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L Torralba

Publications and source records attributed to L Torralba.

11 recordsLinked to original sources
PubMed2004

Prevalence of problematic cocaine consumption in a city of southern Europe, using capture-recapture with a single list.

This study aims to determine the magnitude and characteristics of problematic cocaine consumption in the city of Barcelona, Spain. Capture-recapture with a single source was used to estimate prevalence. Log-linear regression models with interaction terms were fitted to the total sample and to subgroups according to other drugs consumed. Emergency room indicator data were obtained from the Barcelona Drug Information System. Drug-related emergencies of Barcelona residents for 1999 were analyzed. During 1999, a total of 4,035 drug-related emergencies were seen in Barcelona hospitals. Of these, 1,656 (41%) involved cocaine consumption; 41% of these patients had consumed cocaine with an opiate; 29% used cocaine with other substances; and 30% used cocaine alone. It was estimated that there was a total of 25,988 problematic cocaine users (95% confidence interval 11,782-58,064), yielding a rate of 31.27 per 1,000 inhabitants aged 15 to 54 years (95% confidence interval 14.2-69.9). The number of cocaine-related emergencies was high enough to allow capture-recapture to be applied, thus obtaining an estimate of the prevalence of problematic cocaine consumption, and high enough to characterize users according to different profiles. The use of capture-recapture with a single source can be interesting for problems related to the urban context.

Adult↗
PubMed2001

[Change in health-related problems of cocaine consumption in Catalonia, Spain].

BACKGROUND: Our aim was to study the evolution of cocaine-related health problems in Catalonia, Spain. METHODS: Analysis of first treatment admissions, emergency-room episodes, and mortality recorded by information systems on drug abuse in Catalonia and the city of Barcelona (Spain) in 1999. RESULTS: In 1999, cocaine was the illegal drug most frequently reported among drug-related emergency-room episodes (1,093 episodes in the city of Barcelona). In addition, cocaine was the illegal drug most frequently found among fatal drug overdoses (80% of all deaths in the last quarter of 1999) and the one that caused the highest number of treatment admissions (1,547 cases in Catalonia). CONCLUSIONS: There is an increase in cocaine-related health problems which means that it is needed health to improve the diagnosis, health education, treatment and prevention of complications associated with the use of this substance.

Adolescent↗
PubMed1996

Mortality due to acute adverse drug reactions: opiates and cocaine in Barcelona, 1989-93.

Drug-related deaths have become a major source of premature mortality. This paper presents an analysis of deaths due to acute adverse drug reactions caused by opiates or cocaine in the city of Barcelona over a 5-year period during which figures were stable. Annual mortality rates due to adverse drug reactions of city residents for the 1989-93 period were estimated to be 15.3 per 100,000 people in the 15-49-year age group. Mortality rates for men (25.0) are consistently higher than mortality rates for women (5.8). Mortality rates by age group show different patterns by gender. Males in the 25-29-year group have the highest mortality rate (62.8), almost doubling the rates for the 20-24 (36.1) and 30-34 (33.3)-year groups. The highest differential in age-specific mortality by gender is seen in the 35-39-year age group, where mortality rates for men (21.5) are eight times higher than for women (2.6 per 100,000). The distribution by place of residence, stratifying data across city neighbourhoods and municipal districts displays wide differences between districts in the mean annual rates, ranking between 77.3 and 8.3 per 100,000, a nine-fold magnitude. Differences are even steeper when we break down data by neighbourhood. Although all areas with high adverse drug reactions mortality are areas of low socio-economic level, a more complex association between deprivation and drug use must exist, as other areas with similarly low socio-economic indicators do not suffer from such high mortality. A cross-tabulation of place of residence and district of death shows that for most adverse drug reaction deaths, death takes place in the district of residence but patterns related to districts who attract drug-related deaths and districts who export them may be observed. These results provide new insights into the epidemiology of substance abuse in Barcelona, where it follows patterns that may be similar to those of other major urban areas in Spain, but also in other Southern European countries.

Adolescent↗
PubMed1995

[The epidemiology of the acute adverse drug reaction in Barcelona in 1983-1992: a mortality analysis].

BACKGROUND: Mortality caused by acute adverse drug reactions (AADR) increased in Spain over the eighties and has become one of the major causes of death for youth. This paper presents the results of a study in the city of Barcelona during the 1983-92 decade; based in the city drug information system. METHODS: The study includes all deaths caused by AADR autopsied in the Forensic Institute between 1983 and 1992. Mortality of city residents is analyzed by cohort, grouping data in two-years and adjusting Poisson regression to mortality rates by age group, birth cohort and period of study. RESULTS: During this period a sharp increase in AADR mortality is seen, as there were 19 deaths in the city in 1983 and 160 in 1992. The increase concentrates in the years 1987-89. Although previously the increasing mortality of drug users was related by some observers with the progressive deterioration of their health status, linked to their increasing age and to the cumulative effects of years of substance dependence, the mortality analysis points to a clear period effect, resulting in an increased mortality across all age groups, for cohorts born after 1960. CONCLUSIONS: These results point to changes in the illegal drug market in the city or in the patterns of abuse as most likely causes for the increase. The results also suggest that since 1989 there is a stabilization in mortality due to AADR, which deserves further study.

Acute Disease↗
PubMedDate not supplied

[Coping with the toll of heroin: 10 years of the Barcelona Action Plan on Drugs, Spain].

INTRODUCTION: The epidemic of heroin use began in Barcelona, as in the rest of Spain, in the late 70's, to reach its peak by the end of the 80's. In a first period, responsible officers experimented difficulties to define the specific objectives of opiate control policies. This paper reviews the effects of the adoption of an explicit policy on drug dependence grounded on a wide consensus in the City of Barcelona (Catalonia, Spain). SUBJECTS AND METHODS: Over a period of twelve years, from 1986 to 1997, both demand and offer of care and harm reduction services were analyzed, as well as the evolution of the adverse effects of drug use, such as mortality from acute adverse drug reaction, human immunodeficiency virus (HIV) infection, aids incidence, and incidence of tuberculosis. Data for city residents was compared through four different stages in this period. RESULTS: Despite the lack of data in initial years, relevant changes are apparent. Treatment offer changes clearly, with significant increases in initial treatment, coverage of methadone maintenance programmes, and sterile syringes distribution. Therapeutic compliance of tuberculous intravenous drug users IVDU and risk of HIV infection improve. Emergency service use linked to heroin, overdose, or withdrawal syndrome decreases. Mortality rates decline, although this decline does not reach statistical significance. DISCUSSION: Service offer shows a clear increase, reflected in treatment initiation, while harm reduction services expand. With the development of this process, outcome indicators change, both reflecting changes in the toll of the heroin epidemic (cases of tuberculosis and aids among IVDUs, HIV infection). and changes in a more comprehensive care (better treatment compliance of IVDUs with tuberculosis). There is a lower distortion of emergency services. These changes occur although the predominance of white heroin in Barcelona favors parenteral use.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Methadone maintenance programs with supplementary services: a cost-effectiveness study].

OBJECTIVE: Methadone maintenance programs (MMP) currently offer the best treatment for opioid-addicted patients. The aim of this study was to examine the cost-effectiveness of three MMPs that offered varying levels of supplementary services. Health-related quality of life was used as a measure of effectiveness. METHODS: A 12-month follow-up study of 586 patients beginning methadone treatment in Drug Care Centers in Barcelona was performed. The Nottingham Health Profile was used to measure quality of life. Standard unit costs and total cost per patient were calculated from activity registries. Sociodemographic, health-related and toxicological data were collected through a semi-structured interview. A cost-effectiveness analysis was performed through two multiple linear regressions with the same adjusting variables. RESULTS: The greater the number of supplementary services involved, the higher the costs. The adjusted models revealed a significant increase in health-related quality of life (an increase of 8% in the Nottingham Health Profile) and in costs (17%) between low- and medium-intensity programs. CONCLUSION: The medium-intensity program showed the best cost-effectiveness ratio. However, the study's limitations preclude categoric generalization of the data.

Adult↗
PubMedDate not supplied

[Portfolio of services in a public health organization].

Health services in Spain are currently being improved. Definition of the services portfolio has been one of the elements in this process, from which public health services have been largely left out. In the present article public health services are examined from the perspective of the Public Health Agency of Barcelona. We propose a scheme to classify services into productive public health services, health care services, services that are intermediate products, support services, and liaison or coordinating services. Indicators of productivity, result, impact, and cost are explored, and a catalogue of services for a public health organization with a well defined population and area is proposed.

Outcome and Process Assessment, Health Care↗
PubMedDate not supplied

Readiness to change questionnaire: reliability study of its Spanish version.

The present study explored the reliability and validity of a Spanish version of the Readiness to Change Questionnaire (RCQ) (12-item short form) as it might be used for opportunistic intervention. The test has three scales to allocate patients to a stage of change: pre-contemplation (P), contemplation (C) or action (A). The RCQ was translated and back-translated prior to pilot administration to 15 patients. From two settings (a general hospital ward and a primary health care centre), 201 patients were identified as excessive drinkers on the Alcohol Use Disorders Identification Test. Patients known to be alcohol-dependent and attending for alcohol-related reasons were excluded. Patients completed the RCQ. Test-retest reliability after 2 days was assessed in 35 patients. A components analysis was performed. Patients were classified on RCQ scores to a stage of change. Two experts separately interviewed the patients and made an allocation to stage of change, blind to the RCQ score. Test-retest reliability was good (P: r = 0.81; C: r = 0.87; A: r = 0.86). Within the three scales, RCQ items showed fair consistency in terms of Cronbach's alpha (P: 0.58, C: 0.75, A: 0.80). Component analysis showed that together the scales accounted for 57. 4% of the variance. The experts agreed between themselves on patients' stage of change (weighted kappa 0.92) but much less with the stage of change according to RCQ (expert A, kappa = 0.44; expert B, kappa = 0.52). Omitting patients with low consumption did not improve internal reliability, and omitting those with low educational level who might have filled in the questionnaire wrongly did not improve internal reliability or agreement between RCQ and the experts. We conclude that the Spanish RCQ did not function efficiently in a population of opportunistically identified excessive drinkers.

Adult↗