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11 results on '"cumplimiento del paciente"'

1. Adaptaciones de la dispensación hospitalaria a pacientes con hemofilia durante la pandemia COVID-19 en España y su influencia en la adherencia

Author

Blázquez Ramos,N, Romero Garrido,JA, Bilbao Gómez-Martino,C, González del Valle,L, Herrero Ambrosio,A, and Benedí González,J

Subjects
Coronavirus, cumplimiento del paciente, adherencia a la medicación, España, profilaxis, hemofilia
Abstract

Resumen Introducción: El estado de alarma decretado por la pandemia del virus SARS COV-2 del 14 de marzo hasta el 21 de junio, ha supuesto un desafío para el área de pacientes externos de los Servicios de Farmacia. Nos centramos en los pacientes con hemofilia que se administran factores de la coagulación de forma crónica para prevenir hemorragias. Objetivos: Analizar durante este periodo el porcentaje de pacientes que han recogido su medicación, han mantenido la adherencia al tratamiento y las barreras encontradas para ello. Cuantificar el número y gravedad de episodios hemorrágicos (EH) sufridos y su relación con la pandemia. Analizar la prevalencia y gravedad de COVID en hemofílicos. Métodos: Uno objetivo, utilizando los registros del hospital y otro subjetivo, mediante encuesta oral durante la consulta de atención farmacéutica presencial o telemática. Resultados: El 80% de los pacientes retiraron medicación durante el periodo de estudio, un 30% en domicilio. El último mes las dispensaciones a domicilio se acompañaron de consulta telemática. Un 24% de pacientes disminuyó su adherencia respecto al 2019. Las principales causas fueron dificultad para acudir al hospital, y percepción de no necesitar tratamiento ante la inactividad. No se registraron más EH o ingresos por causas imputables a la pandemia. No hubo ningún enfermo COVID-19 grave y la incidencia de pacientes con síntomas leves fue similar a la población general. Conclusión: La mayoría de los pacientes con hemofilia pudieron acceder a su medicación. La adherencia se redujo. Los EH no aumentaron por causas atribuibles a la pandemia. La incidencia de COVID-19 fue similar a la población.

Published
2022

2. Falta de adherencia al tratamiento fisioterapéutico en pacientes con trastornos musculoesqueléticos en una clínica docente en Lima, Perú

Author

D. Coello-Talavera, P. Mayta-Tristán, and N. Rojas-Motta

Subjects
030506 rehabilitation, Servicios integrados de asistencia a la enseñanza, Teaching care integration services, Patient compliance, Physical Therapy, Sports Therapy and Rehabilitation, Treatment, 03 medical and health sciences, 0302 clinical medicine, Cumplimiento del paciente, Tratamiento, 030212 general & internal medicine, 0305 other medical science, Physical therapy, Fisioterapia
Abstract

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. Objetivo Conocer la incidencia y los factores de riesgo asociados a la falta de adherencia al tratamiento fisioterapéutico en pacientes con dolor y trastornos músculo esqueléticos que asisten a una clínica docente en Lima, Perú. Materiales y métodos Estudio de cohorte retrospectivo, incluyó a todos los pacientes nuevos atendidos por dolor y trastornos musculoesqueléticos en el periodo 2012-2014. Se midieron la falta de adherencia (asistencia menor a las 8 sesiones indicadas) y los factores demográficos. Se calcularon los riesgos relativos crudos y ajustados (RRa). Resultados Se incluyó a 549 pacientes, el 68,3% fueron mujeres, el 37,2% tuvo 60 o más años, las lesiones más frecuentes se ubicaron en el miembro inferior (34,2%) y el dorso lumbar (24,6%). Se encontró una incidencia de falta de adherencia de 56,4% (IC del 95%, 52,2 a 60,7%) y estuvo asociada a residir lejos de la clínica (RRa: 1,34; IC del 95%, 1,16 a 1,57) y tener menos de 40 años (RRa: 1,27; IC del 95%, 1,04 a 1,54). Conclusión Existe una alta incidencia de falta de adherencia al tratamiento fisioterapéutico relacionado con la distancia y la edad de los pacientes, por lo que se deben buscar estrategias para aumentar la adherencia. Revisión por pares

Published
2016

3. É-Saúde. Servicio online a pacientes. ACCESO DELEGADO

Author

García Tenorio, Paula and Farjas Abadía, Pilar

Subjects
Patient Access to Records, cumplimiento del paciente, É-Saúde, Patients, acceso del paciente a su historia clínica, pacientes, TICs, Patient Compliance, Acceso Delegado, aplicaciones en aparatos electrónicos portátiles, Mobile Applications
Abstract

É-Saúde es una plataforma tecnológica de servicios online que proporciona herramientas digitales interactivas de comunicación desde cualquier dispositivo conectado a internet como modo de gestión de la información personal de salud entre el paciente y el Servicio Autonómico de Salud. El acceso por parte de terceras personas a la información y servicios que el Servicio Gallego de Salud y la Consellería de Sanidade ponen a disposición de la ciudadanía a través de É-Saúde, se denomina ACCESO DELEGADO. Comunicación - póster presentada en: XXXV Congreso Sociedad Española de Calidad Asistencial (SECA). XIX Jornadas Societat Catalana de Qualitat Assitencial (SCQA). Adecuación y eficiencia: "menos es más", celebrado en Tarragona del 18 al 20 de octubre de 2017.

Published
2017

4. The Effect of a Mediterranean Diet on the Incidence of Cataract Surgery

Author

Mònica Bulló, Lluis Serra-Majem, Miguel Fiol, Jordi Salas-Salvadó, Estefanía Toledo, Miguel Ángel Martínez-González, José V. Sorlí, Ernest Vinyoles, Fernando Arós, Gianfranco Ciufo, María P. Portillo, Montse Fitó, José Lapetra, Xavier Pintó, Aleix Sala-Vila, Dolores Corella, Emilio Ros, Alfredo García-Layana, Enrique Gómez-Gracia, Ramon Estruch, Alimentació, Nutrició, Creixement i Salut Mental, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Universitat de Barcelona, [Garcia-Layana, Alfredo] Univ Navarra, Dept Ophthalmol, Pamplona 31008, Spain, [Ciufo, Gianfranco] Univ Navarra, Dept Ophthalmol, Pamplona 31008, Spain, [Toledo, Estefania] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Martinez-Gonzalez, Miguel A.] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Corella, Dolores] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Fito, Montse] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Estruch, Ramon] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Fiol, Miguel] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Lapetra, Jose] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Serra-Majem, Lluis] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Pinto, Xavier] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Portillo, Maria P.] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Sorli, Jose V.] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Bullo, Monica] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Sala-Vila, Aleix] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Ros, Emilio] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Salas-Salvado, Jordi] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Aros, Fernando] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid 28029, Spain, [Toledo, Estefania] Inst Salud Carlos III ISC III, PREDIMED Prevenc Dieta Mediterranea Res Network R, Madrid 28029, Spain, [Martinez-Gonzalez, Miguel A.] Inst Salud Carlos III ISC III, PREDIMED Prevenc Dieta Mediterranea Res Network R, Madrid 28029, Spain, [Estruch, Ramon] Inst Salud Carlos III ISC III, PREDIMED Prevenc Dieta Mediterranea Res Network R, Madrid 28029, Spain, [Gomez-Gracia, Enrique] Inst Salud Carlos III ISC III, PREDIMED Prevenc Dieta Mediterranea Res Network R, Madrid 28029, Spain, [Serra-Majem, Lluis] Inst Salud Carlos III ISC III, PREDIMED Prevenc Dieta Mediterranea Res Network R, Madrid 28029, Spain, [Pinto, Xavier] Inst Salud Carlos III ISC III, PREDIMED Prevenc Dieta Mediterranea Res Network R, Madrid 28029, Spain, [Bullo, Monica] Inst Salud Carlos III ISC III, PREDIMED Prevenc Dieta Mediterranea Res Network R, Madrid 28029, Spain, [Salas-Salvado, Jordi] Inst Salud Carlos III ISC III, PREDIMED Prevenc Dieta Mediterranea Res Network R, Madrid 28029, Spain, [Aros, Fernando] Inst Salud Carlos III ISC III, PREDIMED Prevenc Dieta Mediterranea Res Network R, Madrid 28029, Spain, [Toledo, Estefania] Univ Navarra, Dept Prevent Med & Publ Hlth, Pamplona 31008, Spain, [Martinez-Gonzalez, Miguel A.] Univ Navarra, Dept Prevent Med & Publ Hlth, Pamplona 31008, Spain, [Corella, Dolores] Univ Valencia, Dept Prevent Med, E-46010 Valencia, Spain, [Sorli, Jose V.] Univ Valencia, Dept Prevent Med, E-46010 Valencia, Spain, [Fito, Montse] Hosp Mar, Med Res Inst IMIM, Cardiovasc Risk & Nutr Regicor Study Grp, E-08003 Barcelona, Spain, [Estruch, Ramon] Univ Barcelona, Hosp Clin, August Pi Sunyer Inst Biomed Res IDIBAPS, Dept Internal Med, Barcelona 08036, Spain, [Gomez-Gracia, Enrique] Univ Malaga, Dept Prevent Med, Malaga 29016, Spain, [Fiol, Miguel] Univ Balear Islands, Inst Hlth Sci, Palma De Mallorca 07122, Spain, [Fiol, Miguel] Son Espases Hosp, Palma De Mallorca 07122, Spain, [Lapetra, Jose] Dist Sanitario Atenc Primaria Sevilla, Ctr Salud San Pablo, Dept Family Med, Seville 41007, Spain, [Serra-Majem, Lluis] Univ Las Palmas Gran Canaria, Dept Clin Sci, Las Palmas Gran Canaria 35001, Spain, [Pinto, Xavier] Univ Hosp Bellvitge, Lipids & Vasc Risk Units Internal Med, Barcelona 08907, Spain, [Portillo, Maria P.] Univ Basque Country, Dept Nutr & Food Sci, Nutr & Obes Grp, Vitoria 48940, Spain, [Portillo, Maria P.] Lucio Lascaray Res Ctr, Vitoria 48940, Spain, [Bullo, Monica] Rovira Virgili Univ, IISPV, Fac Med & Hlth Sci, Human Nutr Unit, Reus 43003, Spain, [Salas-Salvado, Jordi] Rovira Virgili Univ, IISPV, Fac Med & Hlth Sci, Human Nutr Unit, Reus 43003, Spain, [Vinyoles, Ernest] Univ Barcelona, Cap Mina, Barcelona 08930, Spain, [Sala-Vila, Aleix] Univ Barcelona, Hosp Clin, IDIBAPS, Lipid Clin Endocrinol & Nutr Serv, Barcelona 08036, Spain, [Ros, Emilio] Univ Barcelona, Hosp Clin, IDIBAPS, Lipid Clin Endocrinol & Nutr Serv, Barcelona 08036, Spain, [Aros, Fernando] Univ Hosp Araba, Dept Cardiol, Vitoria 01009, Spain, official funding agency for biomedical research of the Spanish government, Instituto de Salud Carlos III (ISCIII), Centro Nacional de Investigaciones Cardiovasculares, Fondo de Investigacion Sanitaria-Fondo Europeo de Desarrollo Regional, Ministerio de Ciencia e Innovacion, Fundacion Mapfre, Consejeria de Salud de la Junta de Andalucia, Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana, Regional Government of Navarra, and Miguel Servet I, ISCIII, Spain

Subjects
Male, cumplimiento del paciente, Mediterranean diet, medicine.medical_treatment, humanos, Extra-virgin olive oil, estudios de seguimiento, Diet, Mediterranean, Dieta mediterrània, Cataract surgery, Antioxidants, law.invention, 0302 clinical medicine, PREDIMED, cataract, cataract surgery, nuts, extra-virgin olive oil, low-fat diet, antioxidants, Randomized controlled trial, Cirurgia de cataractes, law, Risk Factors, Prevalence, Nuts, Age-related cataract, 030212 general & internal medicine, Diet, Fat-Restricted, mediana edad, Aged, 80 and over, Ciències de la salut, anciano, Low-fat diet, Nutrition and Dietetics, dieta, resultado del tratamiento, Incidence (epidemiology), Incidence, Hazard ratio, Vitamins, Metaanalysis, Middle Aged, Ciencias de la salud, catarata, Treatment Outcome, Female, Ciencias de la Salud [Materias Investigacion], lcsh:Nutrition. Foods and food supply, Risk, medicine.medical_specialty, Zeaxanthin, lcsh:TX341-641, incidencia, Article, Cataract, Association, 03 medical and health sciences, Mediterranean cooking, Internal medicine, Cuina mediterrània, medicine, factores de riesgo, Humans, Olive Oil, Aged, Cataractes -- Cirugia, Nuclear cataract, Proportional hazards model, business.industry, Prevention, Health sciences, Confidence interval, Diet, Surgery, nueces, Clinical trial, Food Science, Nutrition & Dietetics, 030221 ophthalmology & optometry, Cataractes, Patient Compliance, business, Follow-Up Studies
Abstract

Background: Cataract is a leading cause of vision impairment worldwide, and surgery is the only available treatment. The process that initiates lens opacification is dependent on the oxidative stress experienced by the lens components. A healthy overall dietary pattern, with the potential to reduce oxidative stress, has been suggested as a means to decrease the risk of developing cataract. We aimed to investigate the hypothesis that an intervention with a Mediterranean diet (MedDiet) rather than a low-fat diet could decrease the incidence of cataract surgery in elderly subjects. Methods: We included 5802 men and women (age range: 55-80 years) from the Prevencion con Dieta Mediterronea study (multicenter, parallel-group, randomized controlled clinical trial) who had not undergone cataract surgery. They were randomly assigned to one of three intervention groups: (1) a MedDiet enriched with extra-virgin olive oil (EVOO) (n = 1998); (2) a MedDiet enriched with nuts (n = 1914), and a control group recommended to follow a low-fat diet (n = 1890). The incidence of cataract surgery was recorded yearly during follow-up clinical evaluations. Primary analyses were performed on an intention-to-treat basis. Cox regression analyses were used to assess the relationship between the nutritional intervention and the incidence of cataract surgery. Results: During a follow-up period of 7.0 years (mean follow-up period: 5.7 years; median: 5.9 years), 559 subjects underwent cataract surgery. Two hundred and six participants from the MedDiet + EVOO group, 174 from the MedDiet + Nuts group, and 179 from the control group underwent cataract surgery. We did not observe a reduction in the incidence of cataract surgery in the MedDiet groups compared to the control group. The multivariable adjusted hazard ratios were 1.03 (95% confidence interval [CI]: 0.84-1.26, p = 0.79) for the control group versus the MedDiet + EVOO group and 1.06 (95% CI: 0.86-1.31, p = 0.58) for the control group versus the MedDiet + Nuts group. Conclusions: To our knowledge, this is the first large randomized trial assessing the role of a MedDiet on the incidence of cataract surgery. Our results showed that the incidence of cataract surgery was similar in the MedDiet with EVOO, MedDiet with nuts, and low-fat diet groups. Further studies are necessary to investigate whether a MedDiet could have a preventive role in cataract surgery., Supported by the official funding agency for biomedical research of the Spanish government, Instituto de Salud Carlos III (ISCIII), through grants provided to research networks specifically developed for the trial (RTIC G03/140, to Ramon Estruch; RTIC RD 06/0045, to Miguel Martinez-Gonzalez and through Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion [CIBEROBN]), and by grants from Centro Nacional de Investigaciones Cardiovasculares (CNIC 06/2007), Fondo de Investigacion Sanitaria-Fondo Europeo de Desarrollo Regional (PI04-2239, PI 05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, and P11/02505; PI13/00462), Ministerio de Ciencia e Innovacion (AGL-2009-13906-C02 and AGL2010-22319-C03), Fundacion Mapfre 2010, Consejeria de Salud de la Junta de Andalucia (PI0105/2007), Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana (ACOMP06109, GVA-COMP2010-181, GVACOMP2011-151, CS2010-AP-111, and CS2011-AP-042), and Regional Government of Navarra (P27/2011). AS-V holds a Miguel Servet I contract (CP12/03299), ISCIII, Spain.

Published
2017
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5. The evaluation of a remote support program on quality of life and evolution of disease in COPD patients with frequent exacerbations

Author

Antonia Fuster, José Miguel Rodríguez González-Moro, Aurelio Arnedillo, Alonso Fernández-Nistal, Joan B. Soriano, Patricia García Sidro, Pilar de Lucas, Bernardino Alcazar, and María José Espinosa de los Monteros

Subjects
Male, modelos logísticos, cumplimiento del paciente, Health Status, humanos, autocuidados, Logistic regression, Severity of Illness Index, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Quality of life, estudios prospectivos, Surveys and Questionnaires, Medicine, evaluación de programas y proyectos de salud, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, mediana edad, Univariate analysis, COPD, anciano, Chronic obstructive pulmonary disease, estado de salud, Middle Aged, Telemedicine, Management, Disease Progression, Population study, Female, telemedicina, Research Article, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Education, Exacerbations, 03 medical and health sciences, Patient Education as Topic, progresión de la enfermedad, Internal medicine, Severity of illness, Humans, índice de gravedad de la enfermedad, análisis multifactorial, Aged, business.industry, medicine.disease, Self Care, Logistic Models, 030228 respiratory system, Spain, calidad de vida, Multivariate Analysis, Physical therapy, Patient Compliance, Observational study, educación de pacientes como asunto, business, Program Evaluation
Abstract

Background: Chronic obstructive pulmonary disease (COPD) patients often present considerable individual medical burden in their symptoms, limitations, and well-being that complicate medical treatment. To improve their overall health status, while reducing the number of exacerbations, a multidisciplinary approach including different elements of care is needed. The aim of this study was to evaluate the effects of a remote support program on COPD patients at high risk of experiencing worsening of their disease and other health-related outcomes. Methods: An observational, multicenter, prospective study aimed at evaluating the impact of a 7-month remote support program on COPD patients in exacerbations control and changes in health status measured with the COPD assessment test (CAT). Factors associated with a clinically relevant decrease in CAT were assessed using a logistic regression analysis. Results: A total of 114 subjects started the program. The majority of the study population were males (81.6 %), retired (70.2 %), without academic qualifications or with a low level of education (68.4 %), and ex-smokers (79.8 %). The mean +/- SD age was 69.6 +/- 9.1 years and the BMI was 27.8 +/- 5.5 Kg/m(2). Overall, 41.9 % (95 % CI 31.9-52.0) patients, significantly improved health status (CAT decrease >= 2 points). Univariate analysis showed that significant improvement in CAT was associated with baseline CAT scores [high CAT score 19.2 (+/- 7.5) vs. low CAT score 12.4 (+/- 6.4); OR = 1.15, 95 % CI: 1.07-1.24; p < 0.001] and with being non-compliant [62.5 % (15/24) of non-compliant vs 34.7 % (24/69) of compliant patients significantly improved CAT scores; OR = 3.13, 95 % CI: 1.19-8.19; p = 0.021). After controlling for the effect of all variables in a multivariable logistic regression model, the only factor that remained significant was baseline CAT score. The proportion of smokers in the total population remained constant during the study. There was a significant reduction in the number of exacerbations after entering this remote support program with median -1 (IQR: -2, 0), (p < 0.001). The Morisky-Green questionnaire showed an increase of treatment compliance, namely at baseline, 25.8 % (24/93) of patients were noncompliant while in the end 66.7 % (16/24) of them became compliant) (p = 0.053). Conclusions: A remote support program for high-risk COPD patients results in an improvement of the patients' health status, particularly in those with initially poor health status, and it helps to reduce COPD exacerbations., The ESOPO study was funded by Takeda Pharmaceutical Spain SA.

Published
2016

6. Association between the Adherence to the International Guidelines for Cancer Prevention and Mammographic Density

Author

Adela Castelló, Leandro Prieto, María Ederra, Dolores Salas-Trejo, Carmen Vidal, Carmen Sánchez-Contador, Carmen Santamariña, Carmen Pedraz, Pilar Moreo, Nuria Aragonés, Beatriz Pérez-Gómez, Virginia Lope, Jesús Vioque, Marina Pollán, DDM-Spain research group, Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo (España), and Federación Española de Cáncer de Mama

Subjects
medicine.medical_specialty, cumplimiento del paciente, Cross-sectional study, humanos, cribado sistemático, Population, Physical activity, lcsh:Medicine, neoplasias de la mama, Breast Neoplasms, Breast cancer, Risk Factors, Environmental health, factores de riesgo, Medicine, Humans, Mass Screening, lcsh:Science, education, Mammary Glands, Human, Mass screening, Breast Density, Gynecology, education.field_of_study, Multidisciplinary, Cancer prevention, business.industry, lcsh:R, MAMMOGRAPHIC DENSITY, medicine.disease, Postmenopause, Cross-Sectional Studies, Spain, postmenopausia, Patient Compliance, lcsh:Q, Smoking status, Female, business, estudios transversales, Research Article
Abstract

Introduction Mammographic density (MD) is considered a strong predictor of Breast Cancer (BC). The objective of the present study is to explore the association between MD and the compliance with the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) recommendations for cancer prevention. Methods Data of 3584 women attending screening from a population-based multicenter cross-sectional study (DDM-Spain) collected from October 7, 2007 through July 14, 2008, was used to calculate a score that measures the level of compliance with the WCRF/AICR recommendations: R1)Maintain adequate body weight; R2)Be physically active; 3R)Limit the intake of high density foods; R4)Eat mostly plant foods; R5)Limit the intake of animal foods; R6)Limit alcohol intake; R7)Limit salt and salt preserved food intake; R8)Meet nutritional needs through diet. The association between the score and MD (assessed by a single radiologist using a semi-quantitative scale) was evaluated using ordinal logistic models with random center-specific intercepts adjusted for the main determinants of MD. Stratified analyses by menopausal status and smoking status were also carried out. Results A higher compliance with the WCRF/AICR recommendations was associated with lower MD (OR1-unit increase = 0.93 95%CI:0.86;0.99). The association was stronger in postmenopausal women (OR = 0.91 95%CI:0.84;0.99) and nonsmokers (OR = 0.87;95%CI:0.80;0.96 for nonsmokers, OR = 1.01 95%CI:0.91;1.12 for smokers, P-interaction = 0.042). Among nonsmokers, maintaining adequate body weight (OR = 0.81 95%CI:0.65;1.01), practicing physical activity (OR = 0.68 95%CI:0.48;0.96) and moderating the intake of high-density foods (OR = 0.58 95%CI:0.40;0.86) and alcoholic beverages (OR = 0.76 95%CI:0.55;1.05) were the recommendations showing the strongest associations with MD. Conclusions postmenopausal women and non-smokers with greater compliance with the WCRF/AICR guidelines have lower MD. These results may provide guidance to design specific recommendations for screening attendants with high MD and therefore at higher risk of developing BC., This study was supported by FIS PI060386 FIS (Health Research Fund) Research Grant; EC11-273 Research Grant from the Spanish Ministy of Health; CD110/00018 FIS Sara Borrell contract; FECMA 485 EPY 1170-10 grant from the Spanish Federation of Breast Cancer Patients.

Published
2015

7. Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study

Author

Carla H. van Gils, E. Riboli, Christos Tsironis, Anne-Claire Vergnaud, H. Bas Bueno-de-Mesquita, Laureen Dartois, José Ramón Quirós, Veronika Fedirko, Pietro Ferrari, Teresa Norat, Pagona Lagiou, Christina C. Dahm, Giovanna Masala, Timothy J. Key, Mark J. Gunter, Maria Wennberg, Kay-Tee Khaw, Verena Katzke, Petra H.M. Peeters, Aurelio Barricarte, Heather Ward, Nicholas J. Wareham, Anne Tjønneland, Lena Maria Nilsson, Bodil Ohlsson, Valeria Pala, Laure Dossus, Antonia Trichopoulou, Tilman Kühn, Heiner Boeing, Elisabete Weiderpass, Petra A. Wark, M. Dorronsoro, Carmen Navarro, Camilla Plambeck Hansen, Genevieve Buckland, Salvatore Panico, Marie-Christine Boutron-Ruault, María José Sánchez, Paolo Vineis, Peter D. Siersema, Karin Jirström, Dora Romaguera, Rosario Tumino, Mazda Jenab, Romaguera, Dora, Ward, Heather, Wark, Petra A, Vergnaud, Anne Claire, Peeters, Petra H, van Gils, Carla H, Ferrari, Pietro, Fedirko, Veronika, Jenab, Mazda, Boutron Ruault, Marie Christine, Dossus, Laure, Dartois, Laureen, Hansen, Camilla Plambeck, Dahm, Christina Catherine, Buckland, Genevieve, Sánchez, María José, Dorronsoro, Miren, Navarro, Carmen, Barricarte, Aurelio, Key, Timothy J, Trichopoulou, Antonia, Tsironis, Christo, Lagiou, Pagona, Masala, Giovanna, Pala, Valeria, Tumino, Rosario, Vineis, Paolo, Panico, Salvatore, Bueno de Mesquita, H. Ba, Siersema, Peter D, Ohlsson, Bodil, Jirström, Karin, Wennberg, Maria, Nilsson, Lena M, Weiderpass, Elisabete, Kühn, Tilman, Katzke, Verena, Khaw, Kay Tee, Wareham, Nick J, Tjønneland, Anne, Boeing, Heiner, Quirós, José R, Gunter, Marc J, Riboli, Elio, Norat, Teresa, Department of Medical and Clinical Genetics, Medicum, BMC, BMC, Department of Epidemiology and Public Health, Imperial College London, Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, CIBER Fisiopatología de la Obesidad y Nutrición ( (CIBEROBN)), Instituto de Salud Carlos III [Madrid] (ISC), Department of Primary Care and Public Health, Department of Epidemiology, University Medical Center [Utrecht]-Julius Center for Health Sciences and Primary Care, Nutrition and Metabolism Section, International Agency for Cancer Research (IACR), Emory University [Atlanta, GA]-Rollins School of Public Health-Winship Cancer Institute, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Section for Epidemiology, Aarhus University [Aarhus], Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL)-Cancer Epidemiology Research Programme, Granada Cancer Registry, Andalusian School of Public Health [Granada], Consorcio de Investigación Biomédica en Red especializado en Epidemiología y Salud Pública (CIBERESP), Los Centros de Investigación Biomédica en Red (CIBER), Murcia Regional Health Council [Murcia], Department of Health and Social Sciences, Universidad de Murcia, Navarre Public Health Institute, Cancer Epidemiology Unit, University of Oxford, Hellenic Health Foundation, Bureau of Epidemiologic Research, Academy of Athens, Department of Hygiene, Epidemiology and Medical Statistics, Harvard School of Public Health, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Tumori - National Cancer Institute [Milan], Cancer Registry and Histopathology Unit, Department of Oncology-Civile - M.P.Arezzo Hospital, Human Genetics Foundation (HuGeF), Università degli studi di Torino = University of Turin (UNITO), Dipartimento di Medicina Clinica e Chirurgia, University of Naples Federico II = Università degli studi di Napoli Federico II, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya = Universiti Malaya [Kuala Lumpur, Malaisie] (UM), Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment [Bilthoven] (RIVM), Department of Gastroenterology and Hepatology, University Medical Center [Utrecht], Division of Internal Medicine, Skane University Hospital [Malmo], Lund University [Lund]-Lund University [Lund], Division of Oncology and Pathology, Lund University [Lund], Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Arctic Research Centre, Department of Community Medicine, The Arctic University of Norway [Tromsø, Norway] (UiT), Department of Research, Cancer Registry of Norway, Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet [Stockholm], Genetic Epidemiology Group [Helsinki], Folkhälsan Research Center, Faculty of Medecine [Helsinki], Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Faculty of Medecine [Helsinki], Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Division of Cancer Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Clinical Gerontology Unit, University of Cambridge [UK] (CAM), MRC Epidemiology Unit, University of Cambridge [UK] (CAM)-Institute of Metabolic Science, Danish Cancer Society Research Center, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, Public Health Directorate, Khaw, Kay-Tee [0000-0002-8802-2903], Wareham, Nicholas [0000-0003-1422-2993], Apollo - University of Cambridge Repository, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), University of Oxford [Oxford], Università degli studi di Torino (UNITO), University of Naples Federico II, University of Malaya, The Arctic University of Norway, University of Helsinki-University of Helsinki-Faculty of Medecine [Helsinki], University of Helsinki-University of Helsinki, [Romaguera,D, Ward,H, Vergnaud,A, Peeters,PH, Vineis,P, Bueno-de-Mesquita,HB, Gunter, MJ, Riboli,E, Norat,T] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. [Romaguera,D] Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, Palma de Mallorca, Spain. [Romaguera,D] CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. [Wark,PA] Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK. [Peeters,PH, Gils, CH] Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. [Ferrari,P, Jenab,M] International Agency for Cancer Research (IARC), Lyon CEDEX, France. [Fedirko,V] Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA. [Fedirko,V] Winship Cancer Institute, Emory University, Atlanta, USA. [Boutron-Ruault,M, Dossus,L, Dartois,L] Inserm (Institut National de la Santé et de la Recherche Médicale), Centre for Research in Epidemiology and Population Health (CESP), Vaillant, Villejuif, Cedex, France. [Boutron-Ruault,M, Dartois,L] Univ Paris Sud, Villejuif, France. [Boutron-Ruault,M, Dartois,L] Gustave Roussy, Villejuif, France. [Hansen,CP, Dahm,CC] Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark. [Buckland,G] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. [Sánchez,MJ] Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs. GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. [Sánchez,MJ, Dorronsoro,M, Navarro,C, Barricarte,A] CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. [Dorronsoro,M] Public Health Direction and Biodonostia Basque Regional Health Department, San Sebastian, Spain. [Navarro,C] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Campus Universitario de Espinardo, Murcia, Spain. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Key,TJ] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford UK. [Trichopoulou,A, Tsironis,C] Hellenic Health Foundation, Athens, Greece . [Trichopoulou,A, Lagiou,P] Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. [Lagiou,P] Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Lagiou,P] Department of Epidemiology, Harvard School of Public Health, Boston, USA. [Masala,G] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy. [Pala,V] Epidemiology and Prevention Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, 'Civic – M.P. Arezzo' Hospital, Ragusa, Italy. [Vineis,P] HuGeF Foundation, Turin, Italy. [Panico,S] Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy. [Bueno-de-Mesquita,HB] Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven The Netherlands. [Bueno-de-Mesquita,HB, Siersema,PD] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. [Bueno-de-Mesquita,HB] Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. [Ohlsson,B] Division of Internal Medicine, Department of Clinical Sciences, Skane University Hospital, Malmo, Lund University, Lund, Sweden. [Jirström,K] Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden. [Wennberg,M] Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden. [Nilsson,LM] Arctic Research Centre, Umeå University, Umeå, Sweden. [Weiderpass,E] Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, ISM - Universitetet i Tromsø, Tromsø, Norway. Department of Research, Cancer Registry of Norway, Majorstuen Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Department of Genetic Epidemiology, Folkhälsan Research Center, Folkhälsan Research Center, Biomedicum 1, University of Helsinki, Helsinki, Finland. [Kühn,T, Katzke,V] German Cancer Research Center (DKFZ), Division of Cancer Epidemiology Im Neuenheimer Feld 581, Heidelberg, Germany. [Khaw,K] University of Cambridge School of Clinical Medicine, Clinical Gerontology Unit Box 251, Addenbrooke’s Hospital, Cambridge, UK. [Wareham,NJ] MRC Epidemiology Unit, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK. [Tjønneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. [Quirós,JR] Public Health Directorate, Oviedo Asturias, Spain., This study was funded by the World Cancer Research Fund (WCRF) International Regular Grant Programme (Grant number 2009/44). Dora Romaguera holds a Ramon y Cajal contract (Ministerio de Economía y Competitividad, Spain and European Regional Development Fund, RYC-2011-08796). In addition, EPIC investigators acknowledge funding from the following agencies: Europe Against Cancer Program of the European Commission (SANCO), German Cancer Aid, German Cancer Research Center (DKFZ), German Federal Ministry of Education and Research (BMBF), Danish Cancer Society, Catalan Institute of Oncology, Spain, Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RCESP exp. C03/09 and ISCIII RETICC RD06/0020/0091, Spain, Cancer Research UK, Medical Research Council, United Kingdom, The Hellenic Health Foundation, Greece, Italian Association for Research on Cancer (AIRC), Italian National Research Council, Fondazione-Istituto Banco Napoli, Italy, Dutch Ministry of Public Health, Welfare and Sports, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), The Netherlands, Swedish Cancer Society, Swedish Scientific Council, Regional Government of Skåne, Sweden, Helga—Nordic Center of Excellence Programme in Nutrition and Health, French League against Cancer (LNCC), National Institute for Health and Medical Research (INSERM), France, Mutuelle Générale de l'Education Romaguera et al. BMC Medicine (2015) 13:107 Page 10 of 12 Nationale (MGEN), France, 3 M Co., France, Gustave Roussy Institute (IGR), France, and and General Councils of France. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Subjects
Male, physical activity, 0302 clinical medicine, estudios prospectivos, Prospective Studies, estudios de cohortes, mediana edad, Aged, 80 and over, anciano, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Motor Activity [Medical Subject Headings], dieta, Incidence, Hazard ratio, COLON-CANCER, General Medicine, adulto, 3. Good health, Näringslära, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, estilo de vida, Cohort, Dieta, Estilo de Vida, RESEARCH FUND/AMERICAN INSTITUTE, Cohort study, Human, medicine.medical_specialty, Concordance, European Continental Ancestry Group, DIAGNOSIS, incidencia, White People, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Càncer colorectal, Neoplasias Colorrectales, BREAST-CANCER, Humans, Life Style, Aged, Cancer prevention, Proportional hazards model, Physical activity, Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [Medical Subject Headings], Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], weight, LIFE-STYLE FACTORS, Colorectal cancer, REPRODUCTIVE HISTORY, Prospective Studie, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Cancer and Oncology, Proportional Hazards Model, grupo de ascendencia continental europea, Estudios de Cohortes, Gerontology, cumplimiento del paciente, Survival, modelos de riesgos proporcionales, VDP::Medisinske Fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803, [SDV]Life Sciences [q-bio], humanos, Colorectal Neoplasm, Alcohol consumption, Breast cancer, Prospective study, Named Groups::Persons::Survivors [Medical Subject Headings], Cohort Studies, 030212 general & internal medicine, Prospective cohort study, Non-U.S. Gov't, 2. Zero hunger, Medicine(all), RISK, Nutrition and Dietetics, Healthy lifestyle, Diet, Weight, Research Support, Non-U.S. Gov't, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, European Prospective Investigation into Cancer and Nutrition, VDP::Medical disciplines: 700::Health sciences: 800::Epidemiology medical and dental statistics: 803, NUTRITION, Female, Colorectal Neoplasms, Research Article, Adult, neoplasias colorrectales, 3122 Cancers, RECREATIONAL PHYSICAL-ACTIVITY, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], colorectal cancer, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], Research Support, survival, Sobrevivientes, healthy lifestyle, Internal medicine, medicine, Journal Article, Proportional Hazards Models, Actividad Motora, business.industry, Physical fitness, BODY-MASS INDEX, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Other Clinical Medicine, 3121 General medicine, internal medicine and other clinical medicine, Patient Compliance, Cohort Studie, business, diet, Condició física
Abstract

Background: Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients. Methods: The association between the WCRF/AICR score (score range 0-6 in men and 0-7 in women; higher scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872) and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. Results: The HRs (95% CIs) for CRC-specific mortality among participants in the second (score range in men/women: 2.25-2.75/3.25-3.75), third (3-3.75/4-4.75), and fourth (4-6/5-7) categories of the score were 0.87 (0.72-1.06), 0.74 (0.61-0.90), and 0.70 (0.56-0.89), respectively (P for trend, We would like to acknowledge the contribution of all participants in the study. This study was funded by the World Cancer Research Fund (WCRF) International Regular Grant Programme (Grant number 2009/44). Dora Romaguera holds a Ramon y Cajal contract (Ministerio de Economia y Competitividad, Spain and European Regional Development Fund; RYC-2011-08796). In addition, EPIC investigators acknowledge funding from the following agencies: Europe Against Cancer Program of the European Commission (SANCO); German Cancer Aid; German Cancer Research Center (DKFZ); German Federal Ministry of Education and Research (BMBF); Danish Cancer Society; Catalan Institute of Oncology, Spain; Health Research Fund (FIS) of the Spanish Ministry of Health; Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia (no. 6236) and Navarra; ISCIII RCESP exp. C03/09 and ISCIII RETICC RD06/0020/0091, Spain; Cancer Research UK; Medical Research Council, United Kingdom; The Hellenic Health Foundation, Greece; Italian Association for Research on Cancer (AIRC); Italian National Research Council; Fondazione-Istituto Banco Napoli, Italy; Dutch Ministry of Public Health, Welfare and Sports, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), The Netherlands; Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, Sweden; Helga-Nordic Center of Excellence Programme in Nutrition and Health; French League against Cancer (LNCC); National Institute for Health and Medical Research (INSERM), France; Mutuelle Generale de l'Education Nationale (MGEN), France; 3 M Co., France; Gustave Roussy Institute (IGR), France; and General Councils of France.

Published
2014

8. Lifestyles and risk factors associated with adherence to the Mediterranean diet: a baseline assessment of the PREDIMED trial

Author

Enrique Gómez-Gracia, Rosa M. Lamuela-Raventós, José V. Sorlí, María P. Portillo, Javier Díez-Espino, Fernando Arós, Dolores Corella, Ramon Estruch, Miquel Fiol, Miguel Ángel Martínez-González, Ernest Vinyoles, José Lapetra, Emily A Hu, Jordi Salas-Salvadó, Xavier Pintó, Lluis Serra-Majem, Estefanía Toledo, Emilio Ros, and Universitat de Barcelona

Subjects
Gerontology, Male, cumplimiento del paciente, distribución territorial de la población, Mediterranean diet, Non-Clinical Medicine, Epidemiology, humanos, Diet, Mediterranean, Cardiovascular, law.invention, Cohort Studies, Clinical trials, Endocrinology, Randomized controlled trial, law, Residence Characteristics, Risk Factors, Food choice, mediana edad, Epidemiological Methods, Aged, 80 and over, anciano, Multidisciplinary, Hàbits alimentaris, dieta, Middle Aged, Health Education and Awareness, Cardiovascular Diseases, estilo de vida, Observational Studies, Medicine, Dieta, Female, Public Health, Research Article, Clinical Research Design, Food habits, Science, enfermedades cardiovasculares, Dietary pattern, factores socioeconómicos, medicine, factores de riesgo, Humans, Clinical Trials, Obesity, Statistical Methods, Socioeconomic status, Life Style, Cardiovascular Disease Epidemiology, Aged, Nutrition, Health Care Policy, business.industry, PREDIMED study, Odds ratio, Anthropometry, medicine.disease, Lifestyle, Confidence interval, Diet, Socioeconomic Factors, Risk factors, Case-Control Studies, Patient Compliance, Preventive Medicine, business, Demography, Assaigs clínics
Abstract

Background: The traditional Mediterranean dietary pattern (MedDiet) is associated with longevity and low rates of cardiovascular disease (CVD). However, there is little information on who is more likely to follow this food pattern. Aim: To evaluate how different factors are associated with lower MedDiet adherence in older Spanish subjects. Methods: We included 7305 participants (men aged 55-80 y, women 60-80 y) at high-risk of CVD recruited into the PREDIMED trial (ISRCTN35739639). Socioeconomic, anthropometric, lifestyle characteristics and CVD risk factors were recorded. A validated 14-item questionnaire was used to evaluate MedDiet adherence at baseline. Multivariate models were used to estimate odds ratios (OR) and 95% confidence intervals for lower adherence to the MedDiet (, Supported by the official funding agency for biomedical research of the Spanish government, Instituto de Salud Carlos III (ISCIII), through grants provided to research networks specifically developed for the trial (RTIC G03/140, to Dr. Estruch; RTIC RD 06/0045, to Dr. Martinez-Gonzalez and through Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion [CIBERobn]), and by grants from Centro Nacional de Investigaciones Cardiovasculares (CNIC 06/2007), Fondo de Investigacion Sanitaria-Fondo Europeo de Desarrollo Regional (PI04-2239, PI 05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, and P11/02505), Ministerio de Ciencia e Innovacion (AGL-2009- 13906-C02, AGL2010-22319-C03 and SAF2009-12304), Fundacion Mapfre 2010, Consejeria de Salud de la Junta de Andalucia (PI0105/2007), Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana (ACOMP06109, GVACOMP2010-181, GVACOMP2011-151, CS2010- AP-111, CS2011-AP-042, BEST11-263, BEST/2011/261, GVACOMP2011-151, ACOMP/2011/145 and ACOMP/2012/190), and Regional Government of Navarra (P27/2011). Dr. Toledo is supported by a Rio Hortega post-residency fellowship of ISCIII, Ministry of Economy and Competitiveness, Spanish Government and by the Fundacion Mutua Madrilena. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Published
2013

9. The effect of patient satisfaction with pharmacist consultation on medication adherence: an instrumental variable approach

Author

Ning Yan Gu, Yunwei Gai, and Joel W. Hay

Subjects
medicine.medical_specialty, Pharmacist, Probit, Pharmacists, Multivariate probit model, Patient satisfaction, Nursing, Cumplimiento del paciente, Probit model, medicine, mesh:Patient Compliance, mesh:Pharmacists, Endogeneity, Medical prescription, health care economics and organizations, Original Research, Farmacéuticos, business.industry, Estados Unidos, Instrumental variable, Satisfacción del paciente, United States, mesh:Patient Satisfaction, Patient Satisfaction, Family medicine, Patient Compliance, mesh:United States, business
Abstract

There are limited studies on quantifying the impact of patient satisfaction with pharmacist consultation on patient medication adherence. Objectives: The objective of this study is to evaluate the effect of patient satisfaction with pharmacist consultation services on medication adherence in a large managed care organization. Methods: We analyzed data from a patient satisfaction survey of 6,916 patients who had used pharmacist consultation services in Kaiser Permanente Southern California from 1993 to 1996. We compared treating patient satisfaction as exogenous, in a single-equation probit model, with a bivariate probit model where patient satisfaction was treated as endogenous. Different sets of instrumental variables were employed, including measures of patients' emotional well-being and patients' propensity to fill their prescriptions at a non-Kaiser Permanente (KP) pharmacy. The Smith-Blundell test was used to test whether patient satisfaction was endogenous. Over-identification tests were used to test the validity of the instrumental variables. The Staiger-Stock weak instrument test was used to evaluate the explanatory power of the instrumental variables. Results: All tests indicated that the instrumental variables method was valid and the instrumental variables used have significant explanatory power. The single equation probit model indicated that the effect of patient satisfaction with pharmacist consultation was significant (p

Published
2008

10. Associations of the FTO rs9939609 and the MC4R rs17782313 polymorphisms with type 2 diabetes are modulated by diet, being higher when adherence to the Mediterranean diet pattern is low

Author

Guillermo Sáez-Tormo, Eva M. Asensio, Jose M. Ordovas, Dolores Corella, Fernando Arós, Miguel Angel Muñoz, Jordi Salas-Salvadó, Enrique Gómez-Gracia, Ramon Estruch, José V. Sorlí, Emilio Ros, Carolina Ortega-Azorín, Miquel Fiol, José Lapetra, Lluis Serra-Majem, Miguel Ángel Martínez-González, O. Coltell, Xavier Pintó, María-Isabel Covas, and Universitat de Barcelona

Subjects
Blood Glucose, Male, lcsh:Diseases of the circulatory (Cardiovascular) system, modelos logísticos, cumplimiento del paciente, Mediterranean diet, Endocrinology, Diabetes and Metabolism, humanos, Type 2 diabetes, frecuencia génica, MC4R, Diet, Mediterranean, Body Mass Index, Nutrigenomics, Gene Frequency, Surveys and Questionnaires, Odds Ratio, mediana edad, Nutrigenetics, Original Investigation, Aged, 80 and over, education.field_of_study, anciano, nutrigenómica, Diabetis, dieta, modelos lineales, Diabetes, ayuno, distribución de la ji al cuadrado, Fasting, Middle Aged, cociente de probabilidades relativas, estado nutricional, Phenotype, interacción gen-ambiente, diabetes mellitus, fenotipo, Receptor, Melanocortin, Type 4, Female, Dieta, Cardiology and Cardiovascular Medicine, FTO, Nutrigenòmica, medicine.medical_specialty, glucosa sanguínea, Gene-diet interactions, Population, estudios de casos y controles, Alpha-Ketoglutarate-Dependent Dioxygenase FTO, Nutritional Status, Diabetes mellitus, Internal medicine, medicine, Genetic predisposition, Humans, Genetic Predisposition to Disease, análisis multifactorial, education, Aged, Chi-Square Distribution, Polymorphism, Genetic, business.industry, proteínas, índice de masa corporal, Case-control study, Proteins, nutritional and metabolic diseases, predisposición genética a la enfermedad, medicine.disease, Obesity, Diet, Endocrinology, Logistic Models, Diabetes Mellitus, Type 2, lcsh:RC666-701, Spain, Case-Control Studies, Multivariate Analysis, Linear Models, Patient Compliance, Gene-Environment Interaction, business, Body mass index
Abstract

Background: Although the Fat Mass and Obesity (FTO) and Melanocortin-4 Receptor (MC4R) genes have been consistently associated with obesity risk, the association between the obesity-risk alleles with type 2 diabetes is still controversial. In some recent meta-analyses in which significant results have been reported, the associations disappeared after adjustment for body mass index (BMI). However gene-diet interactions with dietary patterns have not been investigated. Our main aim was to analyze whether these associations are modulated by the level of adherence to the Mediterranean Diet (MedDiet). Methods: Case-control study in 7,052 high cardiovascular risk subjects (3,430 type 2 diabetes cases and 3,622 non-diabetic subjects) with no differences in BMI. Diet was assessed by validated questionnaires. FTO-rs9939609 and MC4R-rs17782313 were determined. An aggregate genetic score was calculated to test additive effects. Gene-diet interactions were analyzed. Results: Neither of the polymorphisms was associated with type 2 diabetes in the whole population. However, we found consistent gene-diet interactions with adherence to the MedDiet both for the FTO-rs9939609 (P-interaction=0.039), the MC4R-rs17782313 (P-interaction=0.009) and for their aggregate score (P-interaction=0.006). When adherence to the MedDiet was low, carriers of the variant alleles had higher type 2 diabetes risk (OR=1.21, 95%CI: 1.03-1.40; P=0.019 for FTO-rs9939609 and OR=1.17, 95%CI:1.01-1.36; P=0.035 for MC4R-rs17782313) than wild-type subjects. However, when adherence to the MedDiet was high, these associations disappeared (OR=0.97, 95%CI: 0.85-1.16; P=0.673 for FTO-rs9939609 and OR=0.89, 95%CI:0.78-1.02; P=0.097 for MC4R-rs17782313). These gene-diet interactions remained significant even after adjustment for BMI. As MedDiet is rich in folate, we also specifically examined folate intake and detected statistically significant interaction effects on fasting plasma glucose concentrations in non-diabetic subjects. However these findings should be interpreted with caution because folate intake may simply reflect a healthy dietary pattern. Conclusions: These novel results suggest that the association of the FTO-rs9939609 and the MC4R-rs17782313 polymorphisms with type 2 diabetes depends on diet and that a high adherence to the MedDiet counteracts the genetic predisposition., This study has been supported by The Spanish Ministry of Health (Instituto de Salud Carlos III) and the Ministry of Economy and Innovation, Spain and Fondo Europeo de Desarrollo Regional (projects PI051839, PI070240, PI1001407, G03/140, CIBER 06/03, RD06/0045 PI07-0954, CNIC-06, PI11/02505, SAF2009-12304 and AGL2010-22319-C03-03), by contracts 53-K06-5-10 and 58-1950-9-001 from the US Department of Agriculture Research, USA and by the Generalitat Valenciana, Spain (AP111/10, AP-042/11, BEST11-263, BEST/2011/261, GVACOMP2011-151, ACOMP/2011/145 and ACOMP/2012/190).

11. Developing a generic, individualised adherence programme for chronic medication users

Author

Lotte Stig Haugbølle, Charlotte Rossing, Lene Sørensen, Pernille Dam, and Hanne Herborg

Subjects
Counseling, Interview, business.industry, Denmark, Dinamarca, Pharmacist, Pharmacy, Focus group, Coaching, Self Efficacy, Toolbox, Consejo, Nursing, Cumplimiento del paciente, Intervention (counseling), Pharmaconomist, mesh:Denmark, mesh:Patient Compliance, Patient Compliance, Medicine, business, mesh:Self Efficacy, mesh:Counseling, Auto-eficacia, Original Research
Abstract

Objective: The scope of this article is to describe the background for and content of an adherence counselling programme with a specific focus on an individualised, multi-dimensional adherence model for patients with a potential adherence problem (a so-called ‘individualised systems model’). Methods: An intervention programme based on WHO’s systems model for adherence was developed for implementation in primary health care and tested in a development project in Danish pharmacies in 2004-2005 in three pharmacies and 4 GP practices by 27 patients. Data were collected from the participants by registration forms, questionnaires, and focus groups. Since the programme was to support patients in the self-management process regarding choice and implementation of medication treatment, various strategies were used and different theoretical assumptions and choices made prior to setting up the study. These strategies include distinguishing between different types of non-adherence, a model for stages of change, self-efficacy, narratives, motivating interviewing strategies and coaching techniques. These strategic and theoretical choices are described in the article. Results: The strategies and theoretical reflections formed the platform for the creation of a counselling programme, which was tested in two forms, a basic and an extended version - provided by either a pharmaconomist or a pharmacist. The result section also describes a toolbox of instruments to enable pharmacy staff and GPs to tailor a counselling programme for patients individually called ‘Safe and effective use of medicines’. Besides, the results include a description of how the WHO-model is transformed into an individualised counselling model. Objetivo: El ámbito de este artículo es describir los antecedentes y el contenido de un programa de consejo en adherencia específicamente enfocado a un modelo multidimensional individualizado de adherencias para pacientes con un posible problema de adherencia (conocido como ‘modelo de sistemas individualizado’). Métodos: Se desarrolló un programa de intervención basado en el modelo de sistemas de la OMS para adherencia y se probó en un proyecto danés desarrollado en 2004-2005 en 3 farmacias y 4 consultas de médicos generales con 27 pacientes. Se recogieron los datos de los participantes en formularios, cuestionarios y grupos focales. Como el programa era para apoyar a los pacientes en el proceso de auto-gestión en cuanto a la selección, e implantación del tratamiento medicamentoso, se usaron varias estrategias y se hicieron a priori varias asunciones teóricas y elecciones para arrancar el estudio. Estas estrategias incluyeron diferenciar los distintos tipos de no-adherencia, un modelo de estados de cambio, auto-eficacia, narrativas, estrategias de entrevistas motivadoras, y técnicas de entrenamiento. Estas estrategias y elecciones teóricas se describen en el artículo. Resultados: Las estrategias y reflexiones teóricas crearon la plataforma para la creación de un programa de consejo, que se probó de dos formas, una versión básica y una extensa - proporcionado bien por un farmacoeconomista o un farmacéutico. La sección de resultados también describe un conjunto de instrumentos para capacitar al personal de la farmacia y a los médicos a dirigir un programa de consejo para pacientes denominado ‘Uso efectivo y seguro de medicamentos’. Además, los resultados incluyen una descripción de cómo se transformó el modelo de OMS en un modelo de consejo individualizado.

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