinary Incontinence (UI) result in an important personal and economic impact. This work concentrates on the detailed analysis of OAB and UI (derived symptoms and tendencies in medical consultation and resource consumption), in a sample of working women aged 25-64. MATERIAL AND METHODS Study within the framework of the EPICC study of the Spanish Association of Urology (epidemiologic, observational, multicentric, national study) and concentrates on the detailed analysis of the characteristics of the sample of working women aged 25-64 (N=3090) and of the subgroup of individuals with VH and/or IU (N=307). RESULTS 4.01% of the subjects presented UI alone, 2.69% OAB alone, 3.24% presented both pathologies. There exists association between UI and/or VH presence and frequent urinary infections, hypertension and diabetes. Taking into account individuals with UI and/or OAB, 28.01% had problems to retain urine, and 16.94% suffered leakage daily; 27.36% suffered uncontrollable urge to urinate daily; 57.65% had never sought medical advice, 35.40% had visited an specialist, 23.13% would like to visit an specialist in incontinence; 28.01% had received treatment, from which 55.81% had received physiotherapy and 25.58% pharmacologic treatment. CONCLUSION In this study, specific data about VH and IU in working women aged 25-64 are presented, including those referring to the magnitude of these conditions and use of sanitary resources in subjects with UI and/or OAB, aiming at contributing to a better diagnose and handling of patients and resources.
Collapse
|
39
|
Martínez-Agulló E, Ruiz-Cerdá J, Arlandis S, Rebollo P, Pérez M, Chaves J. Análisis del síndrome de vejiga hiperactiva y de la incontinencia urinaria en mujeres laboralmente activas entre 25–64 años. Estudio EPICC. Actas Urol Esp 2010. [DOI: 10.1016/j.acuro.2010.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
40
|
Martínez-Agulló E, Ruíz Cerda J, Arlandis Guzmán S, Rebollo P, Pérez M, Chaves J. Análisis del síndrome de vejiga hiperactiva y de la incontinencia urinaria en varones en la franja de edad de los 50 a los 65 años: Estudio EPICC. Actas Urol Esp 2010. [DOI: 10.4321/s0210-48062010000600009] [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: 11/11/2022]
|
41
|
|
42
|
Martínez-Agulló E, Ruíz Cerda J, Arlandis Guzmán S, Rebollo P, Pérez M, Chaves J. Análisis del síndrome de vejiga hiperactiva y de la incontinencia urinaria en varones en la franja de edad de los 50 a los 65 años. Estudio EPICC. Actas Urol Esp 2010. [DOI: 10.1016/j.acuro.2010.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
43
|
Espuña-Pons M, Blasco P, Pérez M, Rebollo P. Nocturia in patients with overactive bladder. ARCH ESP UROL 2010; 63:363-372. [PMID: 20587841] [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: 05/29/2023]
Abstract
OBJECTIVES Nocturia is a frequent urinary symptom in overactive bladder (OAB) patients, which usually exerts a negative impact upon their quality of life. This study describes the profile of the OAB patient with nocturia, in order to contribute to the adequate identification and medical management of these subjects. METHODS Multicenter, national observational study of 1454 patients over 18 years of age,previously diagnosed with OAB. The relationship between nocturia and different personal and clinical variables was studied, and logistic regression models were used to identify variables independently associated with nocturia in both women and men. RESULTS 84.6% of the patients presented nocturia, considering the restrictive criterion of two or more micturition episodes per night (96.8% according to the ICS definition). Urinary symptoms of frequency, urgency and urge incontinence were associated in a bivariate analysis with nocturia for both genders, while the voiding difficulty variable "pain" was only associated in women, and the voiding difficulty variable "straining" only in men. Older age and presence of comorbidities were associated both in bivariate analysis and independently in logistic regression models to the presence of nocturia in OAB patients of both genders. CONCLUSIONS This study revealed that the profile of subjects with previously diagnosed OAB and nocturia corresponded to older age and the presence of comorbidities of a certain impact for both men and women. The profile for OAB patients with nocturia differs from those previously reported for patients suffering from nocturia and other urinary pathologies.
Collapse
|
44
|
Martínez-Agulló E, Ruíz Cerda JL, Arlandis Guzmán S, Rebollo P, Pérez M, Chaves J. [Analysis of overactive bladder and urinary incontinence in males in the age range between 50 and 65 years. EPICC study]. Actas Urol Esp 2010; 34:543-548. [PMID: 20510118] [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: 05/29/2023]
Abstract
INTRODUCTION The Overactive Bladder syndrome (OAB) and Urinary Incontinence (UI) result in an important personal and economic impact. This work concentrates on the detailed analysis of OAB and UI (derived symptoms and tendencies in medical consultation and resource consumption), in a sample of working men aged 50-65. MATERIAL AND METHODS This study is within the framework of the EPICC study of the Spanish Association of Urology (epidemiologic, observational, multicentric, national study) and concentrates on the detailed analysis of the characteristics of the sample of working men aged 50-65 (N<or=1071) and of the subgroup of individuals with VH and/or IU (N<or=55). RESULTS 0.56% of the subjects presented UI, 3.55% OAB, 1.03% presented both pathologies. Taking into account those individuals with UI and/or OAB, 45.45% had problems to retain urine, and 16.36% suffered leakage daily; 45.45% suffered uncontrollable urge to urinate daily; 23.64% had never sought medical advice, 65.45% had visited an urologist, 14.55% would like to visit an specialist in incontinence; 40% had received treatment, from which 81.82 had received pharmacologic treatment. CONCLUSION In this study, specific data about VH and IU in the reported sample are presented, including those referring to the magnitude of these conditions and use of sanitary resources in subjects with UI and/or OAB, aiming at contributing to a better diagnose and handling of patients and resources.
Collapse
Affiliation(s)
- E Martínez-Agulló
- Servicio de Urología, Hospital Universitario La Fe, Valencia, España
| | | | | | | | | | | |
Collapse
|
45
|
Martínez Agulló E, Ruíz Cerdá J, Gómez Pérez L, Rebollo P, Pérez M, Chaves J. Impacto de la incontinencia urinaria y del síndrome de vejiga hiperactiva en la calidad de vida relacionada con la salud de pacientes de mediana edad laboralmente activos y mayores de 65 años institucionalizados. Actas Urol Esp 2010. [DOI: 10.4321/s0210-48062010000300005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
46
|
Arlandis Guzmán S, García Matres MJ, González Segura D, Rebollo P. [Prevalence of lower urinary tract symptoms in patients with overactive bladder. Patient management in clinical practice]. Actas Urol Esp 2010; 33:902-8. [PMID: 19900385 DOI: 10.1016/s0210-4806(09)72879-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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: 11/20/2022]
Abstract
INTRODUCTION The control of overactive bladder (OAB) symptoms, without worsening voiding symptoms, has become an important therapeutic goal in the management of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia. The objective of the present study was to assess the prevalence of other associated LUTS in patients with OAB. MATERIAL AND METHODS Epidemiological, observational, cross-sectional and multi-centre study, carried out at urology clinics/divisions throughout Spain. The sample included male patients older than 40 who came in for a urology consultation with filling symptoms compatible with OAB. Patient data were collected from the clinical history (demographic data, prostatic disease, other urological and concomitant diseases, OAB and other LUTS symptom data, diagnostic method and treatment data) and from the interview with the patient (I-PSS questionnaire). RESULTS 1,754 patients were included in the study. Mean age (SD) of patients was 65.4 (9.7) years. 74.2% of patients presented a prostatic disease, mainly benign prostatic hyperplasia (90.6%); 8.4% had other urologic diseases and 67.4% had at least one concomitant disease relevant to OAB. 99% of all patients had had at least one urological diagnostic test, 78.4% had received some kind of drug to treat symptoms and 61.3% had taken hygiene or dietetic measures. Filling symptoms were more frequent (93.3%) than voiding symptoms (83.9%). Mean score in the I-PSS was 16.3 (5.6) points, symptoms scored as moderate in 1,153 patients (67.9%) and as severe in 463 patients (27.3%). CONCLUSIONS Most male patients aged over 40 years with OAB symptoms showed other LUTS which worsened their quality of life. Taking this high revalence into account, it seems necessary to manage these patients' diagnosis and treatment according to their symptoms.
Collapse
|
47
|
Martínez Agulló E, Ruíz Cerdá JL, Gómez Pérez L, Rebollo P, Pérez M, Chaves J. [Impact of urinary incontinence and overactive bladder syndrome on health-related quality of life of working middle-aged patients and institutionalized elderly patients]. Actas Urol Esp 2010; 34:242-250. [PMID: 20416241] [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: 05/29/2023]
Abstract
INTRODUCTION Health-related quality of life (HRQoL) is considered by patients with urinary symptoms as the main outcome variable. Descriptive data about HRQoL in patients with urinary incontinence (UI) and/or overactive bladder (OAB) are reported. These data may serve as a reference for comparison purposes. MATERIALS AND METHODS Data were taken from EPICC, a national, multicenter, observational, epidemiological study. Data from representative samples of four population groups were analyzed: working patients of both sexes aged 50-64 years, and institutionalized elderly patients of both sexes with no cognitive impairment. In addition to demographic and clinical data, HRQoL data from the Overactive Bladder Questionnaire (OAB-q SF) and the SF-12 Health Survey were also analyzed. RESULTS Of the total patients in the EPICC study, 26.53% completed the HRQoL questionnaires. Patients with both UI and OAB symptoms had poorer scores than those with OAB or UI respectively in the PCS (41.34 vs. 47.17 and 45) and MCS (46.01 vs. 49.04 and 47.78) of the SF-12, and in the symptom (32.21 vs. 19.19 and 16.65) and quality of life (82.32 vs. 86.72 and 89.45) dimensions of the OAB-q SF. Impact of OAB and UI on HRQoL was higher in men over 65 years of age as compared to women of the same age (76.76 vs. 82.79). CONCLUSIONS Concurrent symptoms of both UI and VH have a greater impact on HRQoL than those of either UI or VH alone. Impact on HRQoL is similar in middle-aged men and women, but higher in elderly men.
Collapse
Affiliation(s)
- E Martínez Agulló
- Servicio de Urología, Hospital Universitario La Fe, Valencia, España
| | | | | | | | | | | |
Collapse
|
48
|
Martínez-Agulló E, Ruíz-Cerda J, Arlandis-Guzmán S, Rebollo P, Pérez M, Chaves J. Analysis of overactive bladder and urinary incontinence in males in the age range between 50 and 65 years. EPICC study. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s2173-5786(10)70127-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
49
|
García Ruiz AJ, Montesinos Gálvez AC, Pérez Costillas L, Rebollo P. [Response of the author to the letter «Cost-effectiveness study of leflunomide vs. methotrexate»]. Reumatol Clin 2009; 5:292-293. [PMID: 21794633 DOI: 10.1016/j.reuma.2009.06.001] [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] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Accepted: 06/11/2009] [Indexed: 05/31/2023]
Affiliation(s)
- Antonio J García Ruiz
- Unidad de Farmacoeconomía e Investigación de Resultados en Salud, Universidad de Málaga, Málaga, España
| | | | | | | |
Collapse
|
50
|
|