Initial opioid prescription characteristics and risk of opioid misuse, poisoning and dependence: retrospective cohort study.

Objective: To identify individual and initial prescription-related factors associated with an increased risk for opioid-related misuse, poisoning and dependence (MPD) in patients with non-cancer pain.

Methods: Cohort study linking several databases covering 5 million inhabitants of the region of Valencia, Spain, including all adults initiating prescription opioids in the period 2012-2018. To ascertain the association between the characteristics of the initial prescription choice and the risk of opioid MPD, we used shared frailty Cox regression models.

[Treatment of disease-related malnutrition: status of regulation in the Spanish National Health System. An exploratory study through focus groups].

Background: the legislation currently regulating the inclusion of Food for Special Medical Purposes (FSMP) among the benefits of the National Health System (SNS) was made approximately 15 years ago. The evolution of the technical characteristics of the FSMP justifies an analysis of the current regulation and the consideration of possible regulatory modifications that would allow the incorporation of the progress achieved. Material and methods: four successive focus groups of experts, mostly doctors (91%), hospital specialists in disciplines related to nutrition (73%), from 8 different hospitals and 6 autonomous communities.

[Prevalence and associated factors in self-monitoring of blood glucose in noninsulin-treated type 2 diabetes patients in the Valencia Community, Spain].

Background: Self-monitoring of blood glucose (SMBG) in noninsulin-treated type 2 diabetes patients (T2DM) is a controversial topic. We aimed to describe the SMBG prevalence in noninsulin-treated (NIT) T2DM patients in the Valencia Community (VC) and to analyze factors associated with their use.

Method: Cross-sectional study with 573 NIT-T2DM patients from 83 primary care surgeries.

Use of monoclonal antibodies for metastatic colorectal cancer in the Andalusian public health system.

Background: The place of monoclonal antibodies in metastatic colorectal cancer has not been clearly defined.

Objective: To determine the treatment pattern of monoclonal antibodies in colorectal cancer patients in the Andalusian Public Healthcare System.

Method: Data were collected from all patients treated with these drugs from July 2009 to December 2010 from pharmacy programs and medical records.

Shared component modelling as an alternative to assess geographical variations in medical practice: gender inequalities in hospital admissions for chronic diseases.

Background: Small area analysis is the most prevalent methodological approach in the study of unwarranted and systematic variation in medical practice at geographical level. Several of its limitations drive researchers to use disease mapping methods -deemed as a valuable alternative. This work aims at exploring these techniques using - as a case of study- the gender differences in rates of hospitalization in elderly patients with chronic diseases.

Income level and regional policies, underlying factors associated with unwarranted variations in conservative breast cancer surgery in Spain.

Background: Geographical variations in medical practice are expected to be small when the evidence about the effectiveness and safety of a particular technology is abundant. This would be the case of the prescription of conservative surgery in breast cancer patients. In these cases, when variation is larger than expected by need, socioeconomic factors have been argued as an explanation.

[Risk factors for 4-year mortality in older adults. Toledo Study].

Introduction: multiple factors contribute to mortality in older adults. Measures of physical and cognitive function are strong predictors of mortality, but the extent to which function, health-related quality of life and other factors contribute independently to mortality risk is not known.

Material And Methods: we performed a prospective study of a representative sample of people aged 65 years and older (n=3,214) followed-up for 4 years.

Patterns of electroconvulsive therapy use in Spain.

Objective: To describe the utilization, geographical variations and adaptation of ECT in the Spanish context.

Method: A cross-sectional study, involving a questionnaire delivered to all hospitals with a Psychiatry Unit (PU) in Spain included in the National Hospitals Catalogue (N = 233). A descriptive analysis was made of the answers to the different questions, using an adequate denominator in each case: all PUs (n = 233), those units that prescribe and apply ECT (n = 174), or only those that apply the technology (n = 108).