Applying reflective multicriteria decision analysis to understand the value of therapeutic alternatives in the management of gestational and peripartum anaemia in Spain.

BACKGROUND: The objective of the FeminFER project was to assess the value of ferric carboxymaltose following a multicriteria decision analysis in obstetrics and gynaecology in Spain. METHODS: Ferric carboxymaltose (FCM) and ferrous sulphate were evaluated using the EVIDEM framework. Ten stakeholders participated to collect different perspectives. The framework was adapted considering evidence retrieved with a PICO-S search strategy and grey literature. Criteria/subcriteria were weighted by level of relevance and an evidence-based decision-making exercise was developed in each criterion; weights and scores were combined to obtain the value of intervention relative to each criterion/subcriterion, that were further combined into the Modulated Relative Benefit-Risk Balance (MRBRB). RESULTS: The most important criterion favouring FCM was Compared Efficacy/Effectiveness (0.183 ± 0.07), followed by Patient Preferences (0.059 ± 0.10). Only Direct medical costs criterion favoured FS (-0.003 ± 0.03). MRBRB favoured FCM; 0.45 ± 0.19; in a scale from -1 to + 1. CONCLUSIONS: In conclusion, considering the several criteria involved in the decision-making process, participants agreed with the use of FCM according to its MRBRB.

Tratamiento adyuvante de la vaginitis con probióticos. Grado de acuerdo basado en el método Delphi / Probiotics as adjuvant therapy for vaginitis. Agreement based on the Delphi method

Objetivo: Reconocer el grado de acuerdo/desacuerdo entre un grupo de ginecólogos españoles sobre el papel de los probióticos como tratamiento adyuvante en la vaginitis. Material y métodos: Estudio prospectivo de metodología Delphi, multicéntrico, con 123 ginecólogos de España, sobre 55 cuestiones, estructuradas en 3 bloques (vaginitis/vaginosis, uso clínico de los probióticos y microbiota vaginal). Resultados: Acuerdo muy consistente en la relación entre vaginitis y edad reproductiva, hormonas y uso de antibióticos como factores favorecedores; alta tasa de recurrencias y complicaciones asociadas a la infección, así como sobre el papel beneficioso de los probióticos. Acuerdo en que los probióticos modulan la proliferación de patógenos vaginales cuando son utilizados principalmente por vía vaginal (cápsulas o tampones). Menor acuerdo con el papel de los probióticos en reducir la transmisión de otras infecciones distintas a candidiasis y vaginosis bacteriana. Conclusiones: Existe un acuerdo muy consistente entre los ginecólogos españoles participantes, sobre el beneficio del uso de probióticos, asociado al antibiótico, para el tratamiento de la vaginitis en la prevención de recurrencias y posibles complicaciones (AU)

Objective: To determine the degree of agreement/disagreement among a group of Spanish gynecologists on the role of probiotics as adjuvant therapy for vaginitis. Material and methods: A prospective, multicenter study with Delphi methodology was performed with 123 Spanish gynecologists on 55 structured issues in 3 blocks (vaginitis/vaginosis, clinical use of probiotics, and vaginal microbiota). Results: There was highly consistent agreement on the relationship between vaginitis and reproductive age, hormones and antibiotics as predisposing factors, on the high rate of recurrence and complications associated with the infection, and on the beneficial role of probiotics. There was agreement that probiotics modulate the growth of vaginal pathogens when used mainly vaginally (capsules or tampons). There was less agreement on the role of probiotics in reducing the transmission of infections other than candidiasis and bacterial vaginosis. Conclusions: There was highly consistent agreement among the participating Spani h gynecologists on the benefits of probiotics associated with antibiotics for the treatment of vaginitis in preventing recurrences and complications (AU)

Estudio crítico del perfil del consumidor español adulto de antibióticos, en base a las Encuestas Nacionales de Salud de 1993, 1995, 1997, 2001 y 2003 / Critical study of spanish adult consumer profile of antibiotics on the basis of National Surveys of Health in 1993, 1995, 1997, 2001 y 2003

Objetivo: El objetivo de este estudio ha sido conocer el consumo de antibióticos en España a través de las Encuestas Nacionales de Salud (ENS). Material y método: Partiendo de las ENS entre 1993 y 2003, han sido analizadas ciertas variables con respecto al consumo de antibióticos; agrupándose por tipología, hábitos, comorbilidad y utilización de recursos sanitarios, y se han comparado con los datos publicados por otros autores. Resultados: El consumo de antibióticos fue del 3% aproximadamente, del que no fue prescrito el 9-19%. Se ha observado asociación estadística significativa entre el consumo de antibióticos y ciertos aspectos como el nivel de estudios e ingresos económicos, hábitos como tabaco, estado general de salud, ciertas enfermedades crónicas, guardar cama por enfermedad y consumo de ciertos medicamentos y vacuna antigripal. Conclusiones: El consumo de antibióticos coincide con lo descrito por otros autores, siendo siempre superior al prescrito. La asociación con otras variables puede estar limitada por la inadecuación del diseño de las ENS para conocer el consumo exacto de antibióticos(AU)

Objective: The objective of this study has been to examine antibiotic consumption in Spain through the use of the National Surveys of Health (NSH) . Material and methods: Taking the NSH, between 1993 and 2003, certain variables regarding the consumption of antibiotics have been analyzed; putting these into groups according to their typology, habits, co-morbidity and the utilization of health resources. This information has been compared with published data by other authors. Results: The consumption of antibiotics was approximately 3%, and 9-19% of this was not prescribed. Significant statistical associations have been observed between the consumption of antibiotics and other aspects such as academic and income levels, habits such as smoking, general health, certain chronic diseases, being bed-ridden due to disease; and also the use of certain medicines and the antiinfluenza vaccine. Conclusions: Consumption of antibiotics coincides with described data by other authors, and this was always higher than prescribed. The association with other variables may be limited by the inadequate NSH design in order to know the exact consumption of antibiotics(AU)