array:24 [
  "pii" => "S2173508510700125"
  "issn" => "21735085"
  "doi" => "10.1016/S2173-5085(10)70012-5"
  "estado" => "S300"
  "fechaPublicacion" => "2010-01-01"
  "aid" => "70012"
  "copyright" => "Sociedad Española de Farmacia Hospitalaria"
  "copyrightAnyo" => "2010"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Farm Hosp. 2010;34:188-93"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 335
    "formatos" => array:3 [
      "EPUB" => 18
      "HTML" => 160
      "PDF" => 157
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173508510700137"
    "issn" => "21735085"
    "doi" => "10.1016/S2173-5085(10)70013-7"
    "estado" => "S300"
    "fechaPublicacion" => "2010-01-01"
    "aid" => "70013"
    "copyright" => "Sociedad Española de Farmacia Hospitalaria"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Farm Hosp. 2010;34:194-203"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 406
      "formatos" => array:3 [
        "EPUB" => 15
        "HTML" => 165
        "PDF" => 226
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Study of use of pemetrexed in non-small cell lung cancer"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "194"
          "paginaFinal" => "203"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Estudio de utilizaci&#243;n de pemetrexed en el c&#225;ncer de pulm&#243;n no microc&#237;tico"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S&#46; Villanueva-Herraiz, M&#46;P&#46; Ortega-Garc&#237;a, C&#46; Camps-Herrero, P&#46; Blasco-Segura"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Villanueva-Herraiz"
            ]
            1 => array:2 [
              "nombre" => "M&#46;P&#46;"
              "apellidos" => "Ortega-Garc&#237;a"
            ]
            2 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Camps-Herrero"
            ]
            3 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Blasco-Segura"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173508510700137?idApp=UINPBA00009S"
    "url" => "/21735085/0000003400000004/v1_201305141058/S2173508510700137/v1_201305141058/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173508510700113"
    "issn" => "21735085"
    "doi" => "10.1016/S2173-5085(10)70011-3"
    "estado" => "S300"
    "fechaPublicacion" => "2010-01-01"
    "aid" => "70011"
    "copyright" => "Sociedad Espa&#241;ola de Farmacia Hospitalaria"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Farm Hosp. 2010;34:181-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 312
      "formatos" => array:3 [
        "EPUB" => 36
        "HTML" => 139
        "PDF" => 137
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Application of joint analysis to ongoing training of pharmacy personnel"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "181"
          "paginaFinal" => "187"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Aplicaci&#243;n del an&#225;lisis conjunto en la formaci&#243;n continua de un servicio de farmacia"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "R&#46; Arias-Rico"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Arias-Rico"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173508510700113?idApp=UINPBA00009S"
    "url" => "/21735085/0000003400000004/v1_201305141058/S2173508510700113/v1_201305141058/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Compliance of prescriptions for chronic obstructive pulmonary disease patients given upon hospital discharge"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "188"
        "paginaFinal" => "193"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "B&#46; Garc&#237;a Robredo, M&#46;A&#46; Calleja Hern&#225;ndez, M&#46;I&#46; Luque Vega, R&#46; Ubago P&#233;rez, M&#46;J&#46; Faus D&#225;der"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "B&#46;"
            "apellidos" => "Garc&#237;a Robredo"
            "email" => array:1 [
              0 => "beafir&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46;A&#46;"
            "apellidos" => "Calleja Hern&#225;ndez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "M&#46;I&#46;"
            "apellidos" => "Luque Vega"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Ubago P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "M&#46;J&#46;"
            "apellidos" => "Faus D&#225;der"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Farmacia&#44; Hospital Universitario Virgen de las Nieves&#44; Granada&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Grupo de Atenci&#243;n Farmac&#233;utica&#44; Universidad de Granada&#44; Granada&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Adecuaci&#243;n de la prescripci&#243;n al alta hospitalaria en pacientes con enfermedad pulmonar obstructiva cr&#243;nica"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2009-09-02"
    "fechaAceptado" => "2010-01-12"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec149696"
          "palabras" => array:4 [
            0 => "Compliance"
            1 => "Hospital discharge"
            2 => "COPD"
            3 => "Prescription"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec149697"
          "palabras" => array:4 [
            0 => "Adecuaci&#243;n"
            1 => "Alta hospitalaria"
            2 => "EPOC"
            3 => "Prescripci&#243;n"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Measure the degree of compliance of prescriptions given to chronic obstructive pulmonary disorder &#40;COPD&#41; patients upon hospital discharge by comparing them to international recommendations&#46; Identify factors that influence the degree of compliance&#46; Evaluate the effect of that degree of compliance on the number of COPD exacerbations&#46;</p> <span class="elsevierStyleSectionTitle">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective observational study&#46; We selected all episodes identified as COPD in a tertiary hospital during 2006&#46; By consulting the clinical history database&#44; we accessed the hospital discharge report and calculated the treatment&#39;s degree of proximity to the recommendations issued in the Global Initiative for Chronic Obstructive Lung Disease &#40;GOLD&#41;&#46; For each episode&#44; we calculated the number of exacerbations in the six following months&#46; Descriptive&#44; bivariate statistical analysis&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We obtained 365 episodes&#46; The mean degree of compliance was 82&#37; &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#46;9&#41;&#46; The patient&#39;s age and the severity of the disease did not influence the degree of compliance&#46; We observed an inverse correlation between the hospital stay and the degree of compliance &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;026&#41;&#46; Discharge reports issued by the Pneumonology Department had a significantly higher degree of compliance &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; No statistically significant relationship was found between the degree of compliance and the number of exacerbations&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The degree of compliance is high according to the GOLD recommendations&#46; The Pneumology Department had the highest degree of compliance&#44; and a higher degree of compliance was related to a shorter hospital stay&#46; The treatment compliance had no effect on the number of exacerbations of the disease&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Cuantificar el grado de adecuaci&#243;n de la prescripci&#243;n al alta hospitalaria a las recomendaciones internacionales en pacientes con EPOC&#46; Identificar los factores que influyen sobre el grado de adecuaci&#243;n&#46; Evaluar la influencia del grado de adecuaci&#243;n sobre el n&#250;mero de reagudizaciones de la EPOC&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional retrospectivo&#46; Se seleccionaron todos los episodios del a&#241;o 2006 con diagn&#243;stico principal codificado como EPOC en un hospital terciario&#46; A trav&#233;s de la consulta de la historia cl&#237;nica digital&#44; se accedi&#243; al informe de alta hospitalaria y se calcul&#243; el grado de adecuaci&#243;n a las recomendaciones de <span class="elsevierStyleItalic">Global Initiative for Chronic Obstructive Lung Disease</span>&#59; se contabiliz&#243; para cada episodio el n&#250;mero de reagudizaciones en los 6 meses posteriores&#46; An&#225;lisis estad&#237;stico descriptivo y bivariante&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se obtuvieron 365 episodios&#46; El grado de adecuaci&#243;n medio fue del 82&#37; &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#44;9&#41;&#46; La edad del paciente y la gravedad de la enfermedad no influyeron sobre el grado de adecuaci&#243;n&#46; Se observ&#243; relaci&#243;n inversa entre estancia hospitalaria y grado de adecuaci&#243;n &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;026&#41;&#46; Los informes de alta hospitalaria a cargo del servicio de neumolog&#237;a presentaron significativamente mayor grado de adecuaci&#243;n &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; No se hall&#243; relaci&#243;n estad&#237;sticamente significativa entre grado de adecuaci&#243;n y n&#250;mero de exacerbaciones&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El grado de adecuaci&#243;n a las recomendaciones de Global Initiative for Chronic Obstructive Lung Disease es elevado&#46; Se detecta mayor adecuaci&#243;n en el servicio de neumolog&#237;a y un mayor grado de adecuaci&#243;n se relaciona con una menor estancia hospitalaria&#46; El grado de adecuaci&#243;n no influye sobre el n&#250;mero de reagudizaciones de la enfermedad&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">This study was partially presented at the 37th European Symposium on Clinical Pharmacy in Dubrovnik&#44; October 2008&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:26 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Miembros del Comit&#233; Est&#225;ndares para el diagn&#243;stico y tratamiento de pacientes con EPOC&#58; resumen del position paper elaborado por el grupo de trabajo ATS&#47;ERS"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46;R&#46; Celli"
                            1 => "W&#46; MacNee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2004"
                        "volumen" => "5"
                        "paginaInicial" => "260"
                        "paginaFinal" => "278"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gu&#237;a cl&#237;nica para el diagn&#243;stico y el tratamiento de la enfermedad pulmonar obstructiva cr&#243;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Barber&#225;"
                            1 => "G&#46; Peces Barba"
                            2 => "A&#46;G&#46;N&#46; Agust&#237;"
                            3 => "J&#46;L&#46; Izquierdo"
                            4 => "L&#46; Mons&#243;"
                            5 => "T&#46; Montemayor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2001"
                        "volumen" => "37"
                        "paginaInicial" => "297"
                        "paginaFinal" => "316"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11412529"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enfermedad pulmonar obstructiva cr&#243;nica&#44; un problema de salud p&#250;blica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; De la Fuente Cid"
                            1 => "F&#46;J&#46; Gonz&#225;lez Barcala"
                            2 => "A&#46; Pose Reino"
                            3 => "L&#46; Vald&#233;s Cuadrado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2006"
                        "volumen" => "206"
                        "paginaInicial" => "442"
                        "paginaFinal" => "443"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17042985"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio IBERPOC en Espa&#241;a&#58; prevalencia de s&#237;ntomas respiratorios habituales y de limitaci&#243;n cr&#243;nica al flujo a&#233;reo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Sobradillo"
                            1 => "M&#46; Miravitlles"
                            2 => "C&#46;A&#46; Jim&#233;nez"
                            3 => "R&#46; Gabriel"
                            4 => "J&#46;L&#46; Viejo"
                            5 => "J&#46;F&#46; Masa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "1999"
                        "volumen" => "35"
                        "paginaInicial" => "159"
                        "paginaFinal" => "166"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10330536"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chronic obstructive pulmonary disease surveillance- United States&#44; 1971&#8211;2000"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46;M&#46; Mannino"
                            1 => "D&#46;M&#46; Homa"
                            2 => "L&#46;J&#46; Akinbami"
                            3 => "E&#46;S&#46; Ford"
                            4 => "S&#46;C&#46; Redd"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "MMWR"
                        "fecha" => "2002"
                        "volumen" => "51"
                        "paginaInicial" => "1"
                        "paginaFinal" => "16"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15580804"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "EPOC&#58; tratamiento farmacol&#243;gico&#46; Monograf&#237;as"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Centro Andaluz de Informaci&#243;n de Medicamentos"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2004"
                        "editorial" => "Escuela Andaluza de Salud P&#250;blica"
                        "editorialLocalizacion" => "Granada"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Etiolog&#237;a bacteriana de la agudizaci&#243;n de la bronquitis cr&#243;nica en atenci&#243;n primaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Llor"
                            1 => "J&#46;M&#46; Cots"
                            2 => "A&#46; Herreras"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2006"
                        "volumen" => "42"
                        "paginaInicial" => "388"
                        "paginaFinal" => "393"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16948991"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors associated with increased risk of admission in a cohort of ambulatory COPD patients&#58; A multiple logistic regression analysis"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "on behalf of the EOLO Group"
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Miravitlles"
                            1 => "T&#46; Guerrero"
                            2 => "C&#46; Mayordomo"
                            3 => "L&#46; Sanchez-Agudo"
                            4 => "F&#46; Nicolau"
                            5 => "J&#46;L&#46; Seu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "67462"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respiration"
                        "fecha" => "2000"
                        "volumen" => "67"
                        "paginaInicial" => "495"
                        "paginaFinal" => "501"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11070451"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gu&#237;as de pr&#225;ctica cl&#237;nica en Internet"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;F&#46; Garc&#237;a Guti&#233;rrez"
                            1 => "R&#46; Bravo Toledo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2001"
                        "volumen" => "28"
                        "paginaInicial" => "74"
                        "paginaFinal" => "79"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11412582"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Qu&#233; son las Gu&#237;as de Pr&#225;ctica Cl&#237;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Casariego Vales"
                            1 => "E&#46; Briones P&#233;rez de la Blanca"
                            2 => "C&#46; Costa Ribas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Gu&#237;as Cl&#237;nicas"
                        "fecha" => "2007"
                        "volumen" => "7"
                        "paginaInicial" => "1"
                        "paginaFinal" => "5"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Global Initiative for Chronic Obstructive Lung Disease&#46; Guide to COPD diagnosis&#44; management&#44; and prevention&#46; GOLD&#59; 2006&#46; Available from&#58; <a class="elsevierStyleInterRef" href="http://www.goldcopd.com/">http&#58;&#47;&#47;www&#46;goldcopd&#46;com</a>&#46;"
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Calidad de la asistencia hospitalaria y riesgo de reingreso precoz en la exacerbaci&#243;n aguda de la EPOC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Jim&#233;nez Puente"
                            1 => "J&#46; Fern&#225;ndez Guerra"
                            2 => "I&#46; Hidalgo Rojas"
                            3 => "S&#46; Domingo Gonz&#225;lez"
                            4 => "A&#46; Lara Blanquer"
                            5 => "J&#46; Garc&#237;a Alegr&#237;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "An Med Interna"
                        "fecha" => "2003"
                        "volumen" => "20"
                        "paginaInicial" => "340"
                        "paginaFinal" => "346"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12892550"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Descripci&#243;n de una muestra de pacientes con enfermedad pulmonar obstructiva cr&#243;nica atendidos en las consultas del &#225;rea de neumolog&#237;a dependientes de un hospital"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Esteban"
                            1 => "J&#46; Moraza"
                            2 => "M&#46; Aburto"
                            3 => "J&#46;M&#46; Quintana"
                            4 => "A&#46; Capelastegui"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2003"
                        "volumen" => "39"
                        "paginaInicial" => "485"
                        "paginaFinal" => "490"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14588200"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impacto asistencial hospitalario de la EPOC Peso espec&#237;fico del paciente con EPOC de alto consumo sanitario"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;J&#46; Soler"
                            1 => "L&#46; S&#225;nchez"
                            2 => "M&#46; Latorre"
                            3 => "J&#46; Alamar"
                            4 => "P&#46; Rom&#225;n"
                            5 => "M&#46; Perpi&#241;&#225;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2001"
                        "volumen" => "37"
                        "paginaInicial" => "375"
                        "paginaFinal" => "381"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11674937"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines versus clinical practice in the treatment of chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46; Roche"
                            1 => "T&#46; Lepage"
                            2 => "J&#46; Bourcereau"
                            3 => "P&#46; Terrioux"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2001"
                        "volumen" => "18"
                        "paginaInicial" => "903"
                        "paginaFinal" => "908"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11829094"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines versus clinical practice in the treatment of chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Miratvilles"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2002"
                        "volumen" => "20"
                        "paginaInicial" => "243"
                        "paginaFinal" => "244"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12166576"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tratamiento farmacol&#243;gico de la EPOC en dos niveles asistenciales Grado de adecuaci&#243;n a las normativas recomendadas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; De Miguel D&#237;ez"
                            1 => "J&#46;L&#46; Izquierdo Alonso"
                            2 => "J&#46;M&#46; Rodr&#237;guez Gonz&#225;lez-Moro"
                            3 => "P&#46; De Lucas Ramos"
                            4 => "J&#46; Molina Par&#237;s"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2003"
                        "volumen" => "39"
                        "paginaInicial" => "195"
                        "paginaFinal" => "202"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12749801"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Knowledge of guidelines for the management of COPD&#58; a survey of primary care physicians"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "O&#46;T&#46; Rutschman"
                            1 => "J&#46;P&#46; Janssens"
                            2 => "B&#46; Vermeulen"
                            3 => "F&#46;P&#46; Sarasin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2004"
                        "volumen" => "98"
                        "paginaInicial" => "932"
                        "paginaFinal" => "937"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15481268"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Global strategy for the diagnosis&#44; management&#44; and prevention of chronic obstructive pulmonary disease&#58; GOLD executive summary"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;F&#46; Rabe"
                            1 => "S&#46; Hurd"
                            2 => "A&#46; Anzueto"
                            3 => "P&#46;J&#46; Barnes"
                            4 => "S&#46;A&#46; Buist"
                            5 => "P&#46; Calverley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.200703-456SO"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2007"
                        "volumen" => "176"
                        "paginaInicial" => "532"
                        "paginaFinal" => "555"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17507545"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;A&#46; Walters"
                            1 => "P&#46;G&#46; Gibson"
                            2 => "R&#46; Wood-Baker"
                            3 => "M&#46; Hannay"
                            4 => "E&#46;H&#46; Walters"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD001288.pub3"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2009"
                        "volumen" => "1"
                        "paginaInicial" => "CD001288"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19160195"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ABC of chronic obstructive pulmonary disease&#58; Acute exacerbations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;P&#46; Currie"
                            1 => "J&#46;A&#46; Wedzicha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.333.7558.87"
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2006"
                        "volumen" => "333"
                        "paginaInicial" => "87"
                        "paginaFinal" => "89"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16825232"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gu&#237;a de recomendaciones en la terapia secuencial antibi&#243;tica&#46; Gu&#237;as Cl&#237;nicas SEIMC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Carratal&#225; Fern&#225;ndez"
                            1 => "E&#46; Navas Elorza"
                            2 => "R&#46; San Juan"
                            3 => "F&#46; Soriano"
                            4 => "V&#46; Rodr&#237;guez Cerrato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Aguado JM&#44; Fort&#250;n J"
                        "fecha" => "2006"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease &#40;bronchitis randomized on NAC Cost-Utility Study BRONCUS&#41;&#58; a randomised placebo controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:1 [
                            0 => "M&#46; Decramer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2005"
                        "volumen" => "365"
                        "paginaInicial" => "1552"
                        "paginaFinal" => "1560"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors of readmission to hospital for a COPD exacerbation&#58; a prospective study"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "on behalf of the EFRAM investigators"
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Garc&#237;a-Aymerich"
                            1 => "E&#46; Farrero"
                            2 => "M&#46;A&#46; F&#233;lez"
                            3 => "J&#46; Izquierdo"
                            4 => "R&#46;M&#46; Marrades"
                            5 => "J&#46;M&#46; Ant&#243;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2003"
                        "volumen" => "58"
                        "paginaInicial" => "100"
                        "paginaFinal" => "105"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12554887"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factores pron&#243;sticos en la EPOC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;J&#46; Soler Catalu&#241;a"
                            1 => "M&#46;A&#46; Mart&#237;nez Garc&#237;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2007"
                        "volumen" => "43"
                        "paginaInicial" => "680"
                        "paginaFinal" => "691"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18053546"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;J&#46; Soler-Catalu&#241;a"
                            1 => "M&#46;A&#46; Mart&#237;nez-Garc&#237;a"
                            2 => "P&#46; Rom&#225;n S&#225;nchez"
                            3 => "E&#46; Salcedo"
                            4 => "M&#46; Navarro"
                            5 => "R&#46; Ochando"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thx.2005.040527"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2005"
                        "volumen" => "60"
                        "paginaInicial" => "925"
                        "paginaFinal" => "931"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16055622"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735085/0000003400000004/v1_201305141058/S2173508510700125/v1_201305141058/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "8927"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original article"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735085/0000003400000004/v1_201305141058/S2173508510700125/v1_201305141058/en/main.pdf?idApp=UINPBA00009S&text.app=https://www.revistafarmaciahospitalaria.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173508510700125?idApp=UINPBA00009S"
]
Share
Journal Information
Vol. 34. Issue 4.
Pages 188-193 (January 2010)
Share
Share
Download PDF
More article options
Vol. 34. Issue 4.
Pages 188-193 (January 2010)
Original article
Full text access
Compliance of prescriptions for chronic obstructive pulmonary disease patients given upon hospital discharge
Adecuación de la prescripción al alta hospitalaria en pacientes con enfermedad pulmonar obstructiva crónica
Visits
1726
B. García Robredoa,
Corresponding author
beafir@hotmail.com

Corresponding author.
, M.A. Calleja Hernándeza, M.I. Luque Vegaa, R. Ubago Péreza, M.J. Faus Dáderb
a Servicio de Farmacia, Hospital Universitario Virgen de las Nieves, Granada, Spain
b Grupo de Atención Farmacéutica, Universidad de Granada, Granada, Spain
This item has received
Article information
Abstract
Objective

Measure the degree of compliance of prescriptions given to chronic obstructive pulmonary disorder (COPD) patients upon hospital discharge by comparing them to international recommendations. Identify factors that influence the degree of compliance. Evaluate the effect of that degree of compliance on the number of COPD exacerbations.

Method

Retrospective observational study. We selected all episodes identified as COPD in a tertiary hospital during 2006. By consulting the clinical history database, we accessed the hospital discharge report and calculated the treatment's degree of proximity to the recommendations issued in the Global Initiative for Chronic Obstructive Lung Disease (GOLD). For each episode, we calculated the number of exacerbations in the six following months. Descriptive, bivariate statistical analysis.

Results

We obtained 365 episodes. The mean degree of compliance was 82% (SD=15.9). The patient's age and the severity of the disease did not influence the degree of compliance. We observed an inverse correlation between the hospital stay and the degree of compliance (P=.026). Discharge reports issued by the Pneumonology Department had a significantly higher degree of compliance (P<.001). No statistically significant relationship was found between the degree of compliance and the number of exacerbations.

Conclusions

The degree of compliance is high according to the GOLD recommendations. The Pneumology Department had the highest degree of compliance, and a higher degree of compliance was related to a shorter hospital stay. The treatment compliance had no effect on the number of exacerbations of the disease.

Keywords:
Compliance
Hospital discharge
COPD
Prescription
Resumen
Objetivo

Cuantificar el grado de adecuación de la prescripción al alta hospitalaria a las recomendaciones internacionales en pacientes con EPOC. Identificar los factores que influyen sobre el grado de adecuación. Evaluar la influencia del grado de adecuación sobre el número de reagudizaciones de la EPOC.

Método

Estudio observacional retrospectivo. Se seleccionaron todos los episodios del año 2006 con diagnóstico principal codificado como EPOC en un hospital terciario. A través de la consulta de la historia clínica digital, se accedió al informe de alta hospitalaria y se calculó el grado de adecuación a las recomendaciones de Global Initiative for Chronic Obstructive Lung Disease; se contabilizó para cada episodio el número de reagudizaciones en los 6 meses posteriores. Análisis estadístico descriptivo y bivariante.

Resultados

Se obtuvieron 365 episodios. El grado de adecuación medio fue del 82% (SD=15,9). La edad del paciente y la gravedad de la enfermedad no influyeron sobre el grado de adecuación. Se observó relación inversa entre estancia hospitalaria y grado de adecuación (p=0,026). Los informes de alta hospitalaria a cargo del servicio de neumología presentaron significativamente mayor grado de adecuación (p<0,001). No se halló relación estadísticamente significativa entre grado de adecuación y número de exacerbaciones.

Conclusiones

El grado de adecuación a las recomendaciones de Global Initiative for Chronic Obstructive Lung Disease es elevado. Se detecta mayor adecuación en el servicio de neumología y un mayor grado de adecuación se relaciona con una menor estancia hospitalaria. El grado de adecuación no influye sobre el número de reagudizaciones de la enfermedad.

Palabras clave:
Adecuación
Alta hospitalaria
EPOC
Prescripción
Full text is only aviable in PDF
References
[1.]
B.R. Celli, W. MacNee.
Miembros del Comité Estándares para el diagnóstico y tratamiento de pacientes con EPOC: resumen del position paper elaborado por el grupo de trabajo ATS/ERS.
Eur Respir J, 5 (2004), pp. 260-278
[2.]
J.A. Barberá, G. Peces Barba, A.G.N. Agustí, J.L. Izquierdo, L. Monsó, T. Montemayor, et al.
Guía clínica para el diagnóstico y el tratamiento de la enfermedad pulmonar obstructiva crónica.
Arch Bronconeumol, 37 (2001), pp. 297-316
[3.]
R. De la Fuente Cid, F.J. González Barcala, A. Pose Reino, L. Valdés Cuadrado.
Enfermedad pulmonar obstructiva crónica, un problema de salud pública.
Rev Clin Esp, 206 (2006), pp. 442-443
[4.]
V. Sobradillo, M. Miravitlles, C.A. Jiménez, R. Gabriel, J.L. Viejo, J.F. Masa, et al.
Estudio IBERPOC en España: prevalencia de síntomas respiratorios habituales y de limitación crónica al flujo aéreo.
Arch Bronconeumol, 35 (1999), pp. 159-166
[5.]
D.M. Mannino, D.M. Homa, L.J. Akinbami, E.S. Ford, S.C. Redd.
Chronic obstructive pulmonary disease surveillance- United States, 1971–2000.
MMWR, 51 (2002), pp. 1-16
[6.]
Centro Andaluz de Información de Medicamentos.
EPOC: tratamiento farmacológico. Monografías.
Escuela Andaluza de Salud Pública, (2004),
[7.]
C. Llor, J.M. Cots, A. Herreras.
Etiología bacteriana de la agudización de la bronquitis crónica en atención primaria.
Arch Bronconeumol, 42 (2006), pp. 388-393
[8.]
M. Miravitlles, T. Guerrero, C. Mayordomo, L. Sanchez-Agudo, F. Nicolau, J.L. Seu, on behalf of the EOLO Group.
Factors associated with increased risk of admission in a cohort of ambulatory COPD patients: A multiple logistic regression analysis.
Respiration, 67 (2000), pp. 495-501
[9.]
J.F. García Gutiérrez, R. Bravo Toledo.
Guías de práctica clínica en Internet.
Aten Primaria, 28 (2001), pp. 74-79
[10.]
E. Casariego Vales, E. Briones Pérez de la Blanca, C. Costa Ribas.
Qué son las Guías de Práctica Clínica.
Guías Clínicas, 7 (2007), pp. 1-5
[11.]
Global Initiative for Chronic Obstructive Lung Disease. Guide to COPD diagnosis, management, and prevention. GOLD; 2006. Available from: http://www.goldcopd.com.
[12.]
A. Jiménez Puente, J. Fernández Guerra, I. Hidalgo Rojas, S. Domingo González, A. Lara Blanquer, J. García Alegría.
Calidad de la asistencia hospitalaria y riesgo de reingreso precoz en la exacerbación aguda de la EPOC.
An Med Interna, 20 (2003), pp. 340-346
[13.]
C. Esteban, J. Moraza, M. Aburto, J.M. Quintana, A. Capelastegui.
Descripción de una muestra de pacientes con enfermedad pulmonar obstructiva crónica atendidos en las consultas del área de neumología dependientes de un hospital.
Arch Bronconeumol, 39 (2003), pp. 485-490
[14.]
J.J. Soler, L. Sánchez, M. Latorre, J. Alamar, P. Román, M. Perpiñá.
Impacto asistencial hospitalario de la EPOC Peso específico del paciente con EPOC de alto consumo sanitario.
Arch Bronconeumol, 37 (2001), pp. 375-381
[15.]
N. Roche, T. Lepage, J. Bourcereau, P. Terrioux.
Guidelines versus clinical practice in the treatment of chronic obstructive pulmonary disease.
Eur Respir J, 18 (2001), pp. 903-908
[16.]
M. Miratvilles.
Guidelines versus clinical practice in the treatment of chronic obstructive pulmonary disease.
Eur Respir J, 20 (2002), pp. 243-244
[17.]
J. De Miguel Díez, J.L. Izquierdo Alonso, J.M. Rodríguez González-Moro, P. De Lucas Ramos, J. Molina París.
Tratamiento farmacológico de la EPOC en dos niveles asistenciales Grado de adecuación a las normativas recomendadas.
Arch Bronconeumol, 39 (2003), pp. 195-202
[18.]
O.T. Rutschman, J.P. Janssens, B. Vermeulen, F.P. Sarasin.
Knowledge of guidelines for the management of COPD: a survey of primary care physicians.
Respir Med, 98 (2004), pp. 932-937
[19.]
K.F. Rabe, S. Hurd, A. Anzueto, P.J. Barnes, S.A. Buist, P. Calverley, et al.
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.
Am J Respir Crit Care Med, 176 (2007), pp. 532-555
[20.]
J.A. Walters, P.G. Gibson, R. Wood-Baker, M. Hannay, E.H. Walters.
Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease.
Cochrane Database Syst Rev, 1 (2009), pp. CD001288
[21.]
G.P. Currie, J.A. Wedzicha.
ABC of chronic obstructive pulmonary disease: Acute exacerbations.
[22.]
J. Carratalá Fernández, E. Navas Elorza, R. San Juan, F. Soriano, V. Rodríguez Cerrato.
Guía de recomendaciones en la terapia secuencial antibiótica. Guías Clínicas SEIMC.
Aguado JM, Fortún J, (2006),
[23.]
M. Decramer, et al.
Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (bronchitis randomized on NAC Cost-Utility Study BRONCUS): a randomised placebo controlled trial.
Lancet, 365 (2005), pp. 1552-1560
[24.]
J. García-Aymerich, E. Farrero, M.A. Félez, J. Izquierdo, R.M. Marrades, J.M. Antó, on behalf of the EFRAM investigators.
Risk factors of readmission to hospital for a COPD exacerbation: a prospective study.
Thorax, 58 (2003), pp. 100-105
[25.]
J.J. Soler Cataluña, M.A. Martínez García.
Factores pronósticos en la EPOC.
Arch Bronconeumol, 43 (2007), pp. 680-691
[26.]
J.J. Soler-Cataluña, M.A. Martínez-García, P. Román Sánchez, E. Salcedo, M. Navarro, R. Ochando.
Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease.
Thorax, 60 (2005), pp. 925-931

This study was partially presented at the 37th European Symposium on Clinical Pharmacy in Dubrovnik, October 2008.

Copyright © 2010. Sociedad Española de Farmacia Hospitalaria
Download PDF
Idiomas
Farmacia Hospitalaria
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.