Publications by authors named "Isabel Aguilar Palacio"

Background: European guidelines recommend the prescription of certain drugs after acute myocardial infarction (AMI). The existence of gender differences in pharmacological treatment after an AMI has been described. This study aims to describe and analyse, using real-world data (RWD), whether there are gender differences in the prescribing patterns and initiation of treatment in secondary prevention after a first AMI, and which are the factors that explain these differences.

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Background: This study aimed to identify profiles of patients with cardiovascular disease (CVD) risk factors, based on their sociodemographic and clinical characteristics, and to analyse how their complexity is related to their frequency of visits in Primary Care.

Methods: Observational longitudinal study conducted in the Spanish CArdiovascular Risk factors for HEalth Services research (CARhES) cohort. Individuals older than 15 with hypertension, type 2 diabetes mellitus (DM) and/or dyslipidaemia in 2017 were selected and followed until 2021.

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Article Synopsis
  • * Conducted in Aragón, Spain, the research analyzed data from March 2020 to March 2021, assessing patients aged 65 and older with confirmed COVID-19, while matching individuals by sex and age for accurate comparisons.
  • * Findings indicated significant differences in healthcare experiences between those in LTC facilities and those living independently, influencing diagnosis time, hospital admissions, lengths of stay, ICU risks, and mortality rates, highlighting the need for better collaboration between LTC staff and health services.
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Background: Despite significant progress in cardiovascular disease (CVD) management, it remains a public health priority and a global challenge. Within the disease process, health care after a cardiovascular event (secondary prevention) is essential to prevent recurrences. Nonetheless, evidence has suggested the existence of gender disparities in CVD management, leaving women in a vulnerable situation.

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Aims: This study aimed to analyse the initiation adherence phase to lipid-lowering therapy for primary prevention of cardiovascular disease in a Spanish population aged 70 years or older. The secondary objective was to identify the determinants of initiation and early discontinuation.

Methods: This was an observational study conducted in the CArdiovascular Risk factors for HEalth Service research (CARhES) cohort.

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Background: In health crisis, inequalities in access to and use of health care services become more evident. The objective of this study is to analyse the existence and evolution of gender inequalities in access to and use of healthcare services in the context of the COVID-19 health crisis.

Methods: Retrospective cohort study using data from all individuals with a confirmed COVID-19 infection from March 2020 to March 2022 in Aragón (Spain) (390,099 cases).

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Virtual consultation has been implemented as a tool to improve the cooperation and coordination between primary care and other specialties. However, in its use in dermatology, inequities have been described. The aim of this study was to identify individual and geographical factors affecting the likelihood of accessing this resource.

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Article Synopsis
  • This study investigates sex differences in cardiovascular risk factors and how they impact the likelihood of major adverse cardiovascular events (MACE).
  • It employs counterfactual analysis on a large population to determine the influence of diabetes, hypertension, hypercholesterolaemia, and socioeconomic status on these differences.
  • Findings indicate that men have higher MACE incidence, primarily due to higher diabetes prevalence and socioeconomic factors, suggesting targeted interventions are needed for men and improved salary equality to mitigate these risks.
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Objective: To know the opinion of Aragon primary care physicians about virtual consultation and its impact on the different healthcare quality domains.

Design: Cross-sectional study through a self-developed survey. Data collection was enabled from April 14th to May 31st, 2023.

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Article Synopsis
  • The study examines how machine learning algorithms can predict cardiovascular events (CVE) based on various cardiovascular risk factors (CVRF), showing advantages over traditional scoring systems and promoting personalized medicine.
  • Data from 3,746 male workers were analyzed using algorithms like XGBoost, Random Forest, and Naïve Bayes, focusing on variables such as age, physical status, and treatment adherence.
  • Age was identified as the most significant risk factor, with treatment adherence proving to be a key influence on CVE risk, particularly when Random Forest was utilized, achieving a high F1 score of 0.84.
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Background: Virtual consultation has been proposed as a promising tool to improve the coordination and quality of healthcare between primary and specialised care. However, despite its potential facilitators, the evidence on the usefulness of virtual consultation for improving healthcare quality domains is fragmented and unclear. This scoping review aims to assess the impact of virtual consultation on different healthcare quality domains.

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Background: The Ascertaining Barriers to Compliance (ABC) taxonomy was developed aiming at systematizing definitions and operationalizations of medication adherence. Its translation is crucial to improve the generalizability, application and comparison of study findings.

Objective: To provide a consensus translation of the ABC taxonomy from English to Spanish.

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Article Synopsis
  • Studying medication adherence helps identify patients who may need interventions to improve their medication-taking behaviors, particularly for those on statins during the COVID-19 pandemic.
  • The CARhES study examined statin users in Aragón, Spain, focusing on their adherence patterns from July 2019 to June 2021, using health data and statistical modeling to classify users into four groups: high adherence, poor adherence, occasional use, and gradual decline.
  • Results revealed that around 30% of new statin users maintained good adherence, with certain demographics, such as younger, non-pensioners with fewer health issues, being more likely to show poor or occasional adherence, especially during the pandemic.
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Old people residing in nursing homes have been a vulnerable group to the coronavirus disease 2019 (COVID-19) pandemic, with high rates of infection and death. Our objective was to describe the profile of institutionalized patients with a confirmed COVID-19 infection and the socioeconomic and morbidity factors associated with hospitalization and death. We conducted a retrospective cohort study including data from subjects aged 65 years or older residing in a nursing home with a confirmed COVID-19 infection from March 2020 to March 2021 (4,632 individuals) in Aragón (Spain).

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Background: We aimed to examine the available evidence about the impact of the crisis on the use of healthcare services in Europe.

Methods: We developed a systematic review of scientific literature for the period 2008-2017. The researchers searched three databases Medline/PubMed, Scopus and Web of Knowledge.

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In this study, we analyzed the effectiveness of statin therapy for the primary prevention of cardiovascular disease (CVD) in low- and medium-risk patients. Using observational data, we estimated effectiveness by emulating a hypothetical randomized clinical trial comparing statin initiators with statin non-initiators. Two approaches were used to adjust for potential confounding factors: matching and inverse probability weighting in marginal structural models.

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Background: The relationship between self-rated health and gender differs across countries and generations. The aim of this study is to analyze the effect of socioeconomic conditions on self-rated health from a generational perspective, its differential effect on gender, and its influence on the gender gap in order to explore health diversity using a multidisciplinary approach and considering policy implications in Eastern European countries.

Methods: We used data drawn from the European Health Interview Survey for eight Eastern European countries and EUROSTAT from 2006 through to 2009.

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Article Synopsis
  • Unhealthy lifestyle behaviors are identified as key contributors to childhood obesity, prompting the need to understand factors that influence children’s lifestyles.
  • A study involving 1,405 children aged 8 to 10 years analyzed how maternal educational level affects child physical activity, screen time, and dietary habits between 2012 and 2014.
  • Results showed that children of mothers with lower educational levels had higher odds of unhealthy dietary choices and excessive screen time, indicating that maternal education is a significant predictor of children's lifestyle behaviors.
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Improved technology facilitates the acceptance of telemedicine. The aim was to analyze the effectiveness of telephone follow-up to detect severe SARS-CoV-2 cases that progressed to pneumonia. A prospective cohort study with 2-week telephone follow-up was carried out March 1 to May 4, 2020, in a primary healthcare center in Barcelona.

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Individuals with type 2 diabetes mellitus are at greater risk of developing cancer and of dying from it. Both diseases are age-related, contributing to the impact of population aging on the long-term sustainability of health care systems in European Union countries. The purpose of this narrative review was to describe, from epidemiological, pathophysiological and preventive perspectives, the links between type 2 diabetes mellitus and the most prevalent cancers in these patients.

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In Spain, regional health systems (universal access) depend on each Autonomous Communities (ACs). The management of the 2008 economic crisis has been different in the ACs, which may have led to an increase in inequities in the use of health services. The objective of this study was to analyse the impact of individual and regional characteristics on public hospitalisation inequities in Spain for the period 2003-2017.

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It is essential to understand the impact of social inequalities on the risk of COVID-19 infection in order to mitigate the social consequences of the pandemic. With this aim, the objective of our study was to analyze the effect of socioeconomic inequalities, both at the individual and area of residence levels, on the probability of COVID-19 confirmed infection, and its variations across three pandemic waves. We conducted a retrospective cohort study and included data from all individuals tested for COVID-19 during the three waves of the pandemic, from March to December 2020 (357,989 individuals) in Aragón (Spain).

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The identification of the cardiovascular risk factor (CVRF) profile of individual patients is key to the prevention of cardiovascular disease (CVD), and the development of personalized preventive approaches. Using data from annual medical examinations in a cohort of workers, the aim of the study was to characterize the evolution of CVRFs and the CVD risk score (SCORE) over three time points between 2009 and 2017. For descriptive analyses, mean, standard deviation, and quartile values were used for quantitative variables, and percentages for categorical ones.

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Medication adherence is a priority for health systems worldwide and is widely recognised as a key component of quality of care for disease management. Adherence-related indicators were rarely explicitly included in national health policy agendas. One barrier is the lack of standardised adherence terminology and of routine measures of adherence in clinical practice.

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