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Your search keyword '"Ricardo Ortega-Sánchez"' showing total 2 results
Start Over Author "Ricardo Ortega-Sánchez" Journal bmc public health
2 results on '"Ricardo Ortega-Sánchez"'

1. Rationale and design of a randomised controlled trial evaluating the effectiveness of an exercise program to improve the quality of life of patients with heart failure in primary care: The EFICAR study protocol.

Author

Zuazagoitia, Ana, Grandes, Gonzalo, Torcal, Jesús, Lekuona, Iñaki, Echevarria, Pilar, Gómez, Manuel A., Domingo, Mar, de la Torre, Maria M., Ramírez, Jose I., Montoya, Imanol, Oyanguren, Juana, and Pinilla, Ricardo Ortega-Sánchez

Subjects
QUALITY of life, HEART failure, RANDOMIZED controlled trials, PRIMARY care, CARDIOVASCULAR diseases
Abstract

Background: Quality of life (QoL) decreases as heart failure worsens, which is one of the greatest worries of these patients. Physical exercise has been shown to be safe for people with heart failure. Previous studies have tested heterogeneous exercise programs using different QoL instruments and reported inconsistent effects on QoL. The aim of this study is to evaluate the effectiveness of a new exercise program for people with heart failure (EFICAR), additional to the recommended optimal treatment in primary care, to improve QoL, functional capacity and control of cardiovascular risk factors. Methods/Design: Multicenter clinical trial in which 600 patients with heart failure in NYHA class II-IV will be randomized to two parallel groups: EFICAR and control. After being recruited, through the reference cardiology services, in six health centres from the Spanish Primary Care Prevention and Health Promotion Research Network (redIAPP), patients are followed for 1 year after the beginning of the intervention. Both groups receive the optimized treatment according to the European Society of Cardiology guidelines. In addition, the EFICAR group performs a 3 month supervised progressive exercise program with an aerobic (high-intensity intervals) and a strength component; and the programme continues linked with community resources for 9 months. The main outcome measure is the change in health-related QoL measured by the SF-36 and the Minnesota Living with Heart Failure Questionnaires at baseline, 3, 6 and 12 months. Secondary outcomes considered are changes in functional capacity measured by the 6-Minute Walking Test, cardiac structure (B-type natriuretic peptides), muscle strength and body composition. Both groups will be compared on an intention to treat basis, using multi-level longitudinal mixed models. Sex, age, social class, co-morbidity and cardiovascular risk factors will be considered as potential confounding and predictor variables. Discussion: A key challenges of this study is to guarantee the safety of the patients; however, the current scientific evidence supports the notion of there being no increase in the risk of decompensation, cardiac events, hospitalizations and deaths associated with exercise, but rather the opposite. Safety assurance will be based on an optimized standardised pharmacological therapy and health education for all the participants. Trial Registration: Clinical Trials.gov Identifier: NCT01033591 [ABSTRACT FROM AUTHOR]

Published
2010

2. Predictors of long-term change of a physical activity promotion programme in primary care

Author

Alvaro, Sanchez, Gonzalo, Grandes, Ricardo, Ortega Sánchez-Pinilla, Jesus, Torcal, Imanol, Montoya, and Cristina, Dıaz

Subjects
Male, medicine.medical_specialty, Health Promotion, Social class, Metabolic equivalent, law.invention, Randomized controlled trial, Risk Factors, law, Epidemiology, Humans, Medicine, Longitudinal Studies, Baseline (configuration management), Exercise, Primary Health Care, Physical activity, business.industry, Public health, Public Health, Environmental and Occupational Health, Middle Aged, Anthropometry, Socioeconomic Factors, Longitudinal predictors, Cardiovascular Diseases, Linear Models, Physical therapy, Female, Biostatistics, Health promotion intervention, business, Research Article
Abstract

Background Further research is needed to improve the evidence regarding determinants of physical activity (PA) as a crucial step to plan higher effective intervention strategies. The goal of the present study is to identify socio-demographic and clinical characteristics of primary care (PHC) insufficiently active patients that are associated with longitudinal changes in the level of physical activity. Methods Longitudinal analysis of baseline socio-demographic and clinical predictors of physical activity change in insufficiently active PHC patients who participated in a PA-promoting multi-centre randomized clinical trial conducted from October 2003 through March 2006. The primary outcome measure was the self-reported physical activity assessed with the 7-day Physical Activity Recall (PAR), at baseline, 6, 12 and 24 months. Baseline covariates included sex, age, social class, anthropometric measures and other cardiovascular risk factors or associated diseases (Diabetes, HTA, tobacco use, etc.), and stage of readiness to change PA. Generalized linear mixed models were used to estimate longitudinal association of studied variables on PA change over the three follow-up measurements. Results A total of 3691 patients (85% of the 4317 recruited in the trial) with at least one follow-up measurement were included in the longitudinal analysis. At baseline, analysed patients (mean age: 50.6 years; 64.6% women) devoted 34.7 minutes and 2.36 metabolic equivalent hours per week (MET.h/week) to moderate and vigorous physical activity. Older age, male gender, higher social class, lower BMI, diagnosis of diabetes or hypertension, and measurement season were significant predictors of PA longitudinal change. The effect of baseline readiness to change on PA dose was modified by time, showing a positive gradient in favour of those with more readiness to change that increases significantly at 12 and 24 months (p-value interaction < .0001). Conclusions Identified baseline characteristics such as readiness to change and risk factors can guide physicians to prioritize time and intervention efforts for maximizing their impact on insufficiently active PHC patients.

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