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Sicras-Mainar A.,Badalona Serveis Assistencials SA | Navarro-Artieda R.,Documentacion Medica | Ruiz-Torrejon A.,Direccion de Atencion Primaria | Saez-Zafra M.,University of Girona | Coll-De Tuero G.,Unitat de Recerca
Actas Urologicas Espanolas | Year: 2016

Objective To assess therapeutic persistence and its relationship with concomitant medication in patients treated with fesoterodine versus tolterodine and solifenacin for overactive bladder (OAB) in standard clinical practice conditions. Material and methods An observational, multicentre retrospective study was performed based on medical registries of patients followed-up in primary care (PC). Three study groups were analysed. Persistence was defined as the time (in months) without withdrawing from the initial therapy or without changing to another medication for at least 30 days after the initial prescription. The concomitant medications were antidepressants, anxiolytic/hypnotic agents, antibiotics, antiseptic agents, laxatives and skin products. We employed the SPSSWIN program version 17 (statistical significance, P <.05). Results We selected 3094 patients for the study. The median age was 54.0 years and 62.2% were women. The patients treated with fesoterodine shown greater treatment persistence (12 months) when compared with those who took solifenacin and tolterodine (40.2% vs. 34.7% and 33.6%, respectively; P =.008). They also showed a lower use of concomitant medication (1.1 vs. 1.2 and 1.2 drugs, respectively; percentages: 61.6% vs. 67.1% and 70.1%, respectively; P <.03). Conclusions The patients undergoing OAB treatment with fesoterodine, when compared with those taking solifenacin and tolterodine, were associated with greater treatment persistence and a reduced use of concomitant medication. © 2015 AEU. Publicado por Elsevier España, S.L.U. Todos los derechos reservados.

Barrasa-Villar J.I.,Hospital Clinico Universitario Lozano Blesa | Castan-Ruiz S.,Direccion de Atencion Primaria
Revista de Calidad Asistencial | Year: 2014

Introduction having an appropriate patient safety culture is the first recommendation to improve it. The aim of this article is to determine the safety culture in family medicine residents and then to identify improvement strategies. Methods an online cross-sectional survey of residents in family medicine teaching units of Aragon using the translated, validated and adapted to Spanish, Medical Office Survey on Patient Safety Culture (MOSPS) questionnaire. The results were grouped in 12-dimensional responses for analysis, and the mean value of each dimension was calculated. Perceptions were described by Percentages of Positive (PRP) and Negative Responses (PRN) to each dimension. Results positive results were seen in «the Patient Care Tracking/Follow-up». There were significant differences in the «Information Exchange With Other Settings», «Staff Training» and «Overall Perceptions of Patient Safety and Quality». Study participants viewed «Work Pressure and Pace» negatively. Conclusions the institutions providing health services, as well as their staff, are increasingly aware of the importance of improving Patient Safety, and the results of this study allowed us to present information that helps identify weaknesses, and to design initiatives and strategies to improve care practices. © 2013 SECA. Publicado por Elsevier España, S.L. Todos los derechos reservados.

Castilla J.,Institute Salud Publica Of Navarra | Castilla J.,CIBER ISCIII | Martinez-Baz I.,Institute Salud Publica Of Navarra | Martinez-Baz I.,CIBER ISCIII | And 10 more authors.
Eurosurveillance | Year: 2014

We estimate mid-2013/14 season vaccine effectiveness (VE) of the influenza trivalent vaccine in Navarre, Spain. Influenza-like illness cases attended in hospital (n=431) and primary healthcare (n=344) were included. The overall adjusted VE in preventing laboratory-confirmed influenza was 24% (95% CI: -14 to 50). The VE was 40% (95% CI: -12 to 68) against influenza A(H1)pdm09 and 13% (95% CI: -36 to 45) against influenza A(H3). These results suggest a moderate preventive effect against influenza A(H1)pdm09 and low protection against influenza A(H3).

Sicras-Mainar A.,Planificacion | Velasco-Velasco S.,Planificacion | Navarro-Artieda R.,Hospital Universitari Germans Trias i Pujol | Blanca Tamayo M.,Servicio de Psiquiatria | And 4 more authors.
Atencion Primaria | Year: 2012

Objective: To compare three methods of measuring multiple morbidity according to the use of health resources (cost of care) in primary healthcare (PHC). Design: Retrospective study using computerized medical records. Setting: Thirteen PHC teams in Catalonia (Spain). Participants: Assigned patients requiring care in 2008. Main measurements: The socio-demographic variables were co-morbidity and costs. Methods of comparison were: a) Combined Comorbidity Index (CCI): an index itself was developed from the scores of acute and chronic episodes, b) Charlson Index (ChI), and c) Adjusted Clinical Groups case-mix: resource use bands (RUB). The cost model was constructed by differentiating between fixed (operational) and variable costs. Statistical analysis: 3 multiple lineal regression models were developed to assess the explanatory power of each measurement of co-morbidity which were compared from the determination coefficient (R2), p<.05. Results: The study included 227,235 patients. The mean unit of cost was 654.2. The CCI explained an R2 = 50.4%, the ChI an R2 = 29.2% and BUR an R2 = 39.7% of the variability of the cost. The behaviour of the ICC is acceptable, albeit with low scores (1 to 3 points), showing inconclusive results. Conclusions: The CCI may be a simple method of predicting PHC costs in routine clinical practice. If confirmed, these results will allow improvements in the comparison of the case-mix. © 2011 Elsevier España, S.L. All rights reserved.

Martinez-Baz I.,Institute Salud Publica Of Navarra | Martinez-Baz I.,CIBER ISCIII | Guevara M.,Institute Salud Publica Of Navarra | Guevara M.,CIBER ISCIII | And 5 more authors.
Gaceta Sanitaria | Year: 2014

Objective: To estimate the effectiveness of the influenza vaccine under different criteria for selecting patients for swabbing. Method: A case-control study was performed of laboratory-confirmed cases (n. = 909) and negative controls for influenza (n. = 732) in the 2010-2011 to 2012-2013 seasons in Navarre (Spain). The adjusted vaccine effectiveness was estimated by including all swabs from patients with influenza-like-illness and selecting only the first two cases per physician and week. Results: The first two patients per physician and week were less frequently vaccinated against influenza (7.9% vs. 12.5%, p. = 0.021) and less often received confirmation of influenza (53.6% vs. 66.4%, p <0.001) than subsequent patients. These differences decreased after adjustment for covariates. The effectiveness of the influenza vaccine was 49% (95% CI: 23-66%) when all swabs were included and was 55% (95% CI: 27-72%) when we selected the first two swabs per week and physician. Conclusion: The selection of the first two patients per physician and week may bias assessment of the effectiveness of the influenza vaccine, although this bias was small in the seasons analyzed. © 2013 SESPAS.

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