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F Martos Crespo

Publications and source records attributed to F Martos Crespo.

13 recordsLinked to original sources
PubMed2005

[Cost-effectiveness analysis of tiotropium compared to ipratropium and salmeterol].

OBJECTIVE: The constant increase in health care costs, in a context of limited resources and the appearance of more costly though more effective drugs, justifies an assessment of the pharmacoeconomics of these drugs. The objective of this study was to evaluate the cost-effectiveness of one of the newest drugs for the treatment of chronic obstructive pulmonary disease (COPD)-tiotropium. MATERIAL AND METHOD: A cost-effectiveness analysis (costs and outcomes) within the framework of the Spanish National Health System was done. The alternatives to tiotropium analyzed were ipratropium and salmeterol. Direct health care costs associated with hospital treatment were calculated. Forced expiratory volume in 1 second, quality of life (with the Saint George's Respiratory Questionnaire), dyspnea transitional index, mean stay in hospital, and exacerbations were the variables used to measure effectiveness. Values for these variables were taken from the main reviews and randomized clinical trials published for tiotropium. RESULTS: For COPD patients, treatment with tiotropium leads to a greater reduction in exacerbations (37% compared to ipratropium and 25% compared to salmeterol 25%), and a reduction in the number of days in hospital (33% compared to ipratropium and 14% compared to salmeterol). Therefore, use of tiotropium could save ;100 000 for the current rates of admission and lengths of hospital stay in Spain. CONCLUSIONS: Tiotropium was more effective than ipratropium and salmeterol as measured by objective clinical variables (forced expiratory volume in 1 second) and subjective ones (the Saint George's Respiratory Questionnaire and dyspnea transitional index). Hospital stays were shorter and exacerbations fewer with tiotropium. In all cases, tiotropium was more cost-effective than the alternatives, thus use of tiotropium could help hospitals to save money.

Adult↗
PubMed2001

[Correlation between subjective and objective health measurements in patients with chronic obstructive pulmonary disease (COPD)].

AIMS: Analyze the relation between objective health assessment (OHA) -Forced spirometry- and subjective health assessment (SHA) -quality of life- in patients with chronic obstructive pulmonary disease (COPD). Analyze the correlation between two different questionnaires to assess quality of life. DESIGN: Cross-sectional study. PARTICIPANTS: 278 patients with COPD (confidence level 95%) from two urban health centers. MAIN MEASUREMENTS: Personal interview. VARIABLES: quality of life (Nottingham Health Profile; St George Respiratory Questionnaire); sociodemographic profile; diagnose of COPD; comorbidity; recent spirometry. STATISTICAL ANALYSES: Descriptive statistics; test ji-squared, Kruskal-Wallis and the correlation coefficient. RESULTS: Age: 66,9 years; sex: 88% male. Quality of life scales (mean and confidence intervals): Nottingham Health Profile subscales (total score 100 points): energy 40 (35.6-44.4), pain 35.9 (32.3-39.5), emotional reactions 32.5 (29.4-38.6), sleep 41.9 (37.8-45.9), social isolation 15.3 (12.7-17.9), mobility 36.7 (33.9-39.5) and global score 33.4 (30.8-36). St George Respiratory Questionnaire subscales (total scores 100 points): impact 38.01 (35.08-40.18), activity 53.8 (50.2-57.4), symptoms 37.7 (35.2-40.3) and global score 40.0 (38.6-43.2). The correlation coefficients between the two questionnaires ranged between 0.12 (for the sleep and symptoms dimensions: p = 0.03) and 0.66 (for the mobility and activity dimensions; p < 0.0001). There is a positive lineal relation between the two questionnaires and the spirometric stages of COPD (measured by the maximum respiratory volume in the first second). CONCLUSIONS: We found a good correlation between the two quality of life questionnaires, but St George was more specific for respiratory illness. There is a mild-light correlation between objective and subjective health assessment in patients with COPD.

Adult↗
PubMed1999

Comparative study of the reconstruction of articular cartilage defects with free costal perichondrial grafts and free tibial periosteal grafts: an experimental study on rabbits.

The purpose of this study was to compare the chondrogenic potential of free perichondrial with free periosteal grafts in the resurfacing of full-thickness defects of patellar articular cartilage in rabbits. We used adolescent New Zealand rabbits weighing between 2.4 and 3.6 kg. A 6-mm wide and 3-mm thick defect was created on the patellar articular surface. A total of 30 rabbits were randomly divided into a control group and two test groups. One test group received free perichondrial grafts (PC); the other received free periosteal grafts (PO). All the animals were killed 8 weeks after surgery. All the histological samples were scored from 0 to 17 according to a standard scoring system. Differences in the quality of the regenerated tissue were only found between the control and the test groups. There were no statistically significant histological differences between the grafted defects of the PC and the PO groups that there are not on any of the variables. The results of this study support that there are not significant differences in the quality of the repair tissue when using these two types of biological grafts.

Animals↗
PubMed1998

[A retrospective evaluation of the behaviour of groups under out-patient care at a health center].

OBJECTIVES: To study and analyse the Out-Patient Care Groups (OCGs), and evaluate how they affect use of health resources. DESIGN: An observational, retrospective study. SETTING: Ciudad Jardín Health Centre, Málaga. PARTICIPANTS: 2999 patients with a clinical history opened before 31.12.95, chosen from 5 of the 17 medical lists at the Health Centre, were included. RESULTS: The statistical analysis was performed with the SPSS software package of the Calculation Centre at Málaga University. A descriptive test produced the following results: 33% of the patients were classified in OCG 41 (combination of 2 or 3 out-patient diagnosis groups in people over 34); 19% belonged to groups of stable or unstable chronic illnesses (OCGs 8, 9 and 10); and 9% had acute children's diseases. Then multiple regression constructed a model with the OCGs as independent variable and annual visits, further tests performed and referral to specialists as dependent variables. In this model the OCGs were able to explain 20.3% of resource consumption. CONCLUSIONS: In the retrospective study and with a limited sample of 2999 patients, the OCGs are able to explain 20.3% of resource consumption. However, it does seem a valid model for discriminating between normal and over-using patients.

Health Behavior↗
PubMedDate not supplied

[Pharmacotherapy and costs of DRD 88. Chronic obstructive pulmonary disease in hospital].

BACKGROUND: Diagnosis-Related Group (DRG) 88 -chronic obstructive pulmonary disease is one of the most frequent groups of patients in hospital case-mix and accounts for substantial health-care costs. Our purpose was to determine drug utilization pattern and related costs for this DRG and to analyse their relationship with several factors. METHODS: 288 patients treated at a tertiary referral hospital between january and december 1997 were studied. We analysed demographic, clinical, and administrative data, as well as drugs prescription and cost for every patient. RESULTS: Most patients received antibiotics (n=267) which, in addition, represented 46% of total pharmacy cost of this DRG. Cephalosporines were the most frequently prescribed. 67% of patients were treated with inhaled B-agonists and theophillyne, whereas the combination of B-agonists and Ipratropium Bromide was less frequent (n=152). Oral or parenteral corticosteroids were used in 233 patients. This treatment regime presented differences according to main diagnosis and to department responsible for patient discharge. Cost per episode was 116,6 +/- 110,5 euros. Cost per hospital stay was 13,1+/- 15,5 euros. Correlation of pharmacy costs with length of stay was moderate. CONCLUSION: Pharmacy costs are mainly determined by the use of antibiotics. Treatment pattern shows a certain variability that can be attributed to patients clinical features as well as to physician prescribing habits.

Adult↗
PubMedDate not supplied

[Hypertensive patients treated in Spain, 1990-1993].

BACKGROUND: The main goal of our work was to gain knowledge from the pharmaco-epidemiological perspective on the use of anti-hypertensive drugs in our country, in order to obtain a rough estimation of the number of hypertensive patients under treatment in various Autonomous Communities. METHODS: The data regarding the consumption of hypertensive drugs (mono-medicines) from 1990 to 1993 have been obtained from the Vice-Directorate General for Treatment and Pharmaceutical Planning. The methodology used to calculate the "Estimated Prevalence Patient-day" under treatment with these drugs is based on the WHO recommendations for the Studies on the use of Medicines. Estimated Prevalence of Patient-day (EPPD) has been calculated by using the Defined Daily Dosage of each anti-hypertensive drug. RESULTS: The number of hypertensive patients under treatment with these drugs was 1.763.937, 1.966.396, 2.226.225 and 2.435.294, from 1990 to 1993, respectively. At the end of our study, in 1993, the number of hypertensive patients under treatment in Spain is nearly 50% of the total number of hypertensive patients. There are some differences amongst regions; thus, the Autonomous Communities of Aragón, Castilla-La Mancha, Cataluña, País Valenciano and Murcia are noticeable as regions where the number of hypertensive patients treated exceeds the national average. CONCLUSIONS: The number of hypertensive patients under treatment has considerably increased between 1990 to 1993 (+ 40%). An increase is observed in the number of hypertensive patients treated with calcium antagonists and ECA inhibitors and a decrease is observed in the proportion of hypertensive patients under treatment with Beta-blockers and diuretics.

Antihypertensive Agents↗
PubMedDate not supplied

[Evaluation of anti-thrombosis treatment in patients with chronic non-valvular atrial fibrillation].

OBJECTIVES: To assess both the indications of anti-thrombosis treatment in patients in our ambit with chronic non-valvular atrial fibrillation, and its observance in Primary Care. DESIGN: A descriptive, crossover, observational study of consecutive cases. SETTING: Third-level referral hospital in our Health District. PATIENTS: 132 adults first diagnosed with chronic atrial fibrillation between July 1st and December 31st 1996. MEASUREMENTS AND MAIN RESULTS: Patients' clinical records were used to assemble data on risk factors of embolism and counter-indications to prescribing antithrombosis treatment. A logistic regression model was performed to analyse the variables affecting the treatment at the time it was first given. 65 men (mean age 68.3) and 67 women (mean age 74.6) were included in the study. 87.9% of the patients had embolism risk factors; and 30.3% had at least one absolute or relative counter-indication to anti-coagulation. 79 patients had risk factors but no counter-indication, of whom 28% took anticoagulants, 39% had anti-aggregates prescribed and the remaining 33% received no anti-thrombosis treatment at all. Only 3 patients taking anticoagulants were referred to the Primary Care doctor. The regression model worked out signalled age under 75 and a previous embolism as factors associated with the indication and anticoagulants: We found no coherent regression model for the indication of anti-aggregates. CONCLUSIONS: Anti-thrombosis treatment is underused in Primary Care. An antecedent of an embolism is the most weight criterion for giving anticoagulants to patients. Age is shown to be the main reason for therapeutic reluctance to give anticoagulants to patients without counter-indications. There should be more patients being treated with anticoagulants in Primary Care.

Aged↗