Manuel Espinoza - Academia.edu (original) (raw)
Papers by Manuel Espinoza
Revista de Saúde Pública
OBJETIVOS: Comparar la autopercepción de discriminación entre inmigrantes y locales en Chile y an... more OBJETIVOS: Comparar la autopercepción de discriminación entre inmigrantes y locales en Chile y analizar la relación entre inmigración y discriminación percibida e inmigración, discriminación y resultados de salud, ajustando por características sociodemográficas y capital social. MÉTODOS: Estudio transversal, utilizando encuesta poblacional (CASEN2017). Se seleccionaron 2.409 inmigrantes (representativos de N = 291.270) y 67.857 locales (representativos de N = 5.438.036) mayores de 18 años encuestados. Se estimaron modelos de regresión logística, considerando la muestra compleja, con discriminación, salud autoevaluada, tratamiento médico, pertenencia al sistema de salud, seguros complementarios de salud, consulta médica y problemas al consultar como variables dependientes, inmigración y discriminación como variables de exposición principal, y capital social y variables sociodemográficas como covariables de los modelos. RESULTADOS: Inmigrantes tuvieron mayor posibilidad de percibir di...
International Journal of Technology Assessment in Health Care, 2021
Objectives Health technology assessment (HTA) can impact health inequities by informing healthcar... more Objectives Health technology assessment (HTA) can impact health inequities by informing healthcare priority-setting decisions. This paper presents a novel checklist to guide HTA practitioners looking to include equity considerations in their work: the equity checklist for HTA (ECHTA). The list is pragmatically organized according to the generic HTA phases and can be consulted at each step. Methods A first set of items was based on the framework for equity in HTA developed by Culyer and Bombard. After rewording and reorganizing according to five HTA phases, they were complemented by elements emerging from a literature search. Consultations with method experts, decision makers, and stakeholders further refined the items. Further feedback was sought during a presentation of the tool at an international HTA conference. Lastly, the checklist was piloted through all five stages of an HTA. Results ECHTA proposes elements to be considered at each one of the five HTA phases: Scoping, Evaluat...
Revista del Instituto de Salud Pública de Chile, 2017
Annals of Hepatology, 2010
Background. Gastroesophageal variceal bleeding is a common complication of portal hypertension. C... more Background. Gastroesophageal variceal bleeding is a common complication of portal hypertension. Current guidelines recommend β-blockers for primary prophylaxis. However, evidence suggests that endoscopic variceal ligation (EVL) reduce bleeding episodes. Aims. To compare endoscopic EVL with propranolol (PPL) for primary prophylaxis of variceal bleeding. Methods. We conducted a randomized controlled trial. Over a 9-year period, 75 patients with cirrhosis and high-risk esophageal varices (HREV) were recruited and allocated to EVL (n=39) or PPL (n=36). Primary outcome was variceal bleeding. Secondary outcomes were survival, source of bleeding and serious adverse events. Analyses were made by intention-to-treat. Results. Baseline characteristics were similar. Medium follow-up was 1647±1096 days. Complete follow-up was achieved in 85% of patients. Variceal bleeding occurred in 12% of EVL and in 25% of PPL group (p=0.17). The actuarial risks of bleeding after 2 years were similar in both groups. Overall mortality was 51% in EVL and 33% in PPL group (p=0.17). Patients in the EVL group showed a lower rate of esophageal variceal bleeding (5.1% v/s 25%, p=0.027) and a higher rate of subcardial variceal bleeding compared with PPL group (7.7% v/s 0%, p=0.027). Serious adverse events related to EVL occurred in 2 patients, including 1 death. Conclusions. The present study supports that PPL should be considered the first choice in primary prophylaxis of variceal bleeding offering similar effects and lower severe adverse events compared with EVL.
Revista Chilena de Salud Pública, 2015
Value in Health Regional Issues, 2017
Value in Health, 2016
Norte, usually followed by Algarve and then Centro, has the lowest percentage of no-registration.... more Norte, usually followed by Algarve and then Centro, has the lowest percentage of no-registration. Patients without registered information for all health indicators are more than twice as likely to be deceased, than patients with information registered (OR> 2.0). Norte presents higher OR for Cholesterol and Triglycerides (OR> 13.0) and Blood pressure (OR> 3) and Alentejo for BMI (OR near7). Centro presents high values especially regarding Cholesterol and Triglycerides (3.173 and 4.409). MCA summarizes previous findings with a very clear, visual graphical aid. ConClusions: HIA assesses health impacts (here, mortality) of policies (EHR policy to promote PC uniform information registration), identifying groups where effects are worse (regional equity concerns). Disparities between regions are found regarding registering information, but also concerning association patterns of mortality and registration of these health indicators. Complex multivariate methodologies may generate visual outputs easily interpreted by decision-makers.
PLOS ONE, 2015
Objective Chile, a South American country recently defined as a high-income nation, carried out a... more Objective Chile, a South American country recently defined as a high-income nation, carried out a major healthcare system reform from 2005 onwards that aimed at reducing socioeconomic inequality in health. This study aimed to estimate income-related inequality in self-reported health status (SRHS) in 2000 and 2013, before and after the reform, for the entire adult Chilean population. Methods Using data on equivalized household income and adult SRHS from the 2000 and 2013 CASEN surveys (independent samples of 101 046 and 172 330 adult participants, respectively) we estimated Erreygers concentration indices (CIs) for above average SRHS for both years. We also decomposed the contribution of both "legitimate" standardizing variables (age and sex) and "illegitimate" variables (income, education, occupation, ethnicity, urban/rural, marital status, number of people living in the household, and healthcare entitlement). Results There was a significant concentration of above average SRHS favoring richer people in Chile in both years, which was less pronounced in 2013 than 2000 (Erreygers corrected CI 0.165 [Standard Error, SE 0.
Value in Health Regional Issues, 2015
![Research paper thumbnail of [Medical outcomes and antimicrobial compliance according to the Chilean Society of Respiratory Diseases guidelines for hospitalized patients with community acquired pneumonia]](https://attachments.academia-assets.com/105062896/thumbnails/1.jpg)
](Revista médica de Chile, 2003
The Chilean Society of Respiratory Diseases (SER) developed guidelines for the empirical treatmen... more The Chilean Society of Respiratory Diseases (SER) developed guidelines for the empirical treatment of community acquired pneumonia (CAP). To evaluate the degree of adherence to antibiotic treatment recommended by SER guidelines and its influence on medical outcomes. We prospectively evaluated 453 consecutive immunocompetent adults (mean age +/- SD: 69 +/- 19 years) hospitalized for CAP. Patients were stratified according to the Pneumonia Severity Index (PSI), and initial antibiotic regimen was classified as being consistent or inconsistent with the SER guidelines. Rate of medical complications, switch therapy rate, length of stay (LOS), and 30 days mortality were compared between those treated consistently or inconsistently with the SER guidelines. Adherence to SER guidelines was 46%. Patients treated consistently with the SER guidelines were older (mean age +/- SD: 72 +/- 16 v/s 65 +/- 20 years), had more comorbidities (84 v/s 69%) and a higher proportion belonged to the high-risk ...
Value in Health, 2014
This increasing trend was observed particularly among diabetic patients with low family income (2... more This increasing trend was observed particularly among diabetic patients with low family income (2.3% in 2007 to 5.0% in 2010). In the contrast, the financial burden of medications was relieved for those aged younger than 18 years old (1.8% in 2007 to 0.3% in 2010). Patients receiving insulins and thiazolidinediones had higher out-of-pocket spending as well as financial burden than those used other medications to treat diabetes. ConClusions: Patients' drug costs were reduced successfully between 2007 and 2010. However, the financial burden of prescription drugs for diabetes increased due to decreased family income. Since the use of prescription drugs is a vital part of diabetes management, more efforts should be directed to patients with low family income in order to improve affordability of prescription drugs.
Value in Health, 2008
The purpose of this study was to conduct a critical analysis of the current treatments for upper-... more The purpose of this study was to conduct a critical analysis of the current treatments for upper-limb post-stroke spasticity. METHODS: Using search terms including spasticity, stroke, hemiplegia, phenol, baclofen, tizanidine, dantrolene, benzodiazepine, and botulinum toxin, the databases MEDLINE, EMBASE, and Cochrane Controlled Trials Register were used to identify studies in English published from 2004-December 2007. Citations of the extracted articles were reviewed to identify any further articles not captured through the database search. Articles were excluded for the following reasons: lower extremity treatments, pediatric studies, commentaries, duplicate studies, and those that focused on the use of treatments for spasticity secondary to a non-stroke etiology (e.g. multiple sclerosis, cerebral palsy, etc.). RESULTS: A total of 34 studies were reviewed and assessed using the Oxford Levels of Evidence quality scale. Fourteen clinical trials, two pooled analyses, two meta-analyses, one cost-effectiveness study, two retrospective cohort studies, three case reports/case-series, five systematic reviews, and five non-systematic reviews were identified. Thirty-one studies focused on botulinum toxin. All clinical trials compared botulinum toxin to either placebo or no treatment. Eleven studies followed patients through one treatment cycle (generally, 12-16 weeks) to determine the duration of treatment efficacy. Three clinical trials completed multiple treatment cycles which lasted 24-42 weeks. Most clinical trials measured spasticity in multiple locations of the arm, such as the fingers, wrist and shoulder. All studies used multiple outcome measures, including instruments that assessed spasticity, pain, quality of life, disability, and functional status. All clinical trials showed a significant difference in spasticity when botulinum toxin was used, as compared either to baseline measurements or placebo. CONCLUSION: This analysis showed that botulinum toxin effectively reduces upper-limb spasticity in post-stroke patients. Despite utilization of broad search criteria, no current trials demonstrating the efficacy of other treatments were identified.
Obesity Surgery, 2010
Background Reduced serum levels of adiponectin have been associated with insulin resistance and n... more Background Reduced serum levels of adiponectin have been associated with insulin resistance and non-alcoholic fatty liver disease (NAFLD). However, the relationship between serum adiponectin levels and hepatic histology in NAFLD is controversial. The aim of this study was to
Value in Health, 2009
Symptoms Score (IPSS). 44 articles which used the IPSS were able to detect a significant change i... more Symptoms Score (IPSS). 44 articles which used the IPSS were able to detect a significant change in the symptom scores. The remaining articles used various other PRO measures for their BPH endpoints. Of the 70 articles yielded from the Phase II search, 11 were utility studies, 25 were BPH-specific articles, 29 were overactive bladder (OAB)specific articles, and 5 were urge urinary incontinence (UUI)-specific articles. From the BPH, OAB, and UUI articles, we identified the key QOL instruments utilized to measure the various domains key to BPH. CONCLUSIONS: There have been a large number of PRO measures used in the literature to study BPH and related endpoints. It is clear that the IPSS has been used in the majority of the studies focused on BPH symptoms (81.25% of the ones reviewed).
Value in Health, 2011
OBJECTIVOS: Describir la calidad de vida relacionada con la salud (CVRS) de los estudiantes de fa... more OBJECTIVOS: Describir la calidad de vida relacionada con la salud (CVRS) de los estudiantes de farmacia y explorar su relación con el apoyo social percibido (AS). METODOLOGÍAS: Una muestra al azar, de 71 estudiantes de Farmacia de la Universidad Central de Venezuela se entrevistó usando un cuestionario escrito. La CVRS fue determinada usando los cuestionarios de salud: Forma Corta 36 (SF-36) y EQ-5D. El AS se evaluó usando la Lista de Evaluación de Apoyo Interpersonal (ISEL). Estadísticos descriptivos fueron calculados para todas las variables. La asociación entre CVRS y AS se estimó mediante coeficiente de correlación de Pearson. RESULTADOS: La muestra estuvo formada por 53 mujeres y 18 hombres con edad promedio de 19.31 años. Los promedios obtenidos para el ISEL fueron: Emocio-nalϭ76.97, Informaciónϭ80.32 y Tangibleϭ78.13. Los promedios obtenidos para el SF-36 fueron: Función Físicaϭ90.34, Rol Físicoϭ57.75, Dolor Corporalϭ70.28, Salud Generalϭ68.59, Vitalidadϭ49.85, Función Socialϭ67.96, Rol Emocionalϭ50.70 y Salud Mentalϭ62.93. Los valores obtenidos para el EQ-5D fueron: Movilidad: 87.7% sin problemas y 11.3% tiene problemas moderados; Cuidado Personal: 90.1% sin problemas y 9.9% tiene problemas moderados; Actividades Cotidianas: 64.8% sin problemas y 35.2% tiene problemas moderados; Dolor: 52.1% sin problemas y 47.9% tiene problemas moderados; Ansiedad: 53.5% sin problemas, 40.8% tienen problemas moderados y 5.6% problemas severos. Para la EQ-VAS se obtuvo un promedio de 75.48. La EQ-VAS se encontró estar asociada en forma positiva como todas las dimensiones del ISEL. CONCLUSIONES: Pese a limitaciones en generalizabilidad de los resultados y diseño transversal, el estudio encontró que la CVRS de los estudiantes de farmacia es buena. Los principales problemas detectados corresponden a Rol Emocional, Vitalidad, Ansiedad y Dolor. Esto resalta necesidades de atención en esta población de jóvenes universitarios. El apoyo psicosocial puede ser una opción de atención.
Value in Health, 2010
Monitoring of antibiotic prescribing promotes rational use of drugs, reduces costs and slows down... more Monitoring of antibiotic prescribing promotes rational use of drugs, reduces costs and slows down the development of resistance. The purpose of this study was to evaluate the prescribing of antibiotics in PHC of Niš region, during 2005-2009 and to identify the practice of drug overuse, under-use or inappropriate use. METHODS: The data on outpatient use of antibacterials for systemic use was obtained by retrospective study and expressed as the number of defi ned daily doses per 1000 inhabitants per day (DDD), according to WHO anatomic therapeutic chemical classifi cation and DDD measurement methodology. The City Pharmacy Department provided automatic reports on antibiotics prescribed by physicians for certain diagnoses in the Nis region over the 2005-2009 period. RESULTS: In the same period, outpatient antibiotic use in Nis region increased by 9.02% (22.83/ 25.96 DID). The most commonly prescribed drugs were semi-synthetics penicillins (9.67/10.00 DDD) and macrolides (3.05 /4.90 DDD). The greatest increase in antibiotics prescriptions was noted in azithromycin (0.26/0.70 DID, by 164%). Out of the total number of antibiotics, 70.5% prescriptions were made for treatment of URIs. Pharingitis ac. (J02) was the most common indication for prescription of antimicrobial medicines (45.26%). Amoxicillin (33%) and cephalexin (35%) were most commonly prescribed antibiotics for this indication. The total number of antibiotics prescriptions was increased by 14% while the cost was increased by 28% compared to 2005. CONCLUSIONS: Outpatient antibiotics use in Niš is high compared to the majority of European countries, which indicates the need for additional educational programs and monitoring of microbiological sensitivity in future. The received results will be the basis for further evaluation of the rationality of use of antibiotics in primary health care.
Revista de Saúde Pública
OBJETIVOS: Comparar la autopercepción de discriminación entre inmigrantes y locales en Chile y an... more OBJETIVOS: Comparar la autopercepción de discriminación entre inmigrantes y locales en Chile y analizar la relación entre inmigración y discriminación percibida e inmigración, discriminación y resultados de salud, ajustando por características sociodemográficas y capital social. MÉTODOS: Estudio transversal, utilizando encuesta poblacional (CASEN2017). Se seleccionaron 2.409 inmigrantes (representativos de N = 291.270) y 67.857 locales (representativos de N = 5.438.036) mayores de 18 años encuestados. Se estimaron modelos de regresión logística, considerando la muestra compleja, con discriminación, salud autoevaluada, tratamiento médico, pertenencia al sistema de salud, seguros complementarios de salud, consulta médica y problemas al consultar como variables dependientes, inmigración y discriminación como variables de exposición principal, y capital social y variables sociodemográficas como covariables de los modelos. RESULTADOS: Inmigrantes tuvieron mayor posibilidad de percibir di...
International Journal of Technology Assessment in Health Care, 2021
Objectives Health technology assessment (HTA) can impact health inequities by informing healthcar... more Objectives Health technology assessment (HTA) can impact health inequities by informing healthcare priority-setting decisions. This paper presents a novel checklist to guide HTA practitioners looking to include equity considerations in their work: the equity checklist for HTA (ECHTA). The list is pragmatically organized according to the generic HTA phases and can be consulted at each step. Methods A first set of items was based on the framework for equity in HTA developed by Culyer and Bombard. After rewording and reorganizing according to five HTA phases, they were complemented by elements emerging from a literature search. Consultations with method experts, decision makers, and stakeholders further refined the items. Further feedback was sought during a presentation of the tool at an international HTA conference. Lastly, the checklist was piloted through all five stages of an HTA. Results ECHTA proposes elements to be considered at each one of the five HTA phases: Scoping, Evaluat...
Revista del Instituto de Salud Pública de Chile, 2017
Annals of Hepatology, 2010
Background. Gastroesophageal variceal bleeding is a common complication of portal hypertension. C... more Background. Gastroesophageal variceal bleeding is a common complication of portal hypertension. Current guidelines recommend β-blockers for primary prophylaxis. However, evidence suggests that endoscopic variceal ligation (EVL) reduce bleeding episodes. Aims. To compare endoscopic EVL with propranolol (PPL) for primary prophylaxis of variceal bleeding. Methods. We conducted a randomized controlled trial. Over a 9-year period, 75 patients with cirrhosis and high-risk esophageal varices (HREV) were recruited and allocated to EVL (n=39) or PPL (n=36). Primary outcome was variceal bleeding. Secondary outcomes were survival, source of bleeding and serious adverse events. Analyses were made by intention-to-treat. Results. Baseline characteristics were similar. Medium follow-up was 1647±1096 days. Complete follow-up was achieved in 85% of patients. Variceal bleeding occurred in 12% of EVL and in 25% of PPL group (p=0.17). The actuarial risks of bleeding after 2 years were similar in both groups. Overall mortality was 51% in EVL and 33% in PPL group (p=0.17). Patients in the EVL group showed a lower rate of esophageal variceal bleeding (5.1% v/s 25%, p=0.027) and a higher rate of subcardial variceal bleeding compared with PPL group (7.7% v/s 0%, p=0.027). Serious adverse events related to EVL occurred in 2 patients, including 1 death. Conclusions. The present study supports that PPL should be considered the first choice in primary prophylaxis of variceal bleeding offering similar effects and lower severe adverse events compared with EVL.
Revista Chilena de Salud Pública, 2015
Value in Health Regional Issues, 2017
Value in Health, 2016
Norte, usually followed by Algarve and then Centro, has the lowest percentage of no-registration.... more Norte, usually followed by Algarve and then Centro, has the lowest percentage of no-registration. Patients without registered information for all health indicators are more than twice as likely to be deceased, than patients with information registered (OR> 2.0). Norte presents higher OR for Cholesterol and Triglycerides (OR> 13.0) and Blood pressure (OR> 3) and Alentejo for BMI (OR near7). Centro presents high values especially regarding Cholesterol and Triglycerides (3.173 and 4.409). MCA summarizes previous findings with a very clear, visual graphical aid. ConClusions: HIA assesses health impacts (here, mortality) of policies (EHR policy to promote PC uniform information registration), identifying groups where effects are worse (regional equity concerns). Disparities between regions are found regarding registering information, but also concerning association patterns of mortality and registration of these health indicators. Complex multivariate methodologies may generate visual outputs easily interpreted by decision-makers.
PLOS ONE, 2015
Objective Chile, a South American country recently defined as a high-income nation, carried out a... more Objective Chile, a South American country recently defined as a high-income nation, carried out a major healthcare system reform from 2005 onwards that aimed at reducing socioeconomic inequality in health. This study aimed to estimate income-related inequality in self-reported health status (SRHS) in 2000 and 2013, before and after the reform, for the entire adult Chilean population. Methods Using data on equivalized household income and adult SRHS from the 2000 and 2013 CASEN surveys (independent samples of 101 046 and 172 330 adult participants, respectively) we estimated Erreygers concentration indices (CIs) for above average SRHS for both years. We also decomposed the contribution of both "legitimate" standardizing variables (age and sex) and "illegitimate" variables (income, education, occupation, ethnicity, urban/rural, marital status, number of people living in the household, and healthcare entitlement). Results There was a significant concentration of above average SRHS favoring richer people in Chile in both years, which was less pronounced in 2013 than 2000 (Erreygers corrected CI 0.165 [Standard Error, SE 0.
Value in Health Regional Issues, 2015
Revista médica de Chile, 2003
The Chilean Society of Respiratory Diseases (SER) developed guidelines for the empirical treatmen... more The Chilean Society of Respiratory Diseases (SER) developed guidelines for the empirical treatment of community acquired pneumonia (CAP). To evaluate the degree of adherence to antibiotic treatment recommended by SER guidelines and its influence on medical outcomes. We prospectively evaluated 453 consecutive immunocompetent adults (mean age +/- SD: 69 +/- 19 years) hospitalized for CAP. Patients were stratified according to the Pneumonia Severity Index (PSI), and initial antibiotic regimen was classified as being consistent or inconsistent with the SER guidelines. Rate of medical complications, switch therapy rate, length of stay (LOS), and 30 days mortality were compared between those treated consistently or inconsistently with the SER guidelines. Adherence to SER guidelines was 46%. Patients treated consistently with the SER guidelines were older (mean age +/- SD: 72 +/- 16 v/s 65 +/- 20 years), had more comorbidities (84 v/s 69%) and a higher proportion belonged to the high-risk ...
Value in Health, 2014
This increasing trend was observed particularly among diabetic patients with low family income (2... more This increasing trend was observed particularly among diabetic patients with low family income (2.3% in 2007 to 5.0% in 2010). In the contrast, the financial burden of medications was relieved for those aged younger than 18 years old (1.8% in 2007 to 0.3% in 2010). Patients receiving insulins and thiazolidinediones had higher out-of-pocket spending as well as financial burden than those used other medications to treat diabetes. ConClusions: Patients' drug costs were reduced successfully between 2007 and 2010. However, the financial burden of prescription drugs for diabetes increased due to decreased family income. Since the use of prescription drugs is a vital part of diabetes management, more efforts should be directed to patients with low family income in order to improve affordability of prescription drugs.
Value in Health, 2008
The purpose of this study was to conduct a critical analysis of the current treatments for upper-... more The purpose of this study was to conduct a critical analysis of the current treatments for upper-limb post-stroke spasticity. METHODS: Using search terms including spasticity, stroke, hemiplegia, phenol, baclofen, tizanidine, dantrolene, benzodiazepine, and botulinum toxin, the databases MEDLINE, EMBASE, and Cochrane Controlled Trials Register were used to identify studies in English published from 2004-December 2007. Citations of the extracted articles were reviewed to identify any further articles not captured through the database search. Articles were excluded for the following reasons: lower extremity treatments, pediatric studies, commentaries, duplicate studies, and those that focused on the use of treatments for spasticity secondary to a non-stroke etiology (e.g. multiple sclerosis, cerebral palsy, etc.). RESULTS: A total of 34 studies were reviewed and assessed using the Oxford Levels of Evidence quality scale. Fourteen clinical trials, two pooled analyses, two meta-analyses, one cost-effectiveness study, two retrospective cohort studies, three case reports/case-series, five systematic reviews, and five non-systematic reviews were identified. Thirty-one studies focused on botulinum toxin. All clinical trials compared botulinum toxin to either placebo or no treatment. Eleven studies followed patients through one treatment cycle (generally, 12-16 weeks) to determine the duration of treatment efficacy. Three clinical trials completed multiple treatment cycles which lasted 24-42 weeks. Most clinical trials measured spasticity in multiple locations of the arm, such as the fingers, wrist and shoulder. All studies used multiple outcome measures, including instruments that assessed spasticity, pain, quality of life, disability, and functional status. All clinical trials showed a significant difference in spasticity when botulinum toxin was used, as compared either to baseline measurements or placebo. CONCLUSION: This analysis showed that botulinum toxin effectively reduces upper-limb spasticity in post-stroke patients. Despite utilization of broad search criteria, no current trials demonstrating the efficacy of other treatments were identified.
Obesity Surgery, 2010
Background Reduced serum levels of adiponectin have been associated with insulin resistance and n... more Background Reduced serum levels of adiponectin have been associated with insulin resistance and non-alcoholic fatty liver disease (NAFLD). However, the relationship between serum adiponectin levels and hepatic histology in NAFLD is controversial. The aim of this study was to
Value in Health, 2009
Symptoms Score (IPSS). 44 articles which used the IPSS were able to detect a significant change i... more Symptoms Score (IPSS). 44 articles which used the IPSS were able to detect a significant change in the symptom scores. The remaining articles used various other PRO measures for their BPH endpoints. Of the 70 articles yielded from the Phase II search, 11 were utility studies, 25 were BPH-specific articles, 29 were overactive bladder (OAB)specific articles, and 5 were urge urinary incontinence (UUI)-specific articles. From the BPH, OAB, and UUI articles, we identified the key QOL instruments utilized to measure the various domains key to BPH. CONCLUSIONS: There have been a large number of PRO measures used in the literature to study BPH and related endpoints. It is clear that the IPSS has been used in the majority of the studies focused on BPH symptoms (81.25% of the ones reviewed).
Value in Health, 2011
OBJECTIVOS: Describir la calidad de vida relacionada con la salud (CVRS) de los estudiantes de fa... more OBJECTIVOS: Describir la calidad de vida relacionada con la salud (CVRS) de los estudiantes de farmacia y explorar su relación con el apoyo social percibido (AS). METODOLOGÍAS: Una muestra al azar, de 71 estudiantes de Farmacia de la Universidad Central de Venezuela se entrevistó usando un cuestionario escrito. La CVRS fue determinada usando los cuestionarios de salud: Forma Corta 36 (SF-36) y EQ-5D. El AS se evaluó usando la Lista de Evaluación de Apoyo Interpersonal (ISEL). Estadísticos descriptivos fueron calculados para todas las variables. La asociación entre CVRS y AS se estimó mediante coeficiente de correlación de Pearson. RESULTADOS: La muestra estuvo formada por 53 mujeres y 18 hombres con edad promedio de 19.31 años. Los promedios obtenidos para el ISEL fueron: Emocio-nalϭ76.97, Informaciónϭ80.32 y Tangibleϭ78.13. Los promedios obtenidos para el SF-36 fueron: Función Físicaϭ90.34, Rol Físicoϭ57.75, Dolor Corporalϭ70.28, Salud Generalϭ68.59, Vitalidadϭ49.85, Función Socialϭ67.96, Rol Emocionalϭ50.70 y Salud Mentalϭ62.93. Los valores obtenidos para el EQ-5D fueron: Movilidad: 87.7% sin problemas y 11.3% tiene problemas moderados; Cuidado Personal: 90.1% sin problemas y 9.9% tiene problemas moderados; Actividades Cotidianas: 64.8% sin problemas y 35.2% tiene problemas moderados; Dolor: 52.1% sin problemas y 47.9% tiene problemas moderados; Ansiedad: 53.5% sin problemas, 40.8% tienen problemas moderados y 5.6% problemas severos. Para la EQ-VAS se obtuvo un promedio de 75.48. La EQ-VAS se encontró estar asociada en forma positiva como todas las dimensiones del ISEL. CONCLUSIONES: Pese a limitaciones en generalizabilidad de los resultados y diseño transversal, el estudio encontró que la CVRS de los estudiantes de farmacia es buena. Los principales problemas detectados corresponden a Rol Emocional, Vitalidad, Ansiedad y Dolor. Esto resalta necesidades de atención en esta población de jóvenes universitarios. El apoyo psicosocial puede ser una opción de atención.
Value in Health, 2010
Monitoring of antibiotic prescribing promotes rational use of drugs, reduces costs and slows down... more Monitoring of antibiotic prescribing promotes rational use of drugs, reduces costs and slows down the development of resistance. The purpose of this study was to evaluate the prescribing of antibiotics in PHC of Niš region, during 2005-2009 and to identify the practice of drug overuse, under-use or inappropriate use. METHODS: The data on outpatient use of antibacterials for systemic use was obtained by retrospective study and expressed as the number of defi ned daily doses per 1000 inhabitants per day (DDD), according to WHO anatomic therapeutic chemical classifi cation and DDD measurement methodology. The City Pharmacy Department provided automatic reports on antibiotics prescribed by physicians for certain diagnoses in the Nis region over the 2005-2009 period. RESULTS: In the same period, outpatient antibiotic use in Nis region increased by 9.02% (22.83/ 25.96 DID). The most commonly prescribed drugs were semi-synthetics penicillins (9.67/10.00 DDD) and macrolides (3.05 /4.90 DDD). The greatest increase in antibiotics prescriptions was noted in azithromycin (0.26/0.70 DID, by 164%). Out of the total number of antibiotics, 70.5% prescriptions were made for treatment of URIs. Pharingitis ac. (J02) was the most common indication for prescription of antimicrobial medicines (45.26%). Amoxicillin (33%) and cephalexin (35%) were most commonly prescribed antibiotics for this indication. The total number of antibiotics prescriptions was increased by 14% while the cost was increased by 28% compared to 2005. CONCLUSIONS: Outpatient antibiotics use in Niš is high compared to the majority of European countries, which indicates the need for additional educational programs and monitoring of microbiological sensitivity in future. The received results will be the basis for further evaluation of the rationality of use of antibiotics in primary health care.