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Paloma Ortega-Molina

Bio: Paloma Ortega-Molina is an academic researcher from Complutense University of Madrid. The author has contributed to research in topics: COPD. The author has an hindex of 3, co-authored 3 publications receiving 70 citations.
Topics: COPD

Papers
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Journal ArticleDOI
TL;DR: This study mainly aimed at describing the prevalence of psychotropic medication consumption in the Spanish elderly population between the years 1993 and 2003.
Abstract: Purpose This study mainly aimed at describing the prevalence of psychotropic medication consumption in the Spanish elderly population between the years 1993 and 2003. Methods Descriptive, cross-sectional study covering the Spanish population aged 65 years and over, using data drawn from the 1993 and 2003 Spanish National Health Surveys (ENSS). A total of 9570 interviews were analysed (3436 from 1993 and 6134 from 2003). The independent variables were sociodemographic and health-related, and the dependent variable was total consumption of psychotropic medication. Using logistic multivariate regression models, we have analysed the temporal evolution of psychotropic medication consumption between 1993 and 2003. Results The prevalence of consumption was significantly higher in women (6.7% from 1993 and 26.4 % from 2003) versus men (2.4% from 1993 and 10.6% from 2003) (p < 0.001). Multivariate analysis, highlighted the association between increased psychoactive drug intake and sex, nervous, depressive, sleep disorders and negative perception of health, displayed a strong association with consumption of psychoactive drugs across the 2 years. Conclusions In Spain, the prevalence of psychoactive drug consumption is higher among elderly women than men, and increases with negative perception of health. The prevalence of consumption was significantly higher in the year 2003. Copyright © 2006 John Wiley & Sons, Ltd.

47 citations

Journal ArticleDOI
TL;DR: Among COPD patients the uptake of vaccination increased with age, and other factors associated with an increase in vaccination coverage were: being male, perceiving one’s health as fair or poor, not smoking, and having seen a doctor during the previous month.
Abstract: The aim of this study is to compare influenza vaccination coverage among Spaniards aged 40 y or over who suffer from chronic obstructive pulmonary disease (COPD) with those without this illness to ...

23 citations

Journal ArticleDOI
TL;DR: This research showed that incidence of CDI was higher in HF than non-HF patients, and HF is a risk factor for in-hospital mortality (IHM) after suffering CDI.
Abstract: Background: We aimed to (1) analyze time trends in the incidence and in-hospital outcomes of heart failure (HF) patients suffering Clostridioides difficile infection (CDI); (2) compare clinical characteristics of CDI patients between those with HF and matched non-HF patients; and (3) identify predictors of in-hospital mortality (IHM) among HF patients suffering CDI. Methods: Retrospective study using the Spanish National Hospital Discharge Database from 2001 to 2015. Patients of age ≥40 years with CDI were included. For each HF patient, we selected a year, age, sex, and readmission status-matched non-HF patient. Results: We found 44,695 patients hospitalized with CDI (15.46% with HF). HF patients had a higher incidence of CDI (202.05 vs. 145.09 per 100,000 hospitalizations) than patients without HF (adjusted IRR 1.35; 95% CI 1.31–1.40). IHM was significantly higher in patients with HF when CDI was coded as primary (18.39% vs. 7.63%; p < 0.001) and secondary diagnosis (21.12% vs. 14.76%; p < 0.001). Among HF patient’s predictor of IHM were older age (OR 8.80; 95% CI 2.55–20.33 for ≥85 years old), those with more comorbidities (OR 1.68; 95% CI 1.12–2.53 for those with Charlson Comorbidity index ≥2), and in those with severe CDI (OR 6.19; 95% CI 3.80–10.02). Conclusions: This research showed that incidence of CDI was higher in HF than non-HF patients. HF is a risk factor for IHM after suffering CDI.

8 citations


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Journal ArticleDOI
26 Jan 2017-PLOS ONE
TL;DR: Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified and map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area.
Abstract: Background Influenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake. Objective This review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area. Methods Thirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination. Results Most studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups. Conclusion Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.

738 citations

Journal ArticleDOI
27 Sep 2012-BMJ
TL;DR: The result was robust in pooled analyses across cohorts of new users of benzodiazepines throughout the study and in a complementary case-control study, and indiscriminate widespread use should be cautioned against.
Abstract: Objective To evaluate the association between use of benzodiazepines and incident dementia. Design Prospective, population based study. Setting PAQUID study, France. Participants 1063 men and women (mean age 78.2 years) who were free of dementia and did not start taking benzodiazepines until at least the third year of follow-up. Main outcome measures Incident dementia, confirmed by a neurologist. Results During a 15 year follow-up, 253 incident cases of dementia were confirmed. New use of benzodiazepines was associated with an increased risk of dementia (multivariable adjusted hazard ratio 1.60, 95% confidence interval 1.08 to 2.38). Sensitivity analysis considering the existence of depressive symptoms showed a similar association (hazard ratio 1.62, 1.08 to 2.43). A secondary analysis pooled cohorts of participants who started benzodiazepines during follow-up and evaluated the association with incident dementia. The pooled hazard ratio across the five cohorts of new benzodiazepine users was 1.46 (1.10 to 1.94). Results of a complementary nested case-control study showed that ever use of benzodiazepines was associated with an approximately 50% increase in the risk of dementia (adjusted odds ratio 1.55, 1.24 to 1.95) compared with never users. The results were similar in past users (odds ratio 1.56, 1.23 to 1.98) and recent users (1.48, 0.83 to 2.63) but reached significance only for past users. Conclusions In this prospective population based study, new use of benzodiazepines was associated with increased risk of dementia. The result was robust in pooled analyses across cohorts of new users of benzodiazepines throughout the study and in a complementary case-control study. Considering the extent to which benzodiazepines are prescribed and the number of potential adverse effects of this drug class in the general population, indiscriminate widespread use should

387 citations

Journal ArticleDOI
TL;DR: The trends in the prescribing of subsidised anxiolytic, hypnotic and sedative medication use in the Australian population from 2002 to 2007 are examined.
Abstract: Purpose New sedative drugs have been marketed in Australia in the last few years. We examined the trends in the prescribing of subsidised anxiolytic, hypnotic and sedative (AHS) medication use in the Australian population from 2002 to 2007. Methods We analysed the Medicare Australia and Drug Utilisation Sub-Committee databases for AHS script data from 2002 to 2007 by source, class of prescriber, gender and 5-year age groups. Scripts were converted to defined daily dose per 1000 population per day (DDD/1000 population/day) using Australian Bureau of Statistics population data. Results Overall use of AHS increased from 23.76 to 24.11 DDD/1000 population/day between 2002 and 2007. Anxiolytic medication utilisation increased as hypnotic medication utilisation decreased. Diazepam was the most widely used anxiolytic followed by alprazolam and oxazepam. Temazepam was the most widely used hypnotic followed by nitrazepam. Medication use was concentrated in those aged ≥65 years with peak use in those aged 85–89 years. There was substantial use of anxiolytics in those aged 30–65 years. Age-adjusted utilization was higher in females than males. Conclusions The prescribing of AHS medications increased slightly over the last half decade. There is growing use of zolpidem on private prescription. The gender differences in use reflect the higher prevalence of anxiety and sleep disorders in women. The very high use of these drugs in elderly people warrants further exploration because of the concomitant increased risks of mortality and morbidity. Copyright © 2010 John Wiley & Sons, Ltd.

90 citations

Journal ArticleDOI
TL;DR: The use of benzodiazepines is associated with increased risk of dementia, but it remains unclear whether the risk relates to short or long half‐life Benzodiazepine and whether it extends to other psychotropic drugs.
Abstract: Introduction Benzodiazepine use has been associated with increased risk of dementia. However, it remains unclear whether the risk relates to short or long half-life benzodiazepines and whether it extends to other psychotropic drugs. Methods Prospective cohort study among 8240 individuals ≥65, interviewed on medication use. Incident dementia confirmed by an end point committee after a multistep procedure. Results During a mean of 8 years of follow-up, 830 incident dementia cases were observed. Users of benzodiazepines at baseline had a 10% increased risk of dementia (adjusted hazard ratio [HR], 1.10; 95% confidence interval, 0.90–1.34). However, long half-life (>20 hours) benzodiazepine users had a marked increased risk of dementia (HR = 1.62; 1.11–2.37) compared with short half-life users (HR = 1.05; 0.85–1.30). Users of psychotropics had an increased risk of dementia (HR = 1.47; 1.16–1.86). Discussion Results of this large, prospective study show increased risk of dementia for long half-life benzodiazepine and psychotropic use.

73 citations

Journal ArticleDOI
TL;DR: Available data, although limited, do not support the routine use of benzodiazepines for the treatment of BPSD, but these drugs may be used in certain circumstances where other psychotropic medications are unsafe for use in individuals with B PSD or when there are significant medication allergies or tolerability issues with certain classes of psychotropic medication.
Abstract: The objective of this review is to summarize the available data on the use of benzodiazepines for the treatment of behavioral and psychological symptoms of dementia (BPSD) from randomized controlled trials (RCTs). A systematic search of 5 major databases, PubMed, MEDLINE, PsychINFO, EMBASE, and Cochrane Collaboration, yielded a total of 5 RCTs. One study compared diazepam to thioridazine, 1 trial compared oxazepam to haloperidol and diphenhydramine, 1 trial compared alprazolam to lorazepam, 1 trial compared lorazepam to haloperidol, and 1 trial compared intramuscular (IM) lorazepam to IM olanzapine and placebo. The data indicates that in 4 of the 5 studies, there was no significant difference in efficacy between the active drugs to treat the symptoms of BPSD. One study indicated that thioridazine may have better efficacy than diazepam for treating symptoms of BPSD. In 1 study, the active drugs had greater efficacy in treating BPSD when compared to placebo. There was no significant difference between the active drugs in terms of tolerability. However, in 2 of the 5 studies, about a third of the patients were noted to have dropped out of the studies. Available data, although limited, do not support the routine use of benzodiazepines for the treatment of BPSD. But these drugs may be used in certain circumstances where other psychotropic medications are unsafe for use in individuals with BPSD or when there are significant medication allergies or tolerability issues with certain classes of psychotropic medications.

64 citations