Attitudes towards anti-smoking legislation and prevalence of tobacco consumption in Spanish primary healthcare personnel.

INTRODUCTION: Our aim was to ascertain how the anti-smoking legislation of 2005/2010 has affected the behavior of primary healthcare center (PHC) personnel (medical and nonmedical) with respect to their attitudes towards tobacco, its consumption and the legislative changes. METHODS: We conducted a multi-center descriptive study of a randomized conglomerate sample of PHC personnel from each Autonomous Community in Spain. The questionnaire covered tobacco consumption, and knowledge/attitudes towards smoking and legislation. The statistical analysis used SPSS software. RESULTS: The sample consisted of 2040 PHC employees (1578 women, 77.4%). Never smokers, ex-smokers, and smokers represented 46.7%, 37.8%, and 15.5% of the sample, respectively. Tobacco prevalence amongst physicians and nurses was 12.3%. Following the introduction of the antismoking legislation, a decrease in consumption was observed. Most of the participants considered that tobacco consumption affected health, was an addictive illness, and passive smoking had an impact on the health of non-smokers. Whilst 91.6% agreed with the current legislation, only 25% felt that it encouraged cessation. CONCLUSIONS: Spanish primary healthcare professionals have a relatively low prevalence of smoking compared to the general population. It is necessary to implement more legislative measures to improve and maintain this outcome.

Calidad de vida y satisfacción con el tratamiento de sujetos con diabetes tipo 2: resultados en España del estudio PANORAMA / Quality of life and satisfaction with treatment in subjects with type 2 diabetes: Results in Spain of the PANORAMA study

OBJETIVOS: La evaluación de la calidad de vida y la satisfacción con el tratamiento relacionados con la diabetes tipo 2 han sido poco estudiados. Ambos son los objetivos principales del estudio PANORAMA (NCT00916513). También se evalúa el grado de control metabólico, los patrones de tratamiento y la actuación del profesional sanitario. MATERIAL Y MÉTODOS: Estudio observacional, transversal y multicéntrico que incluyó pacientes diabéticos tipo 2 mayores de 40 años seleccionados de manera aleatorizada entre los centros de salud españoles. Se determinó la HbA1c mediante un mismo sistema y cada paciente completó cuestionarios de calidad de vida (EQ-5D y ADDQoL), satisfacción con el tratamiento (DTSQ) y temor a la hipoglucemia (HFS-II). RESULTADOS: Cincuenta y cuatro investigadores incluyeron 751 pacientes. El 60,3% presenta HbA1c < 7%. El mayor tiempo de evolución de la enfermedad y los tratamientos complejos, especialmente con insulina, se asocian a peor control. Cerca de un 25% de los pacientes en monoterapia presenta HbA1c ≥ 7%. Aunque la satisfacción con el tratamiento en general es buena (media 29,3 ± 6,1, escala de 0 a 36 puntos), los pacientes con peor control metabólico, hipoglucemias previas y tratamientos más complejos refieren significativamente peor calidad de vida y más miedo a sufrir hipoglucemias. CONCLUSIONES: Aunque el grado de control metabólico ha avanzado, todavía existen áreas de mejora. La adición precoz a la monoterapia de fármacos seguros ayudaría a lograr los objetivos de control sin aumentar el riesgo de hipoglucemias, y retrasando el inicio del tratamiento con insulina. Esto mejoraría la calidad de vida y la satisfacción con el tratamiento

OBJECTIVES: Few studies are available on quality of life and treatment satisfaction of patients with type 2 diabetes mellitus (T2DM). Both of them were the primary objectives of the PANORAMA (NCT00916513) study. Metabolic control, treatment patterns, and management by healthcare professionals were also evaluated. MATERIAL AND METHODS: This multicenter, cross-sectional, observational study randomly recruited > 40 year-old patients with T2DM from Spanish healthcare centers. HbA1c was measured using the same technique in all patients, who also completed quality of life (EQ-5D and ADDQoL) and treatment satisfaction (DTSQ) questionnaires and the Hypoglycemia Fear Survey (HFS-II). RESULTS: Fifty-four investigators recruited 751 patients, 60.3% of whom had HbA1c levels < 7%. Approximately 25% of patients on monotherapy had HbA1c values ≥ 7%, Patients with longer disease duration and more complex treatments, especially with insulin, showed the poorer control. Despite good overall treatment satisfaction (mean 29.3 ± 6.1, 0 to 36-point scale), patients with a poorer metabolic control, previous hypoglycemia episodes, and more complex therapies had a worse QoL and a greater fear of suffering hypoglycemia. CONCLUSIONS: Despite advances in metabolic control, there are still areas to improve. Early addition of safe drugs to monotherapy would help achieve control objectives without increasing the risk of hypoglycemia, and delaying the start of insulin therapy. This would also improve QoL and treatment satisfaction

Quality of life and satisfaction with treatment in subjects with type 2 diabetes: results in Spain of the PANORAMA study.

OBJECTIVES: Few studies are available on quality of life and treatment satisfaction of patients with type 2 diabetes mellitus (T2DM). Both of them were the primary objectives of the PANORAMA (NCT00916513) study. Metabolic control, treatment patterns, and management by healthcare professionals were also evaluated. MATERIAL AND METHODS: This multicenter, cross-sectional, observational study randomly recruited>40 year-old patients with T2DM from Spanish healthcare centers. HbA1c was measured using the same technique in all patients, who also completed quality of life (EQ-5D and ADDQoL) and treatment satisfaction (DTSQ) questionnaires and the Hypoglycemia Fear Survey (HFS-II). RESULTS: Fifty-four investigators recruited 751 patients, 60.3% of whom had HbA1c levels <7%. Approximately 25% of patients on monotherapy had HbA1c values ≥ 7%, Patients with longer disease duration and more complex treatments, especially with insulin, showed the poorer control. Despite good overall treatment satisfaction (mean 29.3±6.1, 0 to 36-point scale), patients with a poorer metabolic control, previous hypoglycemia episodes, and more complex therapies had a worse QoL and a greater fear of suffering hypoglycemia. CONCLUSIONS: Despite advances in metabolic control, there are still areas to improve. Early addition of safe drugs to monotherapy would help achieve control objectives without increasing the risk of hypoglycemia, and delaying the start of insulin therapy. This would also improve QoL and treatment satisfaction.