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Rivero-Santana A, Torrente-Jiménez RS, Perestelo-Pérez L, Torres-Castaño A, Ramos-García V, Bilbao A, Escobar A, Serrano-Aguilar P, Feijoo-Cid M. Effectiveness of a decision aid for patients with knee osteoarthritis: a randomized controlled trial. Osteoarthritis Cartilage 2021; 29:1265-1274. [PMID: 34174455 DOI: 10.1016/j.joca.2021.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 06/03/2021] [Accepted: 06/13/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the effectiveness of a Patient Decision Aid (PtDA) for knee osteoarthritis. METHOD Randomized controlled trial, in which 193 patients were allocated to the PtDA or usual care. Outcome measures were the Decisional Conflict Scale (DCS), knowledge of osteoarthritis and arthroplasty, satisfaction with the decision-making process (SDMP) and treatment preference, assessed immediately after the intervention. At 6 months, the same measures were applied in non-operated patients, whereas those who underwent arthroplasty completed the SDMP and the Decisional Regret Scale (DRS). RESULTS The PtDA produced a significant immediate improvement of decisional conflict (MD = -11.65, 95%CI: -14.93, -8.37), objective knowledge (MD = 10.37, 99%IC: 3.15, 17.70) and satisfaction (MD = 6.77, 99%CI: 1.19, 12.34), and a different distribution of preferences (χ2 = 8.74, p = 0.033). Patients with less than secondary education obtained a stronger effect on decisional conflict (p = 0.015 for the interaction) but weaker for knowledge (p = 0.051). At 6 months, there were no significant differences in any variable, including the rate of total knee replacement. Operated patients showed a low level of regret, which was not affected by the intervention. CONCLUSION The PtDA is effective immediately after its application, but it shows no effects in the medium-term. Future research should investigate which subgroups of patients could benefit more from this intervention, as well as the longitudinal evolution of decision-related psychological variables.
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Affiliation(s)
- A Rivero-Santana
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Canary Islands, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain.
| | - R S Torrente-Jiménez
- Department of Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - L Perestelo-Pérez
- Health Services Research on Chronic Patients Network (REDISSEC), Spain; Evaluation Unit of the Canary Islands Health Service (SESCS), Canary Islands, Spain.
| | - A Torres-Castaño
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Canary Islands, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain.
| | - V Ramos-García
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Canary Islands, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain.
| | - A Bilbao
- Health Services Research on Chronic Patients Network (REDISSEC), Spain; Osakidetza/Basque Health Service, Research Unit, Basurto University Hospital, Bilbao, Bizkaia, Spain.
| | - A Escobar
- Health Services Research on Chronic Patients Network (REDISSEC), Spain; Osakidetza/Basque Health Service, Research Unit, Basurto University Hospital, Bilbao, Bizkaia, Spain
| | - P Serrano-Aguilar
- Health Services Research on Chronic Patients Network (REDISSEC), Spain; Evaluation Unit of the Canary Islands Health Service (SESCS), Canary Islands, Spain.
| | - M Feijoo-Cid
- Department of Nursing, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Grup de Recerca Multidisciplinar en Salut i Societat (GREMSAS), (2017SGR 917), Barcelona, Spain.
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2
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Valcárcel-Nazco C, Alonso-Modino D, Montón-Álvarez F, Sabatel-Hernández R, Pastor-Santoveña M, Mesa-Blanco P, López-Fernández J, Serrano-Aguilar P. Variability in the use of neuroimaging techniques for diagnosis and follow-up of stroke patients. Neurología (English Edition) 2019. [DOI: 10.1016/j.nrleng.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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3
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Sánchez-López C, Perestelo-Pérez L, Escobar A, López-Bastida J, Serrano-Aguilar P. Health-related quality of life in patients with spinocerebellar ataxia. Neurología (English Edition) 2017. [DOI: 10.1016/j.nrleng.2015.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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4
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Brito-García N, Del Pino-Sedeño T, Trujillo-Martín MM, Coco RM, Rodríguez de la Rúa E, Del Cura-González I, Serrano-Aguilar P. Effectiveness and safety of nutritional supplements in the treatment of hereditary retinal dystrophies: a systematic review. Eye (Lond) 2016; 31:273-285. [PMID: 27935602 DOI: 10.1038/eye.2016.286] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 11/13/2016] [Indexed: 12/22/2022] Open
Abstract
The hereditary retinal dystrophies (HRDs) are a group of genetically determined disorders that result in loss of the visual function. There is a lack of standard pharmacological treatments or widely accepted nutritional recommendations. The objective of this review is to summarise the scientific evidence on the effectiveness and safety of nutritional supplements for the treatment of HRDs. We conducted a scientific literature search on Medline and PreMedline, EMBASE, SCI-EXPANDED, SSCI, and The Cochrane Library up to August 2014. Experimental, quasi-experimental and controlled observational studies were selected. Eight studies were ultimately included, seven on retinitis pigmentosa (RP) and one on Best disease. Vitamin A, vitamin E, docosahexaenoic acid (DHA), lutein and β-carotene were assessed. A 15 000 IU daily dose of vitamin A was reported to have shown a small protective effect on the progression of RP, as was the use of the carotenoids lutein and β-carotene. Different DHA doses has no effect on RP or Best disease. No supplement showed severe adverse effects in the selected studies although strong evidence of toxicity exists for high doses of vitamin A and β-carotene in certain populations. The selected studies concluded that there may be a small beneficial effect of vitamin A, lutein and β-carotene on the progression of RP. The limited evidence available indicates some well-designed additional studies on combined supplements strategies may achieve more robust conclusions. Moreover, the scarcity of evidence available on the treatment of HRD other than RP with nutritional supplements supports the need for further research efforts.
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Affiliation(s)
- N Brito-García
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Islas Canarias, Spain
| | - T Del Pino-Sedeño
- Fundación Canaria para el Avance de la Biomedicina y la Biotecnología (BIOAVANCE), Universidad de La Laguna, Islas Canarias, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - M M Trujillo-Martín
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Islas Canarias, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.,Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Universidad de La Laguna, Islas Canarias, Spain
| | - R M Coco
- Institute of Applied Ophthalmo-Biology (IOBA), University of Valladolid, Valladolid, Spain.,RTIC patología ocular del envejecimiento, calidad visual y calidad de vida (OFTARED), Instituto de Salud Carlos III, Madrid, Spain
| | - E Rodríguez de la Rúa
- RTIC patología ocular del envejecimiento, calidad visual y calidad de vida (OFTARED), Instituto de Salud Carlos III, Madrid, Spain.,Unidad de Gestión Clínica de Oftalmología. Hospitales Universitarios Virgen Macarena y Virgen del Rocío, Sevilla, Spain
| | - I Del Cura-González
- Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Universidad de La Laguna, Islas Canarias, Spain.,Unidad de Apoyo a la Investigación. Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - P Serrano-Aguilar
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.,Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Universidad de La Laguna, Islas Canarias, Spain.,Servicio de Evaluación de la Dirección del Servicio Canario de la Salud (SESCS), Tenerife, Spain
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5
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García-Pérez L, Abreu-González R, Pérez-Ramos J, García-Pérez S, Serrano-Aguilar P. Review of economic studies and budget impact analysis of ocriplasmin as a treatment of vitreomacular traction. Arch Soc Esp Oftalmol 2016; 91:257-264. [PMID: 26920947 DOI: 10.1016/j.oftal.2016.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 01/12/2016] [Accepted: 01/15/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To review the evidence on the cost-effectiveness of ocriplasmin as a treatment for vitreomacular traction (VMT), and to estimate the impact on the Spanish National Health System (NHS). MATERIAL AND METHODS 1) Systematic review. The following databases were searched in January 2015: MEDLINE, PREMEDLINE, EMBASE, CRD, the Cochrane Library, and key websites. Selection criteria were: full economic evaluations that compared ocriplasmin with usual care ('watch and wait' and/or vitrectomy) in patients with VMT. The outcomes to extract were costs of the alternatives and the incremental cost-effectiveness ratio. Studies of budget impact analysis were also included. The methodological quality was assessed, and a narrative synthesis of the included studies was carried out. 2) Estimation of budget impact. The impact on the budget as a result of the introduction of ocriplasmin in the NHS was estimated, including data from different sources. RESULTS Six studies were identified, none of them performed in Spain. The two best studies concluded that ocriplasmin is cost-effective in their respective countries (Canada and United Kingdom), but only in patients with certain conditions (without epiretinal membrane, for example). The results of the budget impact analysis are different between countries. The analysis for Spain showed that the introduction of ocriplasmin would mean a saving over 1 million Euros for the NHS in 5 years. CONCLUSIONS The cost-effectiveness of ocriplasmin has not been demonstrated in Spain. However, good studies performed in other countries found that ocriplasmin is cost-effective in selected patients. Given the current prices in Spain, ocriplasmin could involve a saving for the Spanish NHS.
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Affiliation(s)
- L García-Pérez
- Servicio de Evaluación, Servicio Canario de la Salud (SESCS), Tenerife, España; Fundación Canaria de Investigación Sanitaria (FUNCANIS), Tenerife, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, España; Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Universidad de La Laguna, La Laguna, España.
| | - R Abreu-González
- Servicio de Oftalmología, Hospital Universitario Nuestra Señora de La Candelaria, Tenerife, España
| | - J Pérez-Ramos
- Servicio de Evaluación, Servicio Canario de la Salud (SESCS), Tenerife, España; Fundación Canaria de Investigación Sanitaria (FUNCANIS), Tenerife, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, España; Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Universidad de La Laguna, La Laguna, España
| | - S García-Pérez
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, España; Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España
| | - P Serrano-Aguilar
- Servicio de Evaluación, Servicio Canario de la Salud (SESCS), Tenerife, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, España; Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Universidad de La Laguna, La Laguna, España.
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Serrano-Aguilar P, Trujillo-Martin MM, del Pino-Sedeño T, Pérez de la Rosa A, de Pascual y Medina AM, Perestelo-Pérez L, Toledo-Chávarri A, Posada de la Paz M, Sarría Santamera A. Patient participation in the development of a clinical guideline for inherited retinal dystrophies. Expert Opin Orphan Drugs 2016. [DOI: 10.1080/21678707.2016.1182907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- P. Serrano-Aguilar
- Evaluation Service of the Canary Islands Health Service (SESCS), Santa Cruz de Tenerife, Spain
- Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain
- Centre for Biomedical Research of the Canary Islands (CIBICAN), University of La Laguna, Canary Islands, Spain
| | - M. M. Trujillo-Martin
- Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain
- Centre for Biomedical Research of the Canary Islands (CIBICAN), University of La Laguna, Canary Islands, Spain
- Canary Foundation for Health Care Research (FUNCANIS), Canary Islands, Spain
| | - T. del Pino-Sedeño
- Canarian Foundation for Advances in Biomedicine and Biotechnology (BIOAVANCE), Canary Islands, Spain
| | - A. Pérez de la Rosa
- Canary Foundation for Health Care Research (FUNCANIS), Canary Islands, Spain
| | | | - L. Perestelo-Pérez
- Evaluation Service of the Canary Islands Health Service (SESCS), Santa Cruz de Tenerife, Spain
- Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain
- Centre for Biomedical Research of the Canary Islands (CIBICAN), University of La Laguna, Canary Islands, Spain
| | - A. Toledo-Chávarri
- Canary Foundation for Health Care Research (FUNCANIS), Canary Islands, Spain
| | - M. Posada de la Paz
- The Institute of Rare Diseases Research, The Institute of Health Carlos III. Ministry of Economy and Competitiveness, Madrid, Spain
| | - A. Sarría Santamera
- Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain
- Health Technology Assessment Agency, The Institute of Health Carlos III. Ministry of Economy and Competitiveness, Madrid, Spain
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7
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Kuhlmann A, Schmidt T, Treskova M, López-Bastida J, Linertová R, Oliva-Moreno J, Serrano-Aguilar P, Posada-de-la-Paz M, Kanavos P, Taruscio D, Schieppati A, Iskrov G, Péntek M, Delgado C, von der Schulenburg JM, Persson U, Chevreul K, Fattore G. Social/economic costs and health-related quality of life in patients with juvenile idiopathic arthritis in Europe. Eur J Health Econ 2016; 17 Suppl 1:79-87. [PMID: 27086322 DOI: 10.1007/s10198-016-0786-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 01/13/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this study was to determine the economic burden from a societal perspective and the health-related quality of life (HRQOL) of patients with juvenile idiopathic arthritis (JIA) in Europe. METHODS We conducted a cross-sectional study of patients with JIA from Germany, Italy, Spain, France, the United Kingdom, Bulgaria, and Sweden. Data on demographic characteristics, healthcare resource utilization, informal care, labor productivity losses, and HRQOL were collected from the questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D-5L) questionnaire. RESULTS A total of 162 patients (67 Germany, 34 Sweden, 33 Italy, 23 United Kingdom, 4 France, and 1 Bulgaria) completed the questionnaire. Excluding Bulgarian results, due to small sample size, country-specific annual health care costs ranged from €18,913 to €36,396 (reference year: 2012). Estimated direct healthcare costs ranged from €11,068 to €22,138; direct non-healthcare costs ranged from €7837 to €14,155 and labor productivity losses ranged from €0 to €8715. Costs are also shown to differ between children and adults. The mean EQ-5D index score for JIA patients was estimated at between 0.44 and 0.88, and the mean EQ-5D visual analogue scale score was estimated at between 62 and 79. CONCLUSIONS JIA patients incur considerable societal costs and experience substantial deterioration in HRQOL in some countries. Compared with previous studies, our results show a remarkable increase in annual healthcare costs for JIA patients. Reasons for the increase are the inclusion of non-professional caregiver costs, a wider use of biologics, and longer hospital stays.
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Affiliation(s)
- A Kuhlmann
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany.
| | - T Schmidt
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - M Treskova
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - J López-Bastida
- Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - R Linertová
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Las Palmas de Gran Canaria, Spain
| | - J Oliva-Moreno
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Universidad de Castilla-La Mancha, Toledo, Spain
| | - P Serrano-Aguilar
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Evaluation and Planning Service at Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - M Posada-de-la-Paz
- Institute of Rare Diseases Research, ISCIII, SpainRDR & CIBERER, Madrid, Spain
| | - P Kanavos
- Department of Social Policy and LSE Health, London School of Economics and Political Science, London, United Kingdom
| | - D Taruscio
- National Center for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - A Schieppati
- Centro di Ricerche Cliniche per Malattie Rare Aldo e Cele Daccò, Istituto di Ricerche Farmacologiche Mario Negri, Ranica (Bergamo), Italy
| | - G Iskrov
- Institute of Rare Diseases, Plovdiv, Bulgaria
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - C Delgado
- Federación Española de Enfermedades Raras (FEDER), Madrid, Spain
| | - J M von der Schulenburg
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - U Persson
- Swedish Institute for Health Economics, Lund, Sweden
| | - K Chevreul
- URC Eco Ile de France, AP-HP, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France
- INSERM, ECEVE, U1123, Paris, France
| | - G Fattore
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy
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Sánchez-López CR, Perestelo-Pérez L, Escobar A, López-Bastida J, Serrano-Aguilar P. Health-related quality of life in patients with spinocerebellar ataxia. Neurologia 2015; 32:143-151. [PMID: 26541695 DOI: 10.1016/j.nrl.2015.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/21/2015] [Accepted: 09/02/2015] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION The progressive deterioration of patients with spinocerebellar ataxia (SCA) has a major impact on their health-related quality of life (HRQOL). This study evaluates HRQOL in a sample of patients diagnosed with SCA and aims to estimate the predictive ability of a set of sociodemographic variables for the different dimensions of the General Health Questionnaire. METHODS A total of 80 patients diagnosed with SCA were assessed using a sociodemographic questionnaire and the SF-36 General Health Questionnaire. The sociodemographic variables studied were sex, age, presence of a carer, employment status, and time elapsed from diagnosis of the disease. RESULTS The 8 subscales of the SF-36 show positive and significant correlations to one another. Mean scores obtained on each SF-36 subscale differ between women and men, although this difference is significant only on the general health subscale, with men scoring higher than women. We found significant age differences on the vitality and social function subscales, with higher scores among younger patients (< 34 years). The variable 'presence of a carer' accounts for most of the total variance of the questionnaire. CONCLUSIONS The SF-36 is a valid and useful instrument for evaluating HRQOL in patients diagnosed with SCA. Presence of a carer seems to be a determinant of self-perceived quality of life in these patients.
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Affiliation(s)
- C R Sánchez-López
- Facultad de Psicología, Universidad de La Laguna, Tenerife, Santa Cruz de Tenerife, España
| | - L Perestelo-Pérez
- Servicio de Evaluación del Servicio Canario de la Salud, Tenerife, Santa Cruz de Tenerife, España; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Tenerife, Santa Cruz de Tenerife, España; Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Tenerife, Santa Cruz de Tenerife, España.
| | - A Escobar
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Tenerife, Santa Cruz de Tenerife, España; Unidad de Investigación, Hospital de Basurto, Bilbao, Vizcaya, España
| | - J López-Bastida
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Tenerife, Santa Cruz de Tenerife, España; Universidad de Castilla La Mancha, Talavera de la Reina, Toledo, España
| | - P Serrano-Aguilar
- Servicio de Evaluación del Servicio Canario de la Salud, Tenerife, Santa Cruz de Tenerife, España; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Tenerife, Santa Cruz de Tenerife, España; Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Tenerife, Santa Cruz de Tenerife, España
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9
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Abt Sacks A, Perestelo-Perez L, Rodriguez-Martin B, Cuellar-Pompa L, Algara López M, González Hernández N, Serrano-Aguilar P. Breast cancer patients’ narrative experiences about communication during the oncology care process: a qualitative study. Eur J Cancer Care (Engl) 2015; 25:719-33. [DOI: 10.1111/ecc.12384] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2015] [Indexed: 10/23/2022]
Affiliation(s)
- A. Abt Sacks
- Canary Islands Foundation for Health Research (FUNCANIS); Tenerife Spain
- National Institute of Health Carlos III; Health Services Research on Chronic Patients Network (REDISSEC); Madrid Spain
| | - L. Perestelo-Perez
- Evaluation Unit of the Canary Islands Health Service (SESCS); Tenerife Spain
- Health Services Research on Chronic Patients Network (REDISSEC); Madrid Spain
| | - B. Rodriguez-Martin
- Faculty of Occupational Therapy, Speech Therapy and Nursing; University of Castilla-La Mancha; Talavera de la Reina (Toledo) Spain
| | - L. Cuellar-Pompa
- Canary Islands Foundation for Health Research (FUNCANIS); Tenerife Spain
| | - M. Algara López
- Radiation Oncology; L'Esperança Hospital; Municipal Healthcare Institute (IMAS); Barcelona Spain
| | - N. González Hernández
- Research Unit / Health Services Research on Chronic Patients Network (REDISSEC); Galdakao-Usansolo Hospital; Barrio Labeaga, s/n, 48960 Usansolo Bilbao Spain
| | - P. Serrano-Aguilar
- National Institute of Health Carlos III; Health Services Research on Chronic Patients Network (REDISSEC); Madrid Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS); Tenerife Spain
- Centre for Biomedical Research of the Canary Islands (CIBICAN); Tenerife Spain
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10
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Gómez-de la Cámara A, Pinilla-Domínguez P, Vázquez-Fernández del Pozo S, García-Pérez L, Rubio-Herrera M, Gómez-Gerique J, Gutiérrez-Fuentes J, Rivero-Cuadrado A, Serrano-Aguilar P. Costs resulting from premature mortality due to cardiovascular causes: A 20-year follow-up of the DRECE study. Rev Clin Esp 2014. [DOI: 10.1016/j.rceng.2014.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Sarría-Santamera A, Prado-Galbarro J, Ramallo-Farina Y, Quintana-Díaz M, Martínez-Virto A, Serrano-Aguilar P. [Use of emergency departments in rural and urban areas in Spain]. Semergen 2014; 41:63-9. [PMID: 24726281 DOI: 10.1016/j.semerg.2014.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 01/16/2014] [Accepted: 02/13/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Describe the use of emergency departments (ED), and analyse the differences in use between residents in rural and urban areas. MATERIAL AND METHODS Using data from the National Health Survey of 2006 and 2011, the profiles of patients with ED visits by population size of place of residence were obtained. The variables associated with making one visit to the ED were also evaluated, in order to determine the effect of the population size of place of residence. RESULTS A higher use of ED is observed in persons with a higher frequency of use of Primary Care and hospital admissions, and increases with worse self-perceived health and functional status, with more chronic diseases, in people from lower social classes, and younger ages. Adjusting for the other variables, residents in larger cities have a higher use of ED than residents in rural areas, who show a higher use of public and non-hospital based ED, than residents in urban areas. DISCUSSION There is a higher use of ED by inhabitants of urban areas that cannot be justified by a worst health status of that population. This tends to indicate that the use of ED is not under-used in rural areas, but overused in urban areas.
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Affiliation(s)
- A Sarría-Santamera
- Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España; Unidad Docente de Medicina Preventiva y Salud Pública, Universidad de Alcalá, Alcalá de Henares, Madrid, España; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC).
| | - J Prado-Galbarro
- Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España
| | - Y Ramallo-Farina
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC); Servicio de Evaluación y Planificación. Servicio Canario de Salud, Santa Cruz de Tenerife, España
| | - M Quintana-Díaz
- Servicio de Urgencias, Hospital La Paz, Madrid, España; Departamento de Medicina, Universidad Autónoma de Madrid, Madrid, España
| | | | - P Serrano-Aguilar
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC); Servicio de Evaluación y Planificación. Servicio Canario de Salud, Santa Cruz de Tenerife, España
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12
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Sánchez-López C, Perestelo-Pérez L, Ramos-Pérez C, López-Bastida J, Serrano-Aguilar P. Calidad de vida relacionada con la salud en pacientes con esclerosis lateral amiotrófica. Neurologia 2014; 29:27-35. [DOI: 10.1016/j.nrl.2013.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 02/07/2013] [Accepted: 02/08/2013] [Indexed: 12/12/2022] Open
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Taruscio D, Morciano C, Laricchiuta P, Mincarone P, Palazzo F, Leo CG, Sabina S, Guarino R, Auld J, Sejersen T, Gavhed D, Ritchie K, Hilton-Boon M, Manson J, Kanavos PG, Tordrup D, Tzouma V, Le Cam Y, Senecat J, Filippini G, Minozzi S, Del Giovane C, Schünemann H, Meerpohl JJ, Prediger B, Schell L, Stefanov R, Iskrov G, Miteva-Katrandzhieva T, Serrano-Aguilar P, Perestelo-Perez L, Trujillo-Martín MM, Pérez-Ramos J, Rivero-Santana A, Brand A, van Kranen H, Bushby K, Atalaia A, Ramet J, Siderius L, Posada M, Abaitua-Borda I, Ferreira V, Hens-Pérez M, Manzanares FJ. RARE-Bestpractices: a platform for sharing best practices for the management of rare diseases. Orphanet J Rare Dis 2014. [PMCID: PMC4249596 DOI: 10.1186/1750-1172-9-s1-o14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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14
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Serrano-Aguilar P, Abreu R, Antón-Canalís L, Guerra-Artal C, Ramallo-Fariña Y, Gómez-Ulla F, Nadal J. Development and validation of a computer-aided diagnostic tool to screen for age-related macular degeneration by optical coherence tomography. Br J Ophthalmol 2011; 96:503-7. [DOI: 10.1136/bjophthalmol-2011-300660] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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15
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Serrano-Aguilar P, Trujillo-Martín MM, Ramos-Goñi JM, Mahtani-Chugani V, Perestelo-Pérez L, Posada-de la Paz M. Patient involvement in health research: a contribution to a systematic review on the effectiveness of treatments for degenerative ataxias. Soc Sci Med 2009; 69:920-5. [PMID: 19647357 DOI: 10.1016/j.socscimed.2009.07.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Indexed: 11/21/2022]
Abstract
This study aims to incorporate patients' perspective in the design of a systematic review of scientific literature on the effectiveness of degenerative ataxias (DA) treatments. 53 patients with DA from different regions of Spain were consulted using the Delphi method, with three rounds via e-mail. In the first round, obtained information was on treatments used and relevant self-perceived health problems related to DA. The following two rounds were used to prioritize and achieve a consensus on the answers. The participation rate was 100% for all rounds. The most relevant self-perceived health problems were limitations in activities of daily living (ADL), visual and auditory problems and diminished self-esteem. The bibliographic search for the systematic review was enriched by these patient contributions. No study offered information on treatment effectiveness for the following problems prioritized by patients: ADL, social relationships, disease acceptance and quality of life. Thus some of the self-perceived DA-related health problems identified by the patients have never been investigated and should be considered to improve future research projects which should be adapted to meet patients' needs. Effective participation of patients can extend the value of systematic reviews to ensure they respond to both clinicians' information needs and patients' expectations.
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Affiliation(s)
- P Serrano-Aguilar
- Planning & Evaluation Unit, Canary Islands Health Authority, Santa Cruz de Tenerife, Canary Islands, CIBERESP, Spain.
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García-Pérez L, Linertová R, Martín-Olivera R, Serrano-Aguilar P, Benítez-Rosario MA. A systematic review of specialised palliative care for terminal patients: which model is better? Palliat Med 2009; 23:17-22. [PMID: 19039054 DOI: 10.1177/0269216308099957] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is evidence of improved effectiveness of specialised palliative care for terminally ill patients in comparison to conventional care. However, there is uncertainty about which model is better. The objective of this systematic review was to identify studies that compare specialised palliative care models between them assessing their effectiveness or cost-effectiveness. We searched studies published between 2003 and 2006 in several electronic databases and updated the search in MEDLINE up to 2008. Papers published before 2003 were identified by means of previous systematic reviews and manual search. Studies with broad designs comparing two or more specialised palliative care programmes in adults with terminal illness were selected. Six systematic reviews, three studies on effectiveness and one cost study were included. All systematic reviews drew the conclusion that specialised palliative care is more effective than conventional care. The methodological limitations of the original studies and the heterogeneity of programmes did not allow to draw conclusions about whether a specific model of specialised palliative care is more or less effective or cost-effective than other.
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Affiliation(s)
- L García-Pérez
- Canary Islands Foundation for Health and Research, FUNCIS, CIBER Epidemiología y Salud Pública, Canary Islands.
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Abstract
AIMS To assess the effectiveness of a non-mydriatic digital camera (45 degrees -30 degrees photographs) compared with the reference method for screening diabetic retinopathy. METHODS Type 1 and 2 diabetic patients (n = 773; 1546 eyes) underwent screening for diabetic retinopathy in a prospective observational study. Hospital-based non-mydriatic digital retinal imaging by a consultant specialist in retinal diseases was compared with slit-lamp biomicroscopy and indirect ophthalmoscopy through dilated pupils, as a gold standard, previously performed in a community health centre by another consultant specialist in retinal diseases. The main outcome measures were sensitivity and specificity of screening methods and prevalence of diabetic retinopathy. RESULTS The prevalence of any form of diabetic retinopathy was 42.4% (n = 328); the prevalence of sight-threatening including macular oedema and proliferative retinopathy was 9.6% (n = 74). Sensitivity of detection of any diabetic retinopathy by digital imaging was 92% (95% confidence interval 90, 94). Specificity of detection of any diabetic retinopathy was 96% (95, 98). The predictive value of the negative tests was 94% and of a positive test 95%. For sight-threatening retinopathy digital imaging had a sensitivity of 100%. CONCLUSIONS A high sensitivity and specificity are essential for an effective screening programme. These results confirm digital retinal imaging with a non-mydriatic camera as an effective option in community-based screening programmes for diabetic retinopathy.
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Affiliation(s)
- J Lopez-Bastida
- Evaluation and Planning Unit, Canary Islands Health Service, Canary Islands, Spain.
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18
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Serrano-Aguilar P, López-Bastida J, Duque González B, Pedrosa Guerra A, Pino Capote JA, González Miranda F, Rodríguez Pérez A, Erdocia Eguía J, Vila Roig B. [Routine preoperative screening of asymptomatic patients: beliefs and attitudes of anesthesiologists in the Canary Islands, Spain]. Rev Esp Anestesiol Reanim 2005; 52:193-9. [PMID: 15901024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVES To identify factors that explain anesthesiologists' inappropriate use of preoperative tests in asymptomatic patients scheduled for elective surgery. MATERIAL AND METHODS A validated questionnaire was sent to anesthesiologists at university hospitals in the Canary Islands. Information about preoperative testing patterns and reasons for selecting tests was gathered. RESULTS The questionnaire was self-administered by 66 anesthesiologists (68% of the total). Scientific knowledge was not the reason why most respondents ordered preoperative tests in asymptomatic individuals. That was the opinion of 95% of anesthesiologists for chest x-rays, 82% for electrocardiograms, and 68% for laboratory tests. Clinical history and a medical examination gave sufficient information for selecting patients in need of specific tests in the opinion of 77.19% of the respondents. Half did not agree that routine electrocardiograms and laboratory tests should be abandoned. The justification for these tests was coverage of medical malpractice liability for 68.42%. Most considered that the need to order preoperative tests in asymptomatic patients increased after age 40. CONCLUSIONS Although anesthesiologists admit that their request for preoperative tests in asymptomatic individuals is not supported by scientific evidence, the quest for safety and legal protection from the consequences of potential adverse consequences of providing anesthesia affects the selection of preoperative tests for asymptomatic patients.
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Affiliation(s)
- P Serrano-Aguilar
- Servicio de Evaluación y Planificación, Servicio Canario de Salud, Santa Cruz de Tenerife.
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Abstract
OBJECTIVE To evaluate the economic impact in terms of direct and indirect costs of the mental health in Canary Islands (Spain) in 2002. DESIGN The cost-of-illness method was used. Direct and indirect costs were estimated using prevalence cost, i.e., the costs produced in 2002. The human capital theory approach has been used. SETTING Canary Islands, Spain, including primary health care and inpatient care. PARTICIPANTS Mental health patients. MAIN MEASUREMENTS Direct health costs (inpatients, ambulatory care, primary health care, and drugs). Indirect costs (premature death, short-term illness, and permanent disability). RESULTS The total costs of mental health were 189.59 million euros. The direct health costs were 81.67 million euros, constituting 43% of the total costs and 5.2% of the total public health care budget in this region. The indirect costs of mental health were 107.92 million euros, representing 57% of the total costs. CONCLUSIONS Although this study adopts a conservative approach, the high socio-economic cost of the mental health helps us to define better the dimension of the problem to establish priorities besides opening a way towards cost-effectiveness studies that allow a more transparent debate on this topic.
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Affiliation(s)
- J López-Bastida
- Servicio de Evaluación y Planificación, Servicio Canario de Salud, Santa Cruz de Tenerife, Spain.
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López-Bastida J, Serrano-Aguilar P, Duque-González B. [Socioeconomic costs of cardiovascular disease and cancer in the Canary Islands (Spain) in 1998]. Gac Sanit 2003; 17:210-7. [PMID: 12841983 DOI: 10.1016/s0213-9111(03)71730-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the economic impact in terms of direct and indirect costs of the cardiovascular disease and cancer in the Canary Islands in 1998. METHODS The cost-of-illness method was used. Direct and indirect costs were estimated using prevalence costs, i.e., the costs produced in 1998. Direct costs were divided into hospitalization costs, outpatient costs, primary health care costs, and drug costs while indirect costs were obtained through transformation of physical units into monetary units using the approach of human capital theory and the friction cost method. RESULTS The total costs of cardiovascular disease and cancer were 246.11 and 193.72 million euros respectively. The direct costs of the two diseases were 134.44 and 58.04 million euros respectively, representing 55% and 30% of total costs and 16% of total health care expenditure in this region. The indirect costs of these two diseases were 111.68 and 135.68 million euros respectively, representing 45% and 70% of total costs. Use of the friction cost method revealed that indirect costs decreased by 88% for cardiovascular disease and those for cancer decreased by 77%. CONCLUSIONS Although this study adopts a conservative approach by omitting costs associated with pain and suffering, permanent disability, and those of at-home care provided by the family, the annual socioeconomic cost of cardiovascular disease and cancer in the Canary Islands was high, amounting to 440 million euros.
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Affiliation(s)
- J López-Bastida
- Servicio de Evaluación y Planificación. Servicio Canario de Salud, Spain.
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López-Bastida J, Serrano-Aguilar P, Duque-González B, Talavera-Déniz A. [Cost analysis and potential savings related to the use of preoperative tests in the hospitals of the Canary Islands [Spain]]. Gac Sanit 2003; 17:131-6. [PMID: 12729540 DOI: 10.1016/s0213-9111(03)71710-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To estimate the potential cost savings that might take place in the Canary Islands Health Service (CHS) through the appropriate scientific use of preoperative tests, using information obtained from five public university hospitals. METHODS A questionnaire was completed by 55 anesthesiologists, representing 60% of the total in the CHS. The questionnaire paid special attention to the most frequently used preoperative tests: chest radiograph, electrocardiogram, laboratory tests, and spirometry. The mean unit costs for the various preoperative tests were obtained from the two hospitals participating in the study. To calculate the potential cost savings derived from the appropriate use of preoperative tests, several scenarios were considered. These were characterized by different hypotheses or degrees of fulfillment of a protocol based on scientific knowledge and considered as the gold standard. RESULTS In the ideal scenario in which the recommended scientific protocol was fulfilled in 100% of the 16 179 patients with an American Society of Anesthesiologists (ASA) grade of I-II, the economic impact would be notable, since it would free sensitive resources that could be used for other health programs. These figures could amount to approximately 1.02 million euros, without considering the cost of preoperative hospital stay. This figure could increase by up to approximately 2.13 million euros if one day of preoperative hospital stay were included and by up to 3.24 million euros if two days of preoperative hospital stay were included. CONCLUSIONS The recent literature review and the results of the questionnaire applied in the CHS indicate that preoperative tests are of greatest benefit to patients and to society if their use is guided by scientific knowledge. In addition, resources can be freed by better selection and utilization of preoperative tests.
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Affiliation(s)
- J López-Bastida
- Dirección del Servicio Canario de Salud. Servicio Canario de Salud. Santa Cruz de Tenerife. España.
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