{"id":117738,"date":"2018-03-11T10:47:23","date_gmt":"2018-03-11T10:47:23","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/la-receta-medica-como-instrumento-del-estudio-del-consumo-de-medicamentos-en-la-region-de-murcia\/"},"modified":"2018-03-11T10:47:23","modified_gmt":"2018-03-11T10:47:23","slug":"la-receta-medica-como-instrumento-del-estudio-del-consumo-de-medicamentos-en-la-region-de-murcia","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/salud-publica\/la-receta-medica-como-instrumento-del-estudio-del-consumo-de-medicamentos-en-la-region-de-murcia\/","title":{"rendered":"La receta m\u00e9dica como instrumento del estudio del consumo de medicamentos en la regi\u00f3n de murcia."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Diego Pablo Sanchez  Martinez <\/strong><\/h2>\n<p>Resumen objetivos estudio 1: analizar las diferencias por g\u00e9nero y edad en el consumo de medicamentos cardiovasculares. estudio 2: evaluar el efecto de las pol\u00edticas de copago farmac\u00e9utico en la cantidad y la tendencia de consumo de medicamentos. estudio 3: analizar el consumo de antibi\u00f3ticos en la regi\u00f3n de murcia en el contexto nacional y europeo. metodolog\u00eda estudio 1: an\u00e1lisis descriptivo, estratificado por grupos de edad y sexo, del consumo de medicamentos. Se calcularon las razones de dhd por edad y g\u00e9nero compr\u00e1ndolas por tablas de contingencia complementadas con el test de ji al cuadrado. estudio 2: an\u00e1lisis de regresi\u00f3n lineal segmentada de series temporales de consumo de medicamentos expresado en n\u00famero de envases y dhd, con un an\u00e1lisis diferenciado de los cinco grupos terap\u00e9uticos de mayor consumo.  estudio 3: estudio observacional retrospectivo referido a la dispensaci\u00f3n de antibi\u00f3ticos mediante receta en la regi\u00f3n de murcia durante el a\u00f1o 2011. Se calcularon las tasas de consumo expresada en dhd y las razones de utiliza-ci\u00f3n estandarizadas. resultados estudio 1: la probabilidad de recibir tratamiento antiagregante aumenta con la edad, siendo las tasas de consumo superiores en hombres. En el caso de betabloqueantes y ara ii, su uso aumenta con la edad hasta los 79 a\u00f1os y el consumo es mayor en los hombres hasta los 65 a\u00f1os. La probabilidad de recibir tratamiento con calcioantagonistas, iecas y estatinas aumenta con la edad, superando la proporci\u00f3n de hombres en tratamiento a la de mujeres en las edades tempranas, con tendencia a igualarse a partir de los 80 a\u00f1os.   estudio 2: la dispensaci\u00f3n de los 5 grupos terap\u00e9uticos analizados dismi-nuy\u00f3 inmediatamente despu\u00e9s de la introducci\u00f3n de los cambios en el copago. El modelo de regresi\u00f3n segmentada indi\u00f3 que la tasa de consumo en los bene-ficiarios pensionistas del sms habr\u00eda disminuido un 6,76% (ic 95% -8,66% a -5,19%) 12 meses despu\u00e9s de la reforma, en comparaci\u00f3n con la ausencia de una pol\u00edtica de este tipo. Por otro lado la pendiente de crecimiento del consumo se increment\u00f3 de 6,08 (p &lt;0,001) a 12,17(p = 0,019). estudio 3: la tasa de consumo de antibi\u00f3ticos en 2011 en la regi\u00f3n de murcia fue de 30,05 dhd, muy superior a la media nacional (20,9 dhd) y a la de la uni\u00f3n europea (21,57 dhd). Las \u00e1reas de salud con mayor y menor tasa de consumo son, respectivamente vega alta (rue: 124.44; ic95% 124,26 a 124,61) y cartagena (rue: 84.16; ic95% 84,10 a 84,22). Los usuarios mutua-listas de la regi\u00f3n de murcia tienen tasas de consumo superiores a las de los beneficiarios del servicio regional de salud (rue: 105,01; ic95% 104,86 a 105,17) conclusiones estudio 1: este estudio pone de manifiesto que actualmente la prevenci\u00f3n de la enfermedad cardiovascular se centra en la poblaci\u00f3n de 40 a 74 a\u00f1os. El acceso de la mujer a la terap\u00e9utica cardiovascular se produce con un retardo de 3 a 5 a\u00f1os, por lo que deber\u00edan promoverse cambios para mejorar la identi-ficaci\u00f3n precoz de enfermedad cardiovascular en la mujer.  estudio 2: la aplicaci\u00f3n de los cambios en la pol\u00edtica de copago se podr\u00eda asociar con una disminuci\u00f3n significativa de las tasas de consumo de medica-mentos en la regi\u00f3n de murcia, pero parece que con un efecto temporal limita-do en los grupos terap\u00e9uticos analizados, ya que de manera casi simult\u00e1nea se ha producido un aumento en la tendencia de crecimiento. estudio 3: existe  una elevada prescripci\u00f3n de antibi\u00f3ticos en la regi\u00f3n de murcia, observ\u00e1ndose adem\u00e1s una notable variabilidad entre  las distintas \u00e1reas de salud, principalmente en el caso de cefalosporinas y macr\u00f3lidos, que podr\u00eda estar en parte asociada al nivel de frecuentaci\u00f3n. palabras clave medicamentos cardiovasculares, farmacoepidemiolog\u00eda, grupos de edad, g\u00e9nero, utilizaci\u00f3n de medicamentos, copago, an\u00e1lisis de series temporales, antibi\u00f3ticos, farmacoepidemiolog\u00eda, uso de medicamentos, variabilidad, pres-cripci\u00f3n.    abstract objectives study 1: to estimate the use of cardiovascular medicines and its distribu-tion by age and sex. study 2: to analyze if reforms concerning the pharmaceutical reimburse-ment scheme in spain have been associated with changes in the volume and trend of pharmaceutical consumption. study 3: to describe antibiotic consumption in the region of murcia in 2011, within the spanish and european context, as well as to analyze the dif-ferences within the region, both between health areas, and between users of the regional health service and those protected by the civil servants&apos; mutual in-surance society (muface). methodology study 1: observational study. Daily doses of cardiovascular drugs pre-scribed and dispensed in all the pharmacies of the region per 1,000 inhabitans-day (dhd. A comparison was made of consumption rates (dhd) by age and sex.  study 2: segmented regression analysis of interrupted time-series of pre-scription drug consumption. study 3: retrospective observational study of prescriptions dispensed by the pharmacies in the region of murcia during 2011. Consumption rates were expressed as defined daily doses (ddd) per 1,000 inhabitants\/day and stan-dardized consumption ratios (scr). results study 1: the probability of receiving antiplatelet drugs increases with age, with the proportion of men being higher. The use of beta-blockers and angio-tensin ii increases with age up to 79 years, with an increased consumption in men up to 65 years. The probability of receiving treatment with calcium channel blockers, ace inhibitors or statins, linearly increases with age, and the propor-tion of men under treatment exceeds that of women in the early ages, tending to equalize beyond 80 years. study 2: dispensing of all five therapeutic classes fell immediately after co-payment changes. The segmented regression model suggested that per pa-tient drug consumption in pensioners may have decreased by about 6,76% (ic 95% -8,66% a -5,19%) in the twelve months after the reform, compared with the absence of such a policy. Furthermore the slope of the series of consumption increased from 6,08 (p&lt;0,001) to 12,17 (p=0,019). study 3: overall antibiotics consumption rate in the region of murcia in 2011 was 30.05 ddd\/1000\/ day, which is much above the average rate for spain (20.9 dhd) and for the european union (21.57 dhd). Health areas within the region with the highest and lowest consumption rate are, respectively, vega alta (scr:124.44; ci95% 124.26 to 124.61) and cartagena (scr:84.16; ci95% 84.10 to 84.22). Civil servants covered by the mutual society have higher consumption rates than users of the regional health service (scr: 105.01; ci95% 104.86 to 105.17). conclusions study 1: this study shows that the cardiovascular disease prevention fo-cuses on people aged 40 to 74 years. Access by women to cardiovascular ther-apy occurs with a delay of 3-5 years, depending on the treatment subgroup. Changes should be promoted to encourage rational and equitable access and use of the drugs. study 2: the implementation of copayment policies could be associated with a significant decreased level in the level of prescribed drug in murcia re-gion, but this effect seems to have been only temporary in the five therapeutic groups analyzed, since almost simultaneously there has been an increase in the growth trend. study 3: there is a high level of antibiotic prescription in the region of murcia region in relative terms. A great variability in antibiotics consumption was observed between the different health areas, which might be related to the higher rate of the frequency of visits. The highest amount of variability in antibi-otics prescription was found in cephalosporins and macrolides. keywords cardiovascular agents, pharmacoepidemiology, age groups, gender, drug use, co-payment, time series analysis, antibiotics, pharmacoepidemiology, drug utilization, variability, prescription.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>La receta m\u00e9dica como instrumento del estudio del consumo de medicamentos en la regi\u00f3n de murcia.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 La receta m\u00e9dica como instrumento del estudio del consumo de medicamentos en la regi\u00f3n de murcia. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Diego Pablo Sanchez  Martinez <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 29\/06\/2015<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Alberto Manuel Torres Cantero<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: felix Lobo aleu <\/li>\n<li>Jos\u00e9 Mar\u00eda Abellan perpi\u00f1an (vocal)<\/li>\n<li>Mar\u00eda teresa Ruiz cantero (vocal)<\/li>\n<li>isabel Tovar zapata (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Diego Pablo Sanchez Martinez Resumen objetivos estudio 1: analizar las diferencias por g\u00e9nero y edad en el 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