Albert Boada

Universitat Rovira i Virgili, Tarraco, Catalonia, Spain

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Publications (9)13.7 Total impact

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    ABSTRACT: Acute bronchitis is one of the most prevalent respiratory infections in primary care, and in more than 90% of the cases antibiotics are prescribed, mainly when purulent expectoration is present. However, this process is usually viral in origin and the benefits of antibiotic treatment are marginal. On the other hand, in recent years bronchitis has been considered more as an inflammatory than an infectious process. Thus, the aim of this study is to evaluate the clinical effectiveness of a schedule of an oral anti-inflammatory compared with an antibiotic regimen and another group assigned to receive a placebo. A total of 420 patients from 15 to 70 years of age with no associated comorbidity, presenting respiratory tract infection of at least one week of evolution, with cough as the predominant symptom, the presence of purulent expectoration and at least one other symptom of the respiratory tract (dyspnoea, wheezing, chest discomfort or pain), with no alternative explanation such as pneumonia, will be included in a prospective, randomised and controlled, clinical trial with placebo. The patients will be randomised to receive one of three treatments: ibuprofen, amoxycillin and clavulanic acid or placebo for 10 days. The main outcome measure is the number of days with frequent cough defined by the symptom diary with a score of 1 or more. This trial is designed to evaluate the number of days with frequent cough with anti-inflammatory treatment compared with antimicrobial treatment and placebo in previously healthy patients with a clinical picture of acute bronchitis and purulent expectoration. It is hypothesized that anti-inflammatory treatment is more effective than antibiotic treatment to reduce cough, which is the most disturbing symptom for patients with this infection. ISRCTN07852892.
    BMC Pulmonary Medicine 06/2011; 11:38. · 2.76 Impact Factor
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    ABSTRACT: Primary health care (PHC) professionals play a key role in population screening of colorectal cancer. The purposes of the study are: to assess knowledge and attitudes among PHC professionals with regard to colorectal cancer screening, as well as the factors that determine their support for such screening. Questionnaire-based survey of PHC physicians and nurses in the Balearic Islands and in a part of the metropolitan area of Barcelona. We collected 1,219 questionnaires. About 84% of all professionals believe that screening for colorectal cancer by fecal occult blood test (FOBT) is effective. Around 68% would recommend to their clients a colorectal cancer screening program based on FOBT and colonoscopy. About 31% are reluctant or do not know. Professionals perceive the fear of undergoing a colonoscopy as the main obstacle in getting patients to participate, and the invasive nature of this test is the main reason behind their resistance to this program. The main barriers to support the screening program among PHC professionals are lack of knowledge (nurses) and lack of time (physicians). On multivariate analysis, the factors associated with reluctance to recommend colorectal cancer screening were: believing that FOBT has poor sensitivity and is complicated; that colonoscopy is an invasive procedure; that a lack of perceived benefit could discourage client participation; that only a minority of clients would participate; thinking that clients are fed up with screening tests and being unaware if they should be offered something to ensure their participation in the programme. Two in every three PHC professionals would support a population screening program for colorectal cancer screening. Factors associated with reluctance to recommend it were related with screening tests characteristics as sensitivity and complexity of FOBT, and also invasive feature of colonoscopy. Other factors were related with patients' believes.
    BMC Cancer 01/2010; 10:500. · 3.33 Impact Factor
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    Atención Primaria 10/2006; 38(5):307-8; author reply 308-9. · 0.96 Impact Factor
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    Atención Primaria 10/2006; 38(5):304-5. · 0.96 Impact Factor
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    Atencion Primaria - ATEN PRIM. 01/2006; 38(5):307-308.
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    ABSTRACT: Introducción La mayor parte de las infecciones de las vías aéreas son autolimitadas, y las revisiones recientes sugieren que el beneficio de los antibióticos es marginal en las sinusitis agudas1. Sin embargo, su prescripción es muy elevada en nuestro país; por ejemplo, Picazo et al2 encontraron una tasa de prescripción antibiótica del 92% en esta infección. Objetivo Investigar si una intervención basada en una mejora de la calidad asistencial consigue disminuir la prescripción de antibióticos en la sinusitis en España. Diseño Estudio de control de calidad con un diseño controlado no aleatorizado. Emplazamiento Atención primaria de salud. Participantes Un total de 54 médicos registraron todos los pacientes mayores de 14 años con infecciones sinusales durante 3 semanas (15 días laborables). Intervenciones Un total de 17 médicos efectuaron la auditoría antes (año 2002) y después (2005) de una intervención que consistía en feedback de los resultados obtenidos en el registro anterior por cada uno de los médicos participantes y se efectuó una sesión educacional interactiva sobre el manejo de las infecciones de vías aéreas altas de acuerdo con las guías de práctica clínica existentes. Además, para ayudar a los clínicos en diferenciar la etiología viral de la bacteriana se les instruyó en la utilización de la proteína C reactiva en sangre capilar (Orion QuickRead CRP). Los otros 37 médicos participaron como grupo control (año 2005). Mediciones principales Antibióticos prescritos y tipo de antibiótico. Se clasificaron los antibióticos según la clasificación anatómico-terapéutico-química (ATC) definida por la Organización Mundial de la Salud3. Resultados Los médicos asignados a los grupos intervención y control fueron comparables en cuanto a edad, sexo y número de años de ejercicio profesional. Se registraron un total de 149 consultas (47 después de la intervención, 25 antes y 77 en el grupo control). Se determinó la proteína C reactiva en 15 casos, suponiendo un 10,1% de las visitas en estas infecciones. Se prescribieron antibióticos en el 49% (intervalo de confianza [IC] del 95%, 31-67) de las consultas después de la intervención, el 68% antes (IC del 95%, 46-84) y el 61% (IC del 95%, 47-74) en el grupo control. Los criterios que más se acompañaron de prescripción antibiótica fueron la fiebre (entre un 100% en el grupo de antes de la intervención y el 84,4% hallado después de ésta) y la rinorrea purulenta (entre el 86,8% en el grupo control y el 58,6% observado después de la intervención). Después de la intervención no se prescribieron macrólidos ni cefalosporinas, mientras que la prescripción de penicilinas de amplio espectro supuso casi la mitad de todas las visitas (tabla 1). Conclusiones Una intervención dirigida a los médicos de familia para conseguir una mejoría en la calidad del manejo diagnóstico y terapéutico de las infecciones sinusales consigue reducir la prescripción de antibióticos en nuestro país. No sólo se observa una disminución global en la prescripción de antibióticos, sino también un cambio cualitativo de su prescripción.
    Atencion Primaria - ATEN PRIM. 01/2006; 38(5):304-305.
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    ABSTRACT: Treatment for respiratory tract infections (RTI) in the primary care setting is empirical. Antibiotic prescribing patterns differ among countries and are based on the prevalence of antibiotic resistance in the geographical area. The aim of this study was to compare the antibiotics prescribed by general practitioners (GPs) for RTIs between Spain and Denmark. Observational multicenter survey carried out in the primary healthcare setting. Two groups of GPs in Spain and Denmark recorded all contacts with RTI patients during a 3-week period between November 2001 and January 2002. A total of 2833 RTI cases were registered. Broad-spectrum penicillins and combinations of these drugs plus beta-lactamase inhibitors were the antibiotics most frequently prescribed by Spanish GPs (62.3%), followed by macrolides (22.3%). In contrast, narrow-spectrum penicillins were most commonly prescribed by Danish GPs (58% of all prescriptions), followed by macrolides (29%) (P < .001). Antibiotics most frequently prescribed for ear, tonsillar, sinus and bronchopulmonary infections were broad-spectrum penicillins among Spanish GPs and narrow-spectrum penicillins in Denmark. Spanish GPs prescribed penicillin V only for tonsillitis, accounting for 5.1% of the antibiotics used for this condition, whereas this drug accounted for 91.7% of the prescriptions by their Danish colleagues for the same indication. The substantial differences in RTI management between the participating GPs should make us reflect on the rational use of antibiotics. The discrepancies disclosed may indicate dissimilarities in recommendations, traditions, habits, or antibiotic pressures between the countries studied.
    Enfermedades Infecciosas y Microbiología Clínica 12/2005; 23(10):598-604. · 1.48 Impact Factor
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    ABSTRACT: Background Treatment for respiratory tract infections (RTI) in the primary care setting is empirical. Antibiotic prescribing patterns differ among countries and are based on the prevalence of antibiotic resistance in the geographical area. The aim of this study was to compare the antibiotics prescribed by general practitioners (GPs) for RTIs between Spain and Denmark. Methods Observational multicenter survey carried out in the primary healthcare setting. Two groups of GPs in Spain and Denmark recorded all contacts with RTI patients during a 3-week period between November 2001 and January 2002. Results A total of 2833 RTI cases were registered. Broadspectrum penicillins and combinations of these drugs plus beta-lactamase inhibitors were the antibiotics most frequently prescribed by Spanish GPs (62.3%), followed by macrolides (22.3%). In contrast, narrow-spectrum penicillins were most commonly prescribed by Danish GPs (58% of all prescriptions), followed by macrolides (29%) (P < .001). Antibiotics most frequently prescribed for ear, tonsillar, sinus and bronchopulmonary infections were broad-spectrum penicillins among Spanish GPs and narrow-spectrum penicillins in Denmark. Spanish GPs prescribed penicillin V only for tonsillitis, accounting for 5.1% of the antibiotics used for this condition, whereas this drug accounted for 91.7% of the prescriptions by their Danish colleagues for the same indication. Conclusions The substantial differences in RTI management between the participating GPs should make us reflect on the rational use of antibiotics. The discrepancies disclosed may indicate dissimilarities in recommendations, traditions, habits, or antibiotic pressures between the countries studied.
    Enfermedades Infecciosas y Microbiología Clínica 10/2005; 23(10):598–604. · 1.48 Impact Factor
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    ABSTRACT: The prevalence of antibiotic resistance in a country reflects the local consumption of antibiotics. The majority of antibiotics are prescribed in general practice and most prescriptions are attributable to treatment of respiratory tract infections (RTIs). The aim of this study was to compare general practitioners' (GPs') prescribing of antibiotics for respiratory tract infections in a country with a high prevalence of antibiotic resistance (Spain) with a country with a low prevalence of antibiotic resistance (Denmark). A group of GPs in Copenhagen and Barcelona registered all contacts ( n=2833) with patients with RTIs during a 3-week period between 1 November 2001 and 31 January 2002. Overall, Spanish GPs treated a higher proportion of patients than Danish GPs. After adjusting for unequal distribution of age and sex, we found that Spanish GPs prescribed significantly more antibiotics to patients with focus of infection in tonsils and bronchi/lungs. Narrow-spectrum penicillin was the most used antibiotic in Denmark, representing 58% of all prescriptions issued, followed by macrolide and broad-spectrum penicillin. In Spain, prescriptions were distributed among a great number of compounds, with broad-spectrum penicillins and combinations of amoxicillin plus beta-lactamase inhibitors most frequently used. The substantial difference in the way GPs manage respiratory tract infections in Denmark and Spain cannot be explained by different patterns of RTIs in general practice. The discrepancies indicate variations in national recommendations, different treatment traditions or different impact of pharmaceutical marketing.
    European Journal of Clinical Pharmacology 04/2004; 60(1):23-8. · 2.74 Impact Factor

Publication Stats

44 Citations
13.70 Total Impact Points

Institutions

  • 2011
    • Universitat Rovira i Virgili
      Tarraco, Catalonia, Spain
  • 2010
    • Institut Marqués, Spain, Barcelona
      Barcino, Catalonia, Spain