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To determine the prevalence and characteristics of plant-based patterns in the Spanish population and assess their potential impact on individuals with similar socio-demographic backgrounds.
Design:
We estimated vegetarian and vegan individuals’ national and regional prevalence and analysed their socio-demographic characteristics and weekly dietary intake patterns. Individuals with a plant-based dietary pattern were matched to a control group (1:4) with similar socio-demographic characteristics. Associations with the prevalence risk of common chronic diseases, self-reported health status, lifestyle and healthcare use were analysed with unadjusted and adjusted logistic regression models.
Setting:
A population-based survey of individuals residing in Spain.
Participants:
Data from 22 072 participants were examined.
Results:
The prevalence of plant-based diets was 5·62‰ (95 % CI: 4·33, 7·28), and adherents were female (68·6 %), single (62·3 %) and university-educated 41·8 %) (P < 0·001). They reported higher rates of ‘never’ consuming snacks (50 % v. 35 %), fast food (58 % v. 36 %) and sweets (33 % v. 14 %). Lifestyle factors did not differ between the plant-based and omnivorous groups; however, adherence to plant-based diets was associated with a prevalence risk of depressive symptoms (OR 2·58, 95 % CI: 1·00, 6·65), stroke (OR 7·08, 95 % CI: 1·27, 39·46) and increased consultations for mental health and complementary medicine (OR 3·21, 95 % CI: 1·38, 7·43).
Conclusions:
Plant-based diets are uncommon and are associated with specific socio-demographic profiles, particularly sex. When comparing individuals with similar socio-demographic characteristics, individuals with plant-based diets and omnivores had similar lifestyles. Addressing patient concerns regarding diet and personal well-being might prioritise healthy behaviours over specific dietary patterns.
Interventions based on testing and communication training have been developed to reduce antibiotic prescribing in primary healthcare (PHC) for the treatment of acute lower respiratory infections (ALRTIs). However, research based on the experiences of PHC clinicians participating in ALTRIs interventions to reduce antibiotic prescribing in Barcelona is scanty.
Aim:
This study aimed to explore the perceptions and experiences of clinicians (physicians and nurses) on an intervention to reduce antibiotic prescription in PHC in Barcelona (Spain). This intervention was a randomised controlled study (cRCT) based on three arms: 1) use of a C-reactive protein (CRP) rapid test; 2) enhanced communication skills; and 3) combination of CRP rapid test and enhanced communication skills. In addition, the study aimed to explore the impact of COVID-19 on the detection of ALRTIs.
Methods:
This qualitative study used a socio-constructivist perspective. Sampling was purposive. Participants were selected based on age, sex, profession, intervention trial arm in which they participated, and the socioeconomic area of the PHC where they worked. They were recruited through the healthcare centres participating in the study. Nine participants (7 women and 2 men) participated in two focus groups, lasting 65–66 min, in September–October 2022. Framework analysis was used to analyse the data.
Findings:
Three themes were identified: ‘(The intervention) gave us reassurance’: intervention experiences among health professionals. This theme includes accounts of clinicians’ satisfaction with the intervention, particularly with CRP testing to support clinical diagnoses; ‘We don’t have time in primary healthcare’: structural and community resources in healthcare services. This theme encompasses clinicians’ experiences on healthcare pressures and PHC organisational structures barriers to PHC interventions; and ‘I only did three CRP’: impact of COVID-19 pandemic on the intervention. The last theme focuses on the impact of the COVID-19 pandemic on the intervention’s implementation.
Conclusions:
CPR testing and promoting communication skills can be useful tools to support clinical decisions for ALRTIs. Structural barriers (e.g., healthcare pressures) and social inequities amongst service users were acknowledged as the main barriers for the implementation of ALRTIs interventions.
Abdominal aortic aneurysm (AAA) is a progressive and silent enlargement of the aorta, but aortic rupture is associated with a high mortality rate. The main objectives of this study were to assess evidence on the clinical safety, efficacy, and cost effectiveness of an AAA screening program using abdominal ultrasound. An economic evaluation was also conducted to assess the introduction of AAA screening into the Spanish Healthcare System.
Methods
A systematic literature search was conducted according to PRISMA recommendations. Randomized controlled trials were selected to assess clinical safety and efficacy. Systematic reviews were selected to identify prognostic factors for AAA and full economic evaluations were selected for the cost-effectiveness analysis. Data extraction and assessment of evidence certainty were performed using the GRADE methodology. A Markov model was developed to perform an economic evaluation and budget impact analysis of an AAA screening program in the Spanish context.
Results
Screening had a beneficial effect on AAA detection and rates of all-cause and AAA-related mortality in men older than 65 years. It had no effect on rates of AAA rupture or emergency surgery and may increase rates of elective surgery. The evidence was very uncertain for women older than 65 years. Sex and family history of AAA were the most important prognostic factors. Economic evaluation of a program screening men older than 65 years in primary care centers resulted in 0.33 life-years gained, 0.18 quality-adjusted life-years (QALYs) gained, and an incremental cost-effectiveness ratio of EUR81.98 per QALY. The program’s implementation would cost an additional EUR15.68 to EUR28.40 per patient.
Conclusions
The implementation of an AAA screening program in men older than 65 years in Spain is considered effective and could be implemented using the infrastructure, materials, and human resources already present in the Spanish health system. Relevant indicators and dynamic monitoring of the program should be established to allow for continuous and flexible evaluation of results over time.
The prevalence of mental health disorders has significantly increased in recent years, posing substantial challenges to healthcare systems worldwide, particularly primary care (PC) settings. This study examines trends in mental health diagnoses in PC settings in Catalonia from 2010 to 2019 and identifies associated sociodemographic, clinical characteristics, psychopharmacological treatments, and resource utilization patterns.
Methods
Data from 947,698 individuals without prior severe mental illness, derived from the Data Analytics Program for Health Research and Innovation (PADRIS), were analyzed for this study. Sociodemographic data, diagnoses, and resource utilization were extracted from electronic health records. Descriptive statistics, chi-square tests, Mann–Whitney tests, and a multivariate binary logistic regression were employed to analyze the data.
Results
Over the study period, 172,112 individuals (18.2%) received at least one mental health diagnosis in PC, with unspecified anxiety disorder (40.5%), insomnia (15.7%) and unspecified depressive disorder (10.2%) being the most prevalent. The prevalence of these diagnoses increased steadily until 2015 and stabilized thereafter. Significant associations were found between mental health diagnoses, female sex, lower socioeconomic status, higher BMI, and smoking status in a multivariate binary logistic regression.
Conclusions
This study highlights a growing burden of stress-related mental health diagnoses in PC in Catalonia, driven by demographic and socioeconomic factors. These findings may be indicative of broader trends across Europe and globally. Addressing this rising prevalence requires innovative approaches and collaborative strategies that extend beyond traditional healthcare resources. Engaging stakeholders is essential for implementing effective, sustainable solutions that promote mental health in Catalonia and potentially inform similar initiatives worldwide.
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