0000000000010952
AUTHOR
Domingo Orozco-beltrán
showing 16 related works from this author
Clinical Inertia in Poorly Controlled Elderly Hypertensive Patients: A Cross-Sectional Study in Spanish Physicians to Ascertain Reasons for Not Inten…
2013
Clinical inertia, the failure of physicians to initiate or intensify therapy when indicated, is a major problem in the management of hypertension and may be more prevalent in elderly patients. Overcoming clinical inertia requires understanding its causes and evaluating certain factors, particularly those related to physicians.The objective of our study was to determine the rate of clinical inertia and the physician-reported reasons for it.An observational, cross-sectional, multi-center study was carried out in a primary care setting. We included 512 physicians, with a consecutive sampling of 1,499 hypertensive patients with clinical inertia.Clinical inertia was defined when physicians did n…
Mortality and cardiovascular disease burden of uncontrolled diabetes in a registry-based cohort: the ESCARVAL-risk study
2018
Background: Despite the epidemiological evidence about the relationship between diabetes, mortality and cardiovascular disease, information about the population impact of uncontrolled diabetes is scarce. We aimed to estimate the attributable risk associated with HbA1c levels for all-cause mortality and cardiovascular hospitalization.Methods: Prospective study of subjects with diabetes mellitus using electronic health records from the universal public health system in the Valencian Community, Spain 2008–2012. We included 19,140 men and women aged 30 years or older with diabetes who underwent routine health examinations in primary care.Results: A total of 11,003 (57%) patients had uncontrolle…
RESUMEN EJECUTIVO DEL CONSENSO DE EXPERTOS SOBRE LA EFICACIA Y SEGURIDAD DE LOS iDPP-4 EN EL TRATAMIENTO DE PACIENTES CON DIABETES Y COVID-19
2021
Resumen Antecedentes El objetivo de este consenso es esclarecer el papel de los iDPP-4 en el manejo de los pacientes con diabetes durante la pandemia por COVID-19. Material y metodos Se llevo a cabo una busqueda bibliografica en PubMed (diciembre 2019-febrero de 2021). Se empleo la metodologia Oxford y se establecieron de forma consensuada posibles recomendaciones. Resultados La diabetes parece ser un factor independiente en la enfermedad de COVID-19 (evidencia 2b). No se demuestra mayor riesgo de contagio con iDPP-4 (evidencia 2b), y su uso ha demostrado ser seguro (evidencia 2b). Los iDPP-4 pueden presentar un cierto beneficio en la reduccion de la mortalidad, particularmente su uso intra…
In the Identification of Cardiovascular Risk With the SCORE Model, Could We Recommend Its Calculation Interchangeably With Total Cholesterol or Ather…
2011
The SCORE table indiscriminately recommends the use of total cholesterol (SCORE-TC) or atherogenic index (SCORE-AI) for calculating cardiovascular (CV) risk. We evaluated reliability and agreement between both methods and the clinical implications for the identification of high CV risk. Observational study (n = 8942) in a 40- to 65-year-old population. Spearman’s Rho correlation was 0.987 (P < .001), the agreement intraclass correlation coefficient was 0.671 (IC 95% 0.413–0.796; with Bland–Altman’s method, the average of the differences between models was 0.74. Kappa index was poor, 0.297 (P < .001) and positive specific agreement was 0.31. Discrepancies fitted individuals with high CV risk…
Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: The ESCARVAL-RISK study
2017
Introduction The potential impact of targeting different components of an adverse lipid profile in populations with multiple cardiovascular risk factors is not completely clear. This study aims to assess the association between different components of the standard lipid profile with allcause mortality and hospitalization due to cardiovascular events in a high-risk population. Methods This prospective registry included high risk adults over 30 years old free of cardiovascular disease (2008-2012). Diagnosis of hypertension, dyslipidemia or diabetes mellitus was inclusion criterion. Lipid biomarkers were evaluated. Primary endpoints were all-cause mortality and hospital admission due to corona…
Patients&rsquo; and physicians&rsquo; preferences for type 2 diabetes mellitus treatments in Spain and Portugal: a&nbsp;discrete choice e…
2015
Carlos Morillas,1 Rosa Feliciano,2 Pablo Fern&aacute;ndez Catalina,3 Carla Ponte,4 Marta Botella,5 Jo&atilde;o Rodrigues,6 Enric Esmatjes,7 Javier Lafita,8 Luis Liz&aacute;n,9 Ignacio Llorente,10 Crist&oacute;bal Morales,11 Jorge Navarro-P&eacute;rez,12 Domingo Orozco-Beltran,13 Silvia Paz,9 Antonio Ramirez de Arellano,14 Cristina Cardoso,15 Maribel Tribaldos Causadias9 1Hospital Universitario Dr Peset, Valencia, Spain; 2USF S&atilde;o Domingos, Santar&eacute;m, Portugal; 3Hospital Montecelo de Pontevedra, Galicia, Spain; 4USF Porta do Sol, Matosinhos, Portugal; 5Hospital Universitario Principe de Asturias, Madrid, Spain; 6USF Serra da Lous&atilde;, Lous&…
Clinical inertia in diagnosis and treatment of hypertension in primary care: Quantification and associated factors
2009
The objective of the present study was to quantify both diagnostic and therapeutic inertia in hypertension and to identify patient-associated variables.Cross-sectional, multicenter study of 35 424 subjects carried out in 428 health centers and/or primary care clinics in the Valencian Community, Spain, in a preventive activity conducted during 2003 and 2004. Diagnostic inertia was identified when a patient without known hypertension had high blood pressure (BP) but was labeled "normal" by the medical staff, and therapeutic inertia when treatment was not modified for a hypertensive patient on the presence of high BP values. Bivariate and multivariate statistical analyses were performed to ide…
Hospital admissions trends for severe hypoglycemia in diabetes patients in Spain, 2005 to 2015.
2020
Abstract Aims To analyze hospital admissions trends, inpatient mortality, and mean length of hospital stay due to hypoglycemia in patients with diabetes in Spain from 2005 to 2015. Methods National Institute of Statistics provided information on hospital discharge and mortality. Hospital admissions due to severe hypoglycemia were identified using ICD-9 codes. Age-adjusted admission and mortality rates were stratified by sex and year. Joinpoint regression models were used to estimate trends. Results Admissions rates per 100,000 population were higher for men than women in 2005 (30.2, 95%CI:29.3, 31.0 versus 21.5, 95%CI:20.9, 22.1) and 2015 (23.7, 95%CI:23.0, 24.4 versus 13.2, 95%CI:12.7, 13.…
Análisis Bibliométrico de la producción Científica Internacional sobre atención primaria()
2012
ResumenObjetivosDescribir la producción científica internacional en el ámbito de la atención primaria en el período 1985-2004.DiseñoAnálisis bibliométrico.EmplazamientoBase de datos Medline. Acceso mediante WebSPIRS versión 4,3. Se analizan 2 períodos: 2000-2004 (transversal) y 1985-2004 (evolutivo). Búsqueda basada en MesH Major con los descriptores: Primary Care o Primary Health Care, Family Practice, Physicians Family, Nurse Practitioners y los Entry Terms relacionados con ellos.Mediciones principalesSe analizaron los indicadores bibliométricos de producción, circulación, dispersión y visibilidad. Criterios de inclusión: se consideró aquel registro (documento citable) indexado en Medline…
Attitudes towards insulin initiation in type 2 diabetes patients among healthcare providers: A survey research
2016
Aims: To describe the views of healthcare providers about starting insulin in patients with type 2 diabetes and to determine the specific factors that contribute to delay insulin initiation. Methods: Two-phases observational descriptive study. In the quantitative phase we conducted a cross-sectional survey of a sample of 380 healthcare professionals (general practitioners (GPs), endocrinologists, internists and nurses). In the qualitative phase, a discussion group reviewed the results of the survey to propose solutions. Results: In poorly controlled patients, 46% of GPs vs. 43.2% of internists and 31.3% of endocrinologists waited 3-6 months before starting insulin, and 71.4% of GPs vs. 66.7…
El estudio PROPRESE: resultados de un nuevo modelo organizativo en atención primaria para pacientes con cardiopatía isquémica crónica basado en una i…
2014
ResumenObjetivoComparando los resultados obtenidos en los estudios EUROASPIRE I y EUROASPIRE III en pacientes con cardiopatía isquémica se muestra que el grado de control de los factores de riesgo mayores es mejorable. El objetivo de este estudio es evaluar la eficacia de una intervención multifactorial orientada a la mejora del grado de control en estos pacientes en el ámbito de la atención primaria.MétodosEn este estudio de intervención aleatorizado, con 1 año de seguimiento, se reclutó a pacientes con diagnóstico de cardiopatía isquémica (145 en el grupo de intervención y 1.461 en el grupo control). Se aplicó una intervención organizativa mixta basada en la mejora de la relación profesio…
Rationale and methods of the cardiometabolic valencian study (escarval-risk) for validation of risk scales in mediterranean patients with hypertensio…
2010
Abstract Background The Escarval-Risk study aims to validate cardiovascular risk scales in patients with hypertension, diabetes or dyslipidemia living in the Valencia Community, a European Mediterranean region, based on data from an electronic health recording system comparing predicted events with observed during 5 years follow-up study. Methods/Design A cohort prospective 5 years follow-up study has been designed including 25000 patients with hypertension, diabetes and/or dyslipidemia attended in usual clinical practice. All information is registered in a unique electronic health recording system (ABUCASIS) that is the usual way to register clinical practice in the Valencian Health System…
Gender Inequalities in Diagnostic Inertia around the Three Most Prevalent Cardiovascular Risk Studies: Protocol for a Population-Based Cohort Study
2021
Evidence shows that objectives for detecting and controlling cardiovascular risk factors are not being effectively met, and moreover, outcomes differ between men and women. This study will assess the gender-related differences in diagnostic inertia around the three most prevalent cardiovascular risk factors: dyslipidemia, arterial hypertension, and diabetes mellitus, and to evaluate the consequences on cardiovascular disease incidence. This is an epidemiological and cohort study. Eligible patients will be adults who presented to public primary health care centers in a Spanish region from 2008 to 2011, with hypertension, dyslipidemia, or/and diabetes and without cardiovascular disease. Parti…
A cardiovascular educational intervention for primary care professionals in Spain: positive impact in a quasi-experimental study
2015
Background Routine general practice data collection can help identify patients at risk of cardiovascular disease. Aim To determine whether a training programme for primary care professionals improves the recording of cardiovascular disease risk factors in electronic health records. Design and setting A quasi-experimental study without random assignment of professionals. This was an educational intervention study, consisting of an online-classroom 1-year training programme, and carried out in the Valencian community in Spain. Method The prevalence rates of recording of cardiovascular factors (recorded every 6 months over a 4-year period) were compared between intervention and control group. …
A new risk score to assess atrial fibrillation risk in hypertensive patients (ESCARVAL-RISK Project.
2020
AbstractThis study aimed to assess atrial fibrillation (AF) incidence and predictive factors in hypertensive patients and to formulate an AF risk assessment score that can be used to identify the patients most likely to develop AF. This was a cohort study of patients recruited in primary healthcare centers. Patients aged 40 years or older with hypertension, free of AF and with no previous cardiovascular events were included. Patients attended annual visits according to clinical practice until the end of study or onset of AF. The association between AF incidence and explanatory variables (age, sex, body mass index, medical history and other) was analyzed. Finally, 12,206 patients were includ…
Recomendaciones preventivas cardiovasculares. Actualización PAPPS 2020
2020
The recommendations of the semFYC's Program for Preventive Activities and Health Promotion (PAPPS) for the prevention of cardiovascular diseases (CVD) are presented. The following sections are included: Epidemiological review, where the current morbidity and mortality of CVD in Spain and its evolution as well as the main risk factors are described; Cardiovascular (CV) risk tables and recommendations for the calculation of CV risk; Main risk factors such as arterial hypertension, dyslipidemia and diabetes mellitus, describing the method for their diagnosis, therapeutic objectives and recommendations for lifestyle measures and pharmacological treatment; Indications for antiplatelet therapy, a…