Esperanza Escortell Mayor

• MD, MPH
• Técnico de Salud de Atención Primaria at Gerencia Asistencial de Atención Primaria, Madrid

Background Caregivers of patients with chronic conditions or disability experience fatigue, burden and poor health-related quality of life. There is evidence of the effectiveness of support interventions for decreasing this impact. However, little is known about the benefits of home-based nursing intervention in primary health care. Objectives To...

Abstract Objectives: To compare the effectiveness of oral versus intramuscular (IM) vitamin B12 (VB12) in patients aged ≥65 years with VB12 deficiency. Design: Pragmatic, randomised, non-inferiority, multicentre trial in 22 primary healthcare centres in Madrid (Spain). Participants: 283 patients ≥65 years with VB12 deficiency were randomly assign...

Objectives To compare the effectiveness of oral versus intramuscular (IM) vitamin B 12 (VB12) in patients aged ≥65 years with VB12 deficiency. Design Pragmatic, randomised, non-inferiority, multicentre trial in 22 primary healthcare centres in Madrid (Spain). Participants 283 patients ≥65 years with VB12 deficiency were randomly assigned to oral...

AimsInequalities in diabetes prevalence among immigrants from Andean countries remain unknown. Andean populations are one of the largest groups of immigrants in Madrid city. We examined the association between country of birth and type 2 diabetes mellitus (T2DM) prevalence in Andean immigrant population relative to Spanish-natives; and whether this...

Purpose Uncertainty exists regarding the best way to communicate cardiovascular risk (CVR) to patients, and it is unclear whether the comprehension and perception of CVR varies according to the format used. The aim of the present work was to determine whether a strategy designed for communicating CVR information to patients with poorly controlled h...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To determine the effectiveness of strategies targeting primary healthcare professionals to implement clinical guidelines on the prevention of hazardous or harmful alcohol consumption in patients attended to in primary care settings. We will evaluate the effects...

Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough ass...

Abstract Background: Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinic...

Background: In Spain, family is the main source of care for dependent people. Numerous studies suggest that providing informal (unpaid) care during a prolonged period of time results in a morbidity-generating burden. Caregivers constitute a high-risk group that experiences elevated stress levels, which reduce their quality of life.Different strate...

To determine the effect of a seven-week-long, group-delivered, nurse-monitored, exercise training programme on the adherence of obese women to physical exercise routines at 12 months. The worldwide obesity epidemic is posing huge public health challenges. The main cause of obesity in Europe is very possibly a sedentary lifestyle. Uncertainty exists...

Objective To calculate how suitable the lipid-lowering treatment prescribed for pensioners in primary care clinics in four health areas is. Design Cross-sectional descriptive study of quality of pharmacological treatment. Setting Four primary care health districts, INSALUD, Madrid. Participants 1125 patients registered with 49 doctors, chosen at...

The oral administration of vitamin B12 offers a potentially simpler and cheaper alternative to parenteral administration, but its effectiveness has not been definitively demonstrated. The following protocol was designed to compare the effectiveness of orally and intramuscularly administered vitamin B12 in the treatment of patients ≥65 years of age...

Objective To identify factors associated with hospital readmissions in the elderly.

This study investigated effectiveness of manual therapy (MT) with transcutaneous electrical nerve stimulation (TENS) to reduce pain intensity in patients with mechanical neck disorder (MND). A randomized multi-centered controlled clinical trial was performed in 12 Primary Care Physiotherapy Units in Madrid Region. Ninety patients were included with...

High blood pressure (HBP) is a major risk factor for cardiovascular disease (CVD). European hypertension and cardiology societies as well as expert committees on CVD prevention recommend stratifying cardiovascular risk using the SCORE method, the modification of lifestyles to prevent CVD, and achieving good control over risk factors. The EDUCORE (E...

To identify factors associated with hospital readmissions in the elderly. Observational descriptive study. Health area 3 of Madrid. Patients 74 years-old and over with a hospital admission to Hospital Universitario Príncipe de Asturias in 2006. Those with a hospital admission in the previous 6 months were excluded. A total of 1051 patients were ide...

To describe the satisfaction and expectations of the patients with neck pain with relation to the physical therapy received and to analyse the relationship between the patient's characteristics and his degree of satisfaction and expectation. This study is performed in the setting of a random clinical trial. Subjects between 18 and 60 years of age w...

This document aims to comment on the currently used concepts of authorship of scientific articles. Parallelly, the question of the “order of the authors” is discussed. The concept of authorship according to contribution and of the “special case of the group publications” is approached. Special emphasis has been made in the bibliographic search on o...

This document aims to comment on the currently used concepts of authorship of scientific articles. Parallelly, the question of the order of the authors is discussed. The concept of authorship according to contribution and of the special case of the group publications is approached. Special emphasis has been made in the bibliographic search on obtai...

To analyze patient complaints in a Primary Health Care District (PHCD) using statistical process control methods compared to multivariate methods, as regards their results and feasibility of application in this context. Descriptive study based on an aggregate analysis of administrative complaints. Complaints received between January 2005 and August...

Objective To analyze patient complaints in a Primary Health Care District (PHCD) using statistical process control methods compared to multivariate methods, as regards their results and feasibility of application in this context.

Objective: to compare and to describe the prescription of strong opioid analgesics in two sanitary districts of Spain during 2005. Method: Design: an ecological descriptive study. Setting: Lleida Health Service and the Third Sanitary District in Madrid (3D-Madrid) Community. Main outcome measures: a primary healthcare database supplied information...

Objective: to compare and to describe the prescription of strong opioid analgesics in two sanitary districts of Spain during 2005. Method: Design: an ecological descriptive study. Setting: Lleida Health Service and the Third Sanitary District in Madrid (3D-Madrid) Community. Main outcome measures: a primary healthcare database supplied information...

To determine the prevalence of diabetic autonomic neuropathy (DAN) in patients with type 2 diabetes using a cardiovascular test. Observational, descriptive, cross-sectional study. Primary care clinics in Fronteras de Torrejón de Ardoz Health Centre, Area 3, Madrid, Spain. Of the 361 diabetics assigned to 3 participating patient quotas, 317 patients...

Objective To determine the prevalence of diabetic autonomic neuropathy (DAN) in patients with type 2 diabetes using a cardiovascular test. Design Observational, descriptive, crosssectional study. Setting Primary care clinics in Fronteras de Torrejón de Ardoz Health Centre, Area 3, Madrid, Spain. Participants Of the 361 diabetics assigned to 3 pa...

To compare the effectiveness of manual therapy (MT) versus transcutaneous electrical nervous stimulation (TENS) in reducing the intensity of pain in patients with subacute or chronic neck pain (NP) attended at primary care physiotherapy units (PCPU). Randomised clinical trial. Thirteen PCPU in 4 health districts of the Community of Madrid, Spain. N...

Objective To compare the effectiveness of manual therapy (MT) versus transcutaneous electrical nervous stimulation (TENS) in reducing the intensity of pain in patients with subacute or chronic neck pain (NP) attended at primary care physiotherapy units (PCPU). Design Randomised clinical trial. Setting Thirteen PCPU in 4 health districts of the Co...

The aim of this study was to determine the information needs of primary care physicians in Spain and to describe their information-seeking patterns. This observational study took place in primary care practices located in Madrid, Spain. Participants were a random stratified sample of 112 primary care physicians. Physicians' consultations were video...

Objective To improve the use of generic drugs among the professionals of primary health care area 3. Investigate the reluctance of the professionals to prescribe them. Methods Design qualitative study with individual and quantitative interview. Intervention strategies: 1) group intervention: Specific session on generic drugs given by the primary h...

To determine the information needs of primary care physicians by identifying the frequency and type of questions arising during consultation, and by describing the information-search pattern. DESIGN. Observational, descriptive, multi-centre study. Primary care practices in Madrid, Spain. Random sample, proportionally stratified by area (urban/rural...

Objectives To determine the information needs of primary care physicians by identifying the frequency and type of questions arising during consultation, and by describing the information-search pattern. Design Observational, descriptive, multicentre study. Setting Primary care practices in Madrid, Spain. Participants Random sample, proportionall...

The World Health Organization (WHO) considers responsible self-medication as a valid formula for health care in developed societies. For this, there are drugs classified as over the counter (OTC), which are the only ones that can use advertising aimed at the population, always under previous control. The pharmaceutical industry is demanding that th...

To find the number of patients in terminal care in Madrid Health District 3. Ecological, descriptive study. Eleven Health Districts. Madrid, Spain, 2002. Two models were used to calculate the number of patients in terminal care and were compared with data from the Primary Care Service Portfolio. Model A: consumption of morphine and fentanyl. The nu...

Objective To find the number of patients in terminal care in Madrid Health District 3. Design Ecological, descriptive study. Setting Eleven Health Districts. Madrid, Spain, 2002. Main measurements Two models were used to calculate the number of patients in terminal care and were compared with data from the Primary Care Service Portfolio. Model A...

IntroductionHeavy caseload is a significant concern to primary care physicians. The use of consultations can be reduced through the application of strategies directed at the user, the health professional and the organization. One of these strategies is consultation management.Objective To improve the dynamics of family medicine consultations throug...

To assess what information primary care doctors from 5 health areas of Madrid need, through the description of the frequency and kind of clinical questions that arise, the pattern of search for the answers and how well they were answered. Descriptive, observational study. Setting. Primary care consultations in health areas 1, 3, 8, 9, and 10, Madri...

Objective To assess what information primary care doctors from 5 health areas of Madrid need, through the description of the frequency and kind of clinical questions that arise, the pattern of search for the answers and how well they were answered. Design Descriptive, observational study. Setting Primary care consultations in health areas 1, 3, 8...

Objectives The computer system for billing prescriptions (SIFAR in Spanish) enables indicators to be extracted for the study and follow-up of the use of medicines in the INSALUD primary care areas. Concretely, we studied the indicator referring to pensioners’ consumption of lipid-lowering drugs (PCLL), not validated, and whose value is expected to...

Background: The high consumption of hypolipidaemic agents warrants the study of the costs caused by these medicines being inadequately prescribed. Objective: To quantify the economic cost generated in 1 year in primary care by inadequate (or unnecessary) prescriptions for hypolipidaemic drugs. Methods: A cross-sectional study based on hypolipidaemi...

The computer system for billing prescriptions (SIFAR in Spanish) enables indicators to be extracted for the study and follow-up of the use of medicines in the INSALUD primary care areas. Concretely, we studied the indicator referring to pensioners consumption of lipid-lowering drugs (PCLL), not validated, and whose value is expected to drop as qual...

To calculate how suitable the lipid-lowering treatment prescribed for pensioners in primary care clinics in four health areas is. Cross-sectional descriptive study of quality of pharmacological treatment. Four primary care health districts, INSALUD, Madrid. 1125 patients registered with 49 doctors, chosen at random on the basis of three strata defi...

To measure the validity of the attendance pressure indicator in the Primary Care clinics at a Health Centre. An observational, crossover study. Primary Care Area 3, Madrid. Stratified sampling by professional group and systematic sampling out of a total of 296 Primary Care team professionals in the area were performed. The size of the sample was 10...