Utilización de fármacos en el registro REACH: desde las guías a la práctica clínica
Use of drugs in the REACH registry: from guidelines to clinical practice
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array:19 [ "pii" => "S0025775309717543" "issn" => "00257753" "doi" => "10.1016/S0210-5705(09)71003-9" "estado" => "S300" "fechaPublicacion" => "2009-06-01" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2009;132 Supl 2:44-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 11347 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 9606 "PDF" => 1735 ] ] "itemAnterior" => array:16 [ "pii" => "S0025775309717531" "issn" => "00257753" "doi" => "10.1016/S0210-5705(09)71003-9" "estado" => "S300" "fechaPublicacion" => "2009-06-01" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2009;132 Supl 2:41-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 11379 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 9627 "PDF" => 1745 ] ] "es" => array:11 [ "idiomaDefecto" => true "titulo" => "Análisis farmacoeconómico: resultados del registro REACH" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "41" "paginaFinal" => "43" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pharmacoeconomic analysis: results of the REACH registry" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carmen Suárez, Carmen Abadía, Amaya Echevarria" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Carmen" "apellidos" => "Suárez" ] 1 => array:2 [ "nombre" => "Carmen" "apellidos" => "Abadía" ] 2 => array:2 [ "nombre" => "Amaya" "apellidos" => "Echevarria" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775309717531?idApp=UINPBA00004N" "url" => "/00257753/00000132000000S2/v0_201307291439/S0025775309717531/v0_201307291440/es/main.assets" ] "es" => array:12 [ "idiomaDefecto" => true "titulo" => "Utilización de fármacos en el registro REACH: desde las guías a la práctica clínica" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "44" "paginaFinal" => "46" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Jorge Francisco Gómez Cerezo" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Jorge Francisco" "apellidos" => "Gómez Cerezo" "email" => array:1 [ 0 => "jfrancisco.gomez@salud.madrid.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Use of drugs in the REACH registry: from guidelines to clinical practice" ] ] "pdfFichero" => "2v132ns2a13147340pdf001.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec221148" "palabras" => array:7 [ 0 => "Aterotrombosis" 1 => "REACH" 2 => "Guías clínicas" 3 => "Antiagregantes" 4 => "Hipotensores" 5 => "Antidiabéticos" 6 => "Hipolipemiantes" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec221149" "palabras" => array:7 [ 0 => "Atherothrombosis" 1 => "REACH" 2 => "Clinical guidelines" 3 => "Antiplatelet agents" 4 => "Antihypertensives" 5 => "Antidiabetic agents" 6 => "Lipid lowering drugs" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<p class="elsevierStylePara">El registro REACH (REduction of Atherothrombosis for Continued Health) permite evaluar el grado de control de los factores de riesgo asociados a la aterotrombosis. Aunque el 90% de los pacientes con enfermedad vascular (EV) tomaba al menos un fármaco hipotensor, únicamente en el 42,9% se obtuvo el control de la hipertensión arterial (HTA). El origen de este control inadecuado puede ser multifactorial pero probablemente la inercia clínica, el incumplimiento terapéutico y la ausencia de terapias combinadas sean los factores responsables. El porcentaje de control de la diabetes mellitus fue aceptable en el grupo de pacientes con EV. La proporción de sujetos con valores adecuados de colesterol fue subóptima a pesar de que el 71,3% estaba en tratamiento con estatinas. El porcentaje de pacientes con tabaquismo activo fue del 12% en el grupo de pacientes con EV. Más del 80% de la población total tomaba al menos un antiagregante. Aunque el empleo de antiagregantes en prevención secundaria es generalizado y se va ampliando el uso de hipolipemiantes, en la mayoría de los pacientes con EV establecida no se alcanzan los objetivos de presión arterial y colesterol. En el estudio REACH un porcentaje relevante de pacientes no consigue el control adecuado de los factores de riesgo cardiovascular y no recibe los tratamientos recomendados en las guías clínicas.</p>" ] "en" => array:1 [ "resumen" => "<p class="elsevierStylePara">The REACH registry allows the degree of control of risk factors associated with atherothrombosis to be evaluated. Although 90% were taking at least one antihypertensive agent, hypertension was controlled in only 42.9% of the patients with vascular disease. This inadequate control may have multiple causes but the main factors are probably clinical inertia, lack of treatment adherence and the absence of combination therapies. Among patients with vascular disease, the percentage of those with good diabetes mellitus control was acceptable. The proportion of subjects with healthy cholesterol levels was suboptimal, even though 71.3% were receiving statins. The percentage of active smokers was 12% in the group of patients with vascular disease. More than 80% of the total population was taking at least one antiplatelet agent. Although the use of these agents is widespread in secondary prevention and that of lipid-lowering drugs is increasing, blood pressure and cholesterol goals are not being achieved in most patients with established vascular disease. In the REACH study, a substantial percentage of patients are not achieving adequate control of cardiovascular risk factors and are not receiving the treatments recommended in clinical practice guidelines.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:12 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "International prevalence, recognition and treatment of cardiovascular risk factors in outpatients with atherothrombosis." 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