Paula Ribó | Universitat de Barcelona (original) (raw)

Papers by Paula Ribó

Clinical and translational allergy, Jun 1, 2024

Pediatric allergy and immunology, May 1, 2024

XXIX Congreso Nacional de Medicina General y de Familia y V Jornadas SEMG Andalucía Abstracts Publication

Background: Studies on the prevalence of Atopic Dermatitis (AD) for the adolescent cohort in gene... more Background: Studies on the prevalence of Atopic Dermatitis (AD) for the adolescent cohort in general-based large populations are scarce worldwide. We performed a retrospective population-based observational cohort study of 76,665 adolescent patients diagnosed with AD in Catalonia (Spain). We study the prevalence of AD by age, gender, disease severity, comorbidities, and serum total Immunoglobin E (tIgE) and appropriate medical treatment (AMT) for the Catalan population. Methods: Adolescent individuals (12-17y) diagnosed with AD by medical records at different health care levels (primary, hospital, emergency) from the Catalan Health System (CHS) were included. Statistical analyses evaluated sociodemographic characteristics, prevalence, comorbidities, serum tIgE and AMT. Results: The overall diagnosed AD prevalence in the adolescent Catalan population (76,665) was 16.9%, being higher for the non-severe (16.7%) than for the severe (0.2%) populations. Topical corticosteroids were the mo...

Respirology Case Reports, 2013

Gastroesophageal reflux (GER), asthma-type cough and upper airway disease are the most common cau... more Gastroesophageal reflux (GER), asthma-type cough and upper airway disease are the most common causes of chronic cough syndrome. We present a case in which impedance-pH monitoring indicated severe mixed acid-nonacid esophageal reflux reaching the upper third of the esophagus in 75% of nonacid events. GER and the associated aspiration episodes were shown to be the cause of severe asthma attacks and migratory pulmonary infiltrates. GER was caused by a sleeve gastrectomy, which seriously disabled the mechanisms preventing reflux from reaching the airways. Respiratory symptoms improved notably after abdominal surgery to correct the GER, suggesting a close causal relationship between GER and all the symptoms, including asthma. However, this issue remains unresolved in the literature.

Las alteraciones del sueno en la rinitis y el asma pueden deberse a diferentes motivos, y con fre... more Las alteraciones del sueno en la rinitis y el asma pueden deberse a diferentes motivos, y con frecuencia se relacionan directamente con lossintomas propios de la enfermedad. Sin embargo, tambien pueden deberse a una desestructuracion del sueno como consecuencia de sufrir laenfermedad, independientemente de la presencia de sintomas.Las alteraciones del sueno asociadas a patologias cronicas y altamente prevalentes, como la rinitis y el asma, son un problema de saludpublica por su frecuencia y sus consecuencias. El desarrollo de otras comorbilidades, la alteracion de la calidad de vida del paciente y el efectosobre el propio control de la enfermedad son aspectos relevantes relacionados con la falta de sueno. Sin embargo, a pesar de ser un tema deinvestigacion recurrente, parece seguir siendo un aspecto poco considerado en el abordaje diario de estas enfermedades.

npj Primary Care Respiratory Medicine, 2020

Several modifiable factors leading to poor asthma control have been described. We aimed to determ... more Several modifiable factors leading to poor asthma control have been described. We aimed to determine the proportion of patients with inadequate treatment, adherence to it, or critical mistakes with inhaler technique, and their impact on asthma control. We conducted a cross-sectional multicenter observational study including asthma patients referred from primary to specialist care for the first time. Data collected were adequate prescription according to guidelines, treatment adherence, and disease control. Of the 1682 patients (age 45 ± 17 years, 64.6% men), 35.9% showed inadequate prescription, 76.8% low adherence, and 17% critical mistakes with inhaler technique, with significantly less critical mistakes among Easyhaler users versus other dry powder inhaler users (10.3 versus 18.4%; p < 0.05). Factors related to bad asthma control were inadequate prescription (OR: 3.65), non-adherence to treatment (OR: 1.8), and inhaler misuse (OR: 3.03). A higher number of risk factors were as...

The Journal of Allergy and Clinical Immunology: In Practice, 2020

Journal of Clinical Medicine, 2019

Platelet-activating factor (PAF) is a lipid mediator involved in several allergic reactions. It i... more Platelet-activating factor (PAF) is a lipid mediator involved in several allergic reactions. It is released from multiple cells of the immune system, such as eosinophils, neutrophils, and mast cells, and also exerts its effect on most of them upon specific binding to its receptor, becoming a pleiotropic mediator. PAF is considered a potential relevant mediator in allergic rhinitis, with a key role in nasal congestion and rhinorrhoea due to its effect on vascular permeability. Interestingly, despite its potential relevance as a therapeutic target, no specific PAF inhibitors have been studied in humans. However, rupatadine, a second-generation antihistamine with dual antihistamine and anti-PAF effects has shown promising results by both blocking nasal symptoms and inhibiting mast cell activation induced by PAF, in comparison to antihistamine receptor drugs. In conclusion, the inhibition of PAF may be an interesting approach in the treatment of allergic rhinitis as part of a global str...

Airway Pharmacology and Treatment, 2017

Airway Pharmacology and Treatment, 2017

Inhaler devices were compared in an observational, cross-sectional, multicenter study in patients... more Inhaler devices were compared in an observational, cross-sectional, multicenter study in patients with asthma. We evaluated asthma severity, asthma control, patient’s satisfaction with the inhaler (FSI-10/TSQM), adherence (Test of the Adherence to Inhalers (TAI)/Morisky-Green) and quality of life (QoL) (Mini- AQLQ). The sample was stratified into groups according to the type of inhaler used: Easyhaler (n=541), Turbuhaler (n=124) and Accuhaler (n=74). Results: the study included 739 patients, 62.7% were women and the mean (SD) age was 45.72 (16.9) years. FSI-10 questionnaire showed a favourable trend towards Easyhaler, especially in the items referring to the ease and comfort in use. TSQM questionnaire showed the same tendency, highlighting the items that assess the ability of the treatment to prevent or treat asthma and convenience. There were no differences between groups in the adherence questionnaires. The percentage of patients with controlled asthma was significantly higher in the Easyhaler group vs. Turbuhaler and Accuhaler. Patients with Easyhaler slightly surpassed the other devices studied in the global mini-AQLQ score. Easyhaler was superior to Turbuhaler in the domain of environmental stimuli and to Accuhaler in activity limitation. Conclusions: the comparison shows a general trend favouring Easyhaler in patient´s satisfaction, control of asthma and higher QoL. The outcomes achieved with this device are related with a greater ease of use, once excluded differences between inhalers in patient adherence. Study sponsored by Orion Pharma, S.A.

Expert Review of Respiratory Medicine, 2019

Background: The preferences and opinions of patients are important when choosing the optimal inha... more Background: The preferences and opinions of patients are important when choosing the optimal inhaler device for asthma management. We compared patient satisfaction of three dry powder inhalers in patients with moderate to severe asthma. Methods: We selected a group of patients treated with Easyhaler TM (n = 164) and a second group of patients treated with Turbuhaler TM (n = 100) or Diskus TM (Accuhaler TM) (n = 64) from the register of an observational, multicenter study. Data of patients were paired according to age, gender, and asthma severity. Patient satisfaction with the inhaler type was assessed with the specific 'Feeling of Satisfaction with Inhaler' (FSI-10) questionnaire. Results: Specific satisfaction with inhaler was statistically significantly higher with Easyhaler TM , as well as the percentage of patients with high satisfaction with inhaler. (FSI-10 score ≥43). Scores for Easyhaler TM were also statistically significantly better for individual FSI-10 items such as learning how to use, inhaler preparation, inhaler use, weight and size, and portability. There were no significant differences in asthma control (ACT, Mini-AQLQ) and adherence (TAI global score). Conclusions: Specific satisfaction with inhaler was higher with Easyhaler TM in a homogeneous population of patients with moderate to severe asthma. However, the relationship between satisfaction with the inhaler and adherence and asthma control deserves more investigation.

Clinical and Translational Allergy, 2018

Background: Allergic rhinitis (AR) is a highly prevalent disease that generates high social and h... more Background: Allergic rhinitis (AR) is a highly prevalent disease that generates high social and health care costs and also has a significant effect on quality of life and quality of sleep. It has also been related to some psychological disorders like anxiety or depression. Objective: To evaluate anxiety, depression, and quality of sleep and life alteration in a group of patients with perennial AR compared to a group of seasonal AR patients. Methods: Six-hundred seventy adults (> 18 years) with perennial and seasonal AR were recruited consecutively in 47 centers in Spain. Individuals were grouped in "Perennial" and "Seasonal" according to the seasonality of their symptoms. Anxiety, depression, sleep quality and health related quality of life were evaluated using the Hospital Anxiety and Depression Scale, Medical Outcomes Study Sleep Scale (MOS Sleep Scale) and the Health-related quality of life questionnaire ESPRINT-15, respectively. Both groups of patients were evaluated in and out of the pollen season. Results: AR symptoms are related to worse quality of life and more anxiety and depression symptoms. Indeed, symptom severity also correlates with worse outcomes (quality of life, sleep and depression/anxiety) regardless allergen seasonality. Symptoms severity, compared with seasonality and persistence, is the most important factor related with more anxiety and depression and poor sleep. However, symptoms severity, persistence and seasonality are independently affecting the quality of life in patients with AR. Conclusions: Although AR symptoms have a great impact on depression and anxiety symptoms, quality of life and quality of sleep in all AR patients, as expected, individuals with more severe AR seem to suffer more intensely their effects.

Airway Pharmacology and Treatment, 2017

Objetives: To validate the TAI in the clinical practice setting for identifying deficient adheren... more Objetives: To validate the TAI in the clinical practice setting for identifying deficient adherence to therapy associated to poor asthma control; and to identify other factors of inhaled therapy in poor control of the disease. Methods: A non-postmarketing, cross-sectional, multicenter observational study, involving patients of either sex, aged ≥ 18 years with stable moderate-severe persistent asthma. The following was carried out in a single visit: collection of asthma morbidity and clinical data; level of control (Asthma Control Test [ACT]); general satisfaction with treatment (Treatment Satisfaction Questionnaire for Medication [TSQM) and specific satisfaction with the inhaler (Feeling of Satisfaction with Inhaler [FSI-10]); general adherence to therapy (Morisky-Green) and specific adherence to inhalers (Test of Adherence to Inhalers [TAI]); and quality of life (Mini-Asthma Quality of Life Questionnaire [MiniAQLQ]). Results: 778 patients were included. Bivariate statistical analysis showed non-controlled asthma patients, were older, with more exacerbations, poorer lung function, poorer inhaler use, less adherent to therapy, higher rates referred to type of non-adherence (sporadic, intentional, inadvertent), and poorer treatment satisfaction and quality of life. Logistic regression analysis found good asthma control to be correlated to: high specific inhaler satisfaction, high general satisfaction, and high inhaler adherence (TAI). Investigator stimated 14,5% non adherence, TAI yielded 60,5% non adherence rates. Conclusion: The TAI is useful for identifying deficient adherence as a possible cause of poor asthma control and physicians overstimate adherence.

Allergy and Asthma Proceedings, 2018

Background: Asthma guidelines recommend considering patient preferences for inhaler choice. Howev... more Background: Asthma guidelines recommend considering patient preferences for inhaler choice. However, few studies have assessed the impact of patient satisfaction with an inhaler on adherence and health outcomes. Objective: To assess the impact of patient satisfaction with an inhaler on adherence and health outcomes in asthma. Methods: In a cross-sectional, observational, multicenter study, 778 patients with moderate or severe asthma and who were treated with maintenance inhalers completed a number of scales and questionnaires: the Feeling of Satisfaction with Inhaler (FSI-10) questionnaire, the Treatment Satisfaction Questionnaire for Medication, the Test of Adherence to Inhalers (TAI), the Morisky-Green questionnaire, and the Asthma Control Test (ACT). Results: The study population was categorized according to a median FSI-10 score as high (49.4%) and low (50.6%) satisfaction with their inhaler. Logistic regression analysis showed that high specific satisfaction with an inhaler was associated with the younger age group (odds ratio [OR] 0.976 [95% confidence interval {CI} 0.965-0.987]); male gender (OR 1.725 [95%

Clinical and translational allergy, Jun 1, 2024

Pediatric allergy and immunology, May 1, 2024

XXIX Congreso Nacional de Medicina General y de Familia y V Jornadas SEMG Andalucía Abstracts Publication

Background: Studies on the prevalence of Atopic Dermatitis (AD) for the adolescent cohort in gene... more Background: Studies on the prevalence of Atopic Dermatitis (AD) for the adolescent cohort in general-based large populations are scarce worldwide. We performed a retrospective population-based observational cohort study of 76,665 adolescent patients diagnosed with AD in Catalonia (Spain). We study the prevalence of AD by age, gender, disease severity, comorbidities, and serum total Immunoglobin E (tIgE) and appropriate medical treatment (AMT) for the Catalan population. Methods: Adolescent individuals (12-17y) diagnosed with AD by medical records at different health care levels (primary, hospital, emergency) from the Catalan Health System (CHS) were included. Statistical analyses evaluated sociodemographic characteristics, prevalence, comorbidities, serum tIgE and AMT. Results: The overall diagnosed AD prevalence in the adolescent Catalan population (76,665) was 16.9%, being higher for the non-severe (16.7%) than for the severe (0.2%) populations. Topical corticosteroids were the mo...

Respirology Case Reports, 2013

Gastroesophageal reflux (GER), asthma-type cough and upper airway disease are the most common cau... more Gastroesophageal reflux (GER), asthma-type cough and upper airway disease are the most common causes of chronic cough syndrome. We present a case in which impedance-pH monitoring indicated severe mixed acid-nonacid esophageal reflux reaching the upper third of the esophagus in 75% of nonacid events. GER and the associated aspiration episodes were shown to be the cause of severe asthma attacks and migratory pulmonary infiltrates. GER was caused by a sleeve gastrectomy, which seriously disabled the mechanisms preventing reflux from reaching the airways. Respiratory symptoms improved notably after abdominal surgery to correct the GER, suggesting a close causal relationship between GER and all the symptoms, including asthma. However, this issue remains unresolved in the literature.

Las alteraciones del sueno en la rinitis y el asma pueden deberse a diferentes motivos, y con fre... more Las alteraciones del sueno en la rinitis y el asma pueden deberse a diferentes motivos, y con frecuencia se relacionan directamente con lossintomas propios de la enfermedad. Sin embargo, tambien pueden deberse a una desestructuracion del sueno como consecuencia de sufrir laenfermedad, independientemente de la presencia de sintomas.Las alteraciones del sueno asociadas a patologias cronicas y altamente prevalentes, como la rinitis y el asma, son un problema de saludpublica por su frecuencia y sus consecuencias. El desarrollo de otras comorbilidades, la alteracion de la calidad de vida del paciente y el efectosobre el propio control de la enfermedad son aspectos relevantes relacionados con la falta de sueno. Sin embargo, a pesar de ser un tema deinvestigacion recurrente, parece seguir siendo un aspecto poco considerado en el abordaje diario de estas enfermedades.

npj Primary Care Respiratory Medicine, 2020

Several modifiable factors leading to poor asthma control have been described. We aimed to determ... more Several modifiable factors leading to poor asthma control have been described. We aimed to determine the proportion of patients with inadequate treatment, adherence to it, or critical mistakes with inhaler technique, and their impact on asthma control. We conducted a cross-sectional multicenter observational study including asthma patients referred from primary to specialist care for the first time. Data collected were adequate prescription according to guidelines, treatment adherence, and disease control. Of the 1682 patients (age 45 ± 17 years, 64.6% men), 35.9% showed inadequate prescription, 76.8% low adherence, and 17% critical mistakes with inhaler technique, with significantly less critical mistakes among Easyhaler users versus other dry powder inhaler users (10.3 versus 18.4%; p < 0.05). Factors related to bad asthma control were inadequate prescription (OR: 3.65), non-adherence to treatment (OR: 1.8), and inhaler misuse (OR: 3.03). A higher number of risk factors were as...

The Journal of Allergy and Clinical Immunology: In Practice, 2020

Journal of Clinical Medicine, 2019

Platelet-activating factor (PAF) is a lipid mediator involved in several allergic reactions. It i... more Platelet-activating factor (PAF) is a lipid mediator involved in several allergic reactions. It is released from multiple cells of the immune system, such as eosinophils, neutrophils, and mast cells, and also exerts its effect on most of them upon specific binding to its receptor, becoming a pleiotropic mediator. PAF is considered a potential relevant mediator in allergic rhinitis, with a key role in nasal congestion and rhinorrhoea due to its effect on vascular permeability. Interestingly, despite its potential relevance as a therapeutic target, no specific PAF inhibitors have been studied in humans. However, rupatadine, a second-generation antihistamine with dual antihistamine and anti-PAF effects has shown promising results by both blocking nasal symptoms and inhibiting mast cell activation induced by PAF, in comparison to antihistamine receptor drugs. In conclusion, the inhibition of PAF may be an interesting approach in the treatment of allergic rhinitis as part of a global str...

Airway Pharmacology and Treatment, 2017

Airway Pharmacology and Treatment, 2017

Inhaler devices were compared in an observational, cross-sectional, multicenter study in patients... more Inhaler devices were compared in an observational, cross-sectional, multicenter study in patients with asthma. We evaluated asthma severity, asthma control, patient’s satisfaction with the inhaler (FSI-10/TSQM), adherence (Test of the Adherence to Inhalers (TAI)/Morisky-Green) and quality of life (QoL) (Mini- AQLQ). The sample was stratified into groups according to the type of inhaler used: Easyhaler (n=541), Turbuhaler (n=124) and Accuhaler (n=74). Results: the study included 739 patients, 62.7% were women and the mean (SD) age was 45.72 (16.9) years. FSI-10 questionnaire showed a favourable trend towards Easyhaler, especially in the items referring to the ease and comfort in use. TSQM questionnaire showed the same tendency, highlighting the items that assess the ability of the treatment to prevent or treat asthma and convenience. There were no differences between groups in the adherence questionnaires. The percentage of patients with controlled asthma was significantly higher in the Easyhaler group vs. Turbuhaler and Accuhaler. Patients with Easyhaler slightly surpassed the other devices studied in the global mini-AQLQ score. Easyhaler was superior to Turbuhaler in the domain of environmental stimuli and to Accuhaler in activity limitation. Conclusions: the comparison shows a general trend favouring Easyhaler in patient´s satisfaction, control of asthma and higher QoL. The outcomes achieved with this device are related with a greater ease of use, once excluded differences between inhalers in patient adherence. Study sponsored by Orion Pharma, S.A.

Expert Review of Respiratory Medicine, 2019

Background: The preferences and opinions of patients are important when choosing the optimal inha... more Background: The preferences and opinions of patients are important when choosing the optimal inhaler device for asthma management. We compared patient satisfaction of three dry powder inhalers in patients with moderate to severe asthma. Methods: We selected a group of patients treated with Easyhaler TM (n = 164) and a second group of patients treated with Turbuhaler TM (n = 100) or Diskus TM (Accuhaler TM) (n = 64) from the register of an observational, multicenter study. Data of patients were paired according to age, gender, and asthma severity. Patient satisfaction with the inhaler type was assessed with the specific 'Feeling of Satisfaction with Inhaler' (FSI-10) questionnaire. Results: Specific satisfaction with inhaler was statistically significantly higher with Easyhaler TM , as well as the percentage of patients with high satisfaction with inhaler. (FSI-10 score ≥43). Scores for Easyhaler TM were also statistically significantly better for individual FSI-10 items such as learning how to use, inhaler preparation, inhaler use, weight and size, and portability. There were no significant differences in asthma control (ACT, Mini-AQLQ) and adherence (TAI global score). Conclusions: Specific satisfaction with inhaler was higher with Easyhaler TM in a homogeneous population of patients with moderate to severe asthma. However, the relationship between satisfaction with the inhaler and adherence and asthma control deserves more investigation.

Clinical and Translational Allergy, 2018

Background: Allergic rhinitis (AR) is a highly prevalent disease that generates high social and h... more Background: Allergic rhinitis (AR) is a highly prevalent disease that generates high social and health care costs and also has a significant effect on quality of life and quality of sleep. It has also been related to some psychological disorders like anxiety or depression. Objective: To evaluate anxiety, depression, and quality of sleep and life alteration in a group of patients with perennial AR compared to a group of seasonal AR patients. Methods: Six-hundred seventy adults (> 18 years) with perennial and seasonal AR were recruited consecutively in 47 centers in Spain. Individuals were grouped in "Perennial" and "Seasonal" according to the seasonality of their symptoms. Anxiety, depression, sleep quality and health related quality of life were evaluated using the Hospital Anxiety and Depression Scale, Medical Outcomes Study Sleep Scale (MOS Sleep Scale) and the Health-related quality of life questionnaire ESPRINT-15, respectively. Both groups of patients were evaluated in and out of the pollen season. Results: AR symptoms are related to worse quality of life and more anxiety and depression symptoms. Indeed, symptom severity also correlates with worse outcomes (quality of life, sleep and depression/anxiety) regardless allergen seasonality. Symptoms severity, compared with seasonality and persistence, is the most important factor related with more anxiety and depression and poor sleep. However, symptoms severity, persistence and seasonality are independently affecting the quality of life in patients with AR. Conclusions: Although AR symptoms have a great impact on depression and anxiety symptoms, quality of life and quality of sleep in all AR patients, as expected, individuals with more severe AR seem to suffer more intensely their effects.

Airway Pharmacology and Treatment, 2017

Objetives: To validate the TAI in the clinical practice setting for identifying deficient adheren... more Objetives: To validate the TAI in the clinical practice setting for identifying deficient adherence to therapy associated to poor asthma control; and to identify other factors of inhaled therapy in poor control of the disease. Methods: A non-postmarketing, cross-sectional, multicenter observational study, involving patients of either sex, aged ≥ 18 years with stable moderate-severe persistent asthma. The following was carried out in a single visit: collection of asthma morbidity and clinical data; level of control (Asthma Control Test [ACT]); general satisfaction with treatment (Treatment Satisfaction Questionnaire for Medication [TSQM) and specific satisfaction with the inhaler (Feeling of Satisfaction with Inhaler [FSI-10]); general adherence to therapy (Morisky-Green) and specific adherence to inhalers (Test of Adherence to Inhalers [TAI]); and quality of life (Mini-Asthma Quality of Life Questionnaire [MiniAQLQ]). Results: 778 patients were included. Bivariate statistical analysis showed non-controlled asthma patients, were older, with more exacerbations, poorer lung function, poorer inhaler use, less adherent to therapy, higher rates referred to type of non-adherence (sporadic, intentional, inadvertent), and poorer treatment satisfaction and quality of life. Logistic regression analysis found good asthma control to be correlated to: high specific inhaler satisfaction, high general satisfaction, and high inhaler adherence (TAI). Investigator stimated 14,5% non adherence, TAI yielded 60,5% non adherence rates. Conclusion: The TAI is useful for identifying deficient adherence as a possible cause of poor asthma control and physicians overstimate adherence.

Allergy and Asthma Proceedings, 2018

Background: Asthma guidelines recommend considering patient preferences for inhaler choice. Howev... more Background: Asthma guidelines recommend considering patient preferences for inhaler choice. However, few studies have assessed the impact of patient satisfaction with an inhaler on adherence and health outcomes. Objective: To assess the impact of patient satisfaction with an inhaler on adherence and health outcomes in asthma. Methods: In a cross-sectional, observational, multicenter study, 778 patients with moderate or severe asthma and who were treated with maintenance inhalers completed a number of scales and questionnaires: the Feeling of Satisfaction with Inhaler (FSI-10) questionnaire, the Treatment Satisfaction Questionnaire for Medication, the Test of Adherence to Inhalers (TAI), the Morisky-Green questionnaire, and the Asthma Control Test (ACT). Results: The study population was categorized according to a median FSI-10 score as high (49.4%) and low (50.6%) satisfaction with their inhaler. Logistic regression analysis showed that high specific satisfaction with an inhaler was associated with the younger age group (odds ratio [OR] 0.976 [95% confidence interval {CI} 0.965-0.987]); male gender (OR 1.725 [95%