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Arietaleanizbeascoa Sarabia, Marisol
Nuevas tecnologías, Procesos críticos , Procesos crónicos, Promoción de la salud / Educación sanitaria, Salud mental, Metodología docente.
  • Unidad de Investigación de Atención Primaria de Bizkaia-Osakidetza
Efecto del ejercicio físico en pacientes con demencia. Ensayo clínico aleatorio
Proyecto
28/02/15
Área:
Procesos crónicos
Ámbito:
Atención Primaria/Comunitaria
Metodología:
Experimental
Población:
Adultos > 18 años
Investigadores:
Marisol Arietaleanizbeascoa Sarabia
Financiación:
Nacional
Año:
2012 - 2015

Supervised physical exercise to improve the quality of life of cancer patients: the EFICANCER randomised controlled trial
Artículo
06/02/15
Área:
Procesos crónicos
Ámbito:
Varios Ámbitos
Metodología:
Experimental
Población:
Adultos > 18 años
Autores:
Sancho A, Carrera S, Arietaleanizbeascoa M, Arce V, Gallastegui NM, March AG, et al

Background
The optimal form of exercise for individuals with cancer has yet to be identified, but there is
evidence that exercise improves their quality of life. The aim of this study is to assess the
efficacy and efficiency of an innovative physical exercise programme, for individuals
undergoing chemotherapy for breast, gastrointestinal or non-small cell lung tumours, for
improving quality of life, reducing level of fatigue, and enhancing functional capacity over
time.
Design/Methods
We will conduct a clinical trial in 66 patients with stage IV breast, gastrointestinal or nonsmall
cell lung cancer, recruited by the Department of Oncology of the referral hospital from
4 primary care health centres of the Basque Health Service (Osakidetza). These patients will
be randomised to one of two groups. The treatment common to both groups will be the usual
care for cancer: optimized usual drug therapies and strengthening of self-care; in addition,
patients in the intervention group will participate in a 2-month exercise programme, including
both aerobic and strength exercises, supervised by nurses in their health centre. The principal
outcome variable is health-related quality of life, measured blindly with the 30-item
European Organization for the Research and Treatment of Cancer Core Quality of Life
Questionnaire and Short Form-36 four times: at baseline, and 2, 6 and 12 months later. The
secondary outcome variables are fatigue (Functional Assessment of Chronic Illness Therapy-
Fatigue questionnaire), functional capacity (6-Minute Walk Test and cardiorespiratory test),
muscle strength (hand-held dynamometry and sit-to-stand test), radiological response to
treatment (Response Evaluation Criteria In Solid Tumors) and progression-free and overall
survival. Age, sex, diagnosis, chemotherapy regimen, Eastern Cooperative Oncology Group
performance status and smoking status will be considered as predictive variables. Data will
be analysed on an intention-to-treat basis, comparing changes at each time point between
groups, adjusting for baseline values by analysis of covariance.
Discussion
As well as achieving the objectives set, this study will provide us with information on patient
perception of the care received and an opportunity to develop a project based on collaborative
action between the primary care and oncology professionals.

Glycemic index, glycemic load, and pulse wave reflection in adults
Artículo
28/08/14
Área:
Promoción de la salud / Educación sanitaria
Ámbito:
Atención Primaria/Comunitaria
Metodología:
Experimental
Población:
Adultos > 18 años
Autores:
J.I. Recio-Rodriguez a, M.A. Gomez-Marcos a, M.-C. Patino-Alonso b,E. Rodrigo-De Pablo c, A. Cabrejas-Sánchez d, M.S. Arietaleanizbeaskoa

Background and aims: Diets with a high glycemic index (GI), high glycemic load (GL),
or both, increase the risk of cardiovascular disease. This study examined the association of GI and
GL in a regular diet with the peripheral augmentation index (i.e., a marker of vascular aging) in a
sample of adults.
Methods and Results: Cross-sectional study. The findings presented in this manuscript are a subanalysis
of the EVIDENT study whose purpose was to analyze the relationship between lifestyle
and arterial aging. For the sample population, 1553 individuals aged 20e80 years were selected
through random sampling from the patients of general practitioners at six health centers in
Spain. GI and GL for each patient’s diet were calculated from a previously validated, semiquantitative,
137-item food frequency questionnaire. The peripheral augmentation index corrected
for a heart rate of 75 bpm (PAIx75) was measured with pulse-wave application software
(A-Pulse CASP). Based on a risk factor adjusted regression model, for every 5 unit increase in GI,
the PAIx75 increased by 0.11 units (95% CI: 0.04e0.19). Similarly, for every increase in 10 units in
GL, the PAIx75 increased by 1.13 (95% CI: 0.21e2.05). High PAIx75 values were observed in individuals
with diets in the third GI tertile (i.e., the highest), and lower PAIx75 values in those with
diets in the first tertile (i.e., the lowest), (93.1 vs. 87.5, respectively, p Z 0.001).
Conclusions: GI and GL were directly associated with PAIx75 values in adults without cardiovascular
diseases regardless of age, gender, physical activity, and other confounders.

Research within the reach of Osakidetza professionals: Primary Health Care Research Program
Artículo
01/04/14
Área:
Metodología docente
Ámbito:
Atención Primaria/Comunitaria
Metodología:
Estudio descriptivo
Población:
Adultos > 18 años
Autores:
Grandes G, Arce V,Arietaleanizbeaskoa M.
Ref. Bibliográfica:
Objetivo:Describir el proceso y resultados del Programa de Investigación en Atención Primaria de Salud 2010-2011, organizado por la Unidad de Investigación de Atención Primaria de Bizkaia.Estudio descriptivo. .Esta experiencia puede servir para otros interesados en el fomento de la investigación en atención primaria de salud (APS), ya que el programa ha logrado sus objetivos, es útil y productivo

Effectiveness of a smartphone application for improving healthy lifestyles, a randomized clinical trial (EVIDENT II): study protocol
Artículo
15/03/14
Área:
Promoción de la salud / Educación sanitaria
Ámbito:
Atención Primaria/Comunitaria
Metodología:
Experimental
Población:
Adultos > 18 años
Autores:
Recio-Rodríguez JI, Martín-Cantera C, González-Viejo N, Gómez-Arranz A, Arietaleanizbeascoa MS, Schmolling-Guinovart Y, Maderuelo-Fernandez JA,Pérez-Arechaederra D, Rodriguez-Sanchez E, Gómez-Marcos MA, García-Ortiz L;EVIDENT Group

Background: New technologies could facilitate changes in lifestyle and improve public health. However, no large
randomized, controlled studies providing scientific evidence of the benefits of their use have been made. The aims
of this study are to develop and validate a smartphone application, and to evaluate the effect of adding this tool
to a standardized intervention designed to improve adherence to the Mediterranean diet and to physical activity.
An evaluation is also made of the effect of modifying habits upon vascular structure and function, and therefore
on arterial aging.
Methods/Design: A randomized, double-blind, multicenter, parallel group clinical trial will be carried out. A total of
1215 subjects under 70 years of age from the EVIDENT trial will be included. Counseling common to both groups
(control and intervention) will be provided on adaptation to the Mediterranean diet and on physical activity. The
intervention group moreover will receive training on the use of a smartphone application designed to promote a
healthy diet and increased physical activity, and will use the application for three months. The main study endpoints will
be the changes in physical activity, assessed by accelerometer and the 7-day Physical Activity Recall (PAR) interview, and
adaptation to the Mediterranean diet, as evaluated by an adherence questionnaire and a food frequency questionnaire
(FFQ). Evaluation also will be made of vascular structure and function based on central arterial pressure, the
radial augmentation index, pulse velocity, the cardio-ankle vascular index, and carotid intima-media thickness.
Discussion: Confirmation that the new technologies are useful for promoting healthier lifestyles and that their
effects are beneficial in terms of arterial aging will have important clinical implications, and may contribute to
generalize their application in favor of improved population health.

Supervised exercise for acute coronary patients in primary care: a randomized clinical trial
Artículo
02/01/14
Área:
Procesos crónicos
Ámbito:
Atención Primaria/Comunitaria
Metodología:
Experimental
Población:
Adultos > 18 años
Autores:
Ortega R et al

Background. Functional capacity is a prognostic factor for coronary patients; accordingly, they
are recommended to walk.
Objective. To assess whether an exercise program supervised in primary care increases their
functional capacity more than unsupervised walking.
Methods. A randomized clinical trial was carried out at eight primary care centres of the Spanish
Health Service and involving 97 incident cases of low-risk acute coronary patients, <80 years old,
randomly assigned to either an unsupervised walking program (UW group; n = 51) or a 6-month
cycle ergometer exercise program with gradually increasing frequency and workload intensity
supervised by primary care nurses (SE group; n = 46). The two groups received the same common
components of secondary prevention care. Changes in functional capacity were assessed
in terms of peak oxygen consumption (VO2peak) during exercise testing measured at baseline
and at 7 months by cardiologists blinded to group assignment.
Results. Overall, 76% of participants completed the study, 30 in the SE and 44 in the UW.
Both groups increased baseline-adjusted VO2peak: 5.56 ml/kg per minute in the SE (95% confidence
interval [CI] 3.38–7.74) and 1.64 ml/kg per minute in the UW (95% CI −0.15 to 3.45). The
multivariate-adjusted difference between groups was 4.30 ml/kg per minute (95% CI 1.82–6.79;
P = 0.001) when analyzing completers and 2.83 ml/kg per minute (95% CI 0.61–5.05; P = 0.01)
in the intention-to-treat analysis, including all participants with baseline values carried forward
for those lost to follow-up.
Conclusions. A cycle ergometer exercise program supervised by primary care nurses increased
the functional capacity of coronary patients more than unsupervised walking with a clinically
relevant difference

"Validez y fiabilidad de instrumentos de detección y de medición de hábitos y estilos de vida
Proyecto
01/02/13
Área:
Promoción de la salud / Educación sanitaria
Ámbito:
Atención Primaria/Comunitaria
Metodología:
Validación de instrumentos
Población:
Adultos > 18 años
Investigadores:
Marisol Arietaleanizbeascoa Sarabia
Financiación:
Nacional
Año:
2012 - 2013

Reliability and validity of the 7-day Physical Activity Recall interview in a Spanish population
Artículo
25/07/12
Área:
Nuevas tecnologías
Ámbito:
Atención Primaria/Comunitaria
Metodología:
Validación de instrumentos
Población:
Adultos > 18 años
Autores:
Zuazagoitia A, Montoya I, Grandes G, Arietaleanizbeascoa MS, Arce V, Martinez V, Sanchez M, Sanchez A

The aim of this study was to assess the reliability and convergent validity of the 7-day Physical Activity Recall (7-day PAR) interview in a sample of the Spanish population. Valid 7-day PAR interviews were conducted and RT3 accelerometer measurements taken for 160 subjects from the primary care population aged 24–83, 75 men and 85 women. Two 7-day PAR interviews were conducted, with a one-week interval, with 147 of these participants. Test–retest reliability was assessed using intraclass correlation coefficients. Convergent validity between the 7-day PAR and the accelerometer data were examined using Spearman's correlation coefficients, and the kappa index of agreement was calculated. The 7-day PAR reliability coefficients were 0.68 (95%CI: 0.58–0.76) for total energy expenditure, 0.65 (95%CI: 0.54–0.73) for the activity dose, and 0.61 (95%CI: 0.50–0.70) and 0.75 (95%CI: 0.67–0.81) for time spent on moderate and vigorous-intensity activity, respectively. These coefficients ranged from 0.91 to 0.96 in participants who reported a typical week in both interviews. Convergent validity ranged from 0.25 for time spent on vigorous activity to 0.52 for the activity dose, and the kappa index was 0.43 (95%CI: 0.30–0.56). Reliability and convergent validity coefficients in the Spanish population were generally moderate and similar to those found in other studies.

The burden of mental disorders in primary care
Artículo
13/11/10
Área:
Salud mental
Ámbito:
Atención Primaria/Comunitaria
Metodología:
Estudio descriptivo
Población:
Adultos > 18 años
Autores:
G. Grandes , I. Montoya, M.S. Arietaleanizbeaskoa, V. Arce, A. Sanchez

Objectives: To describe and compare the prevalence of mental disorders across primary care populations,
and estimate their impact on quality of life.
Methods: Cross-sectional multilevel analysis of a systematic sample of 2539 attendees to eight primary
care centres in different regions of Spain, assessed with the WHO Composite International Diagnostic
Interview (CIDI 1.1), the Short Form Health Survey (SF-36) quality of life questionnaire and the SF-6D
utility index.
Results: The 12-month prevalence of any mental disorder was 23% (95% confidence interval: 21–24%),
10% had mood, 9% anxiety, 5% organic, 4% somatoform, and 1% alcohol use disorders, with a significant
between-centre variability (P < 0.001). People with mental disorders had one standard deviation lower
mental quality of life than the general population. We estimated that 1831 quality-adjusted life-years
(QALYs) are lost annually per 100,000 patients due to mental disorders, without considering mortality.
Mood disorders have the worst impact with an annual loss of 1124 QALYs per 100,000 patients, excluding
mortality (95% confidence interval: 912–1351).
Conclusions: Prevalence rates were similar to those obtained in international studies using the same
diagnostic instrument and, given the significant between-centre variability found, it is recommended
that mental health statistics be considered at small area level. Mental disorders, and especially mood
disorders, are associated with very poor quality of life and higher scores on disability indexes than other
common chronic conditions.

Rationale and design of a randomised controlled trial evaluating the effectiveness of an exercise program to improve the quality of life of patients with heart failure in primary care: The EFICAR study protocol
Artículo
25/01/10
Área:
Procesos críticos
Ámbito:
Atención Primaria/Comunitaria
Metodología:
Experimental
Población:
Adultos > 18 años
Autores:
Ana Zuazagoitia, Gonzalo Grandes, Jesús Torcal, Iñaki Lekuona, Pilar Echevarria, Manuel A Gómez, Mar Domingo, Maria M de la Torre, Jose I Ramírez, Imanol Montoya, Juana Oyanguren, Ricardo Ortega- Sánchez Pinilla, the EFICAR Group

Background: Quality of life (QoL) decreases as heart failure worsens, which is one of the greatest worries of these
patients. Physical exercise has been shown to be safe for people with heart failure. Previous studies have tested
heterogeneous exercise programs using different QoL instruments and reported inconsistent effects on QoL. The
aim of this study is to evaluate the effectiveness of a new exercise program for people with heart failure (EFICAR),
additional to the recommended optimal treatment in primary care, to improve QoL, functional capacity and
control of cardiovascular risk factors.
Methods/Design: Multicenter clinical trial in which 600 patients with heart failure in NYHA class II-IV will be
randomized to two parallel groups: EFICAR and control. After being recruited, through the reference cardiology
services, in six health centres from the Spanish Primary Care Prevention and Health Promotion Research Network
(redIAPP), patients are followed for 1 year after the beginning of the intervention. Both groups receive the
optimized treatment according to the European Society of Cardiology guidelines. In addition, the EFICAR group
performs a 3 month supervised progressive exercise program with an aerobic (high-intensity intervals) and a
strength component; and the programme continues linked with community resources for 9 months. The main
outcome measure is the change in health-related QoL measured by the SF-36 and the Minnesota Living with Heart
Failure Questionnaires at baseline, 3, 6 and 12 months. Secondary outcomes considered are changes in functional
capacity measured by the 6-Minute Walking Test, cardiac structure (B-type natriuretic peptides), muscle strength
and body composition. Both groups will be compared on an intention to treat basis, using multi-level longitudinal
mixed models. Sex, age, social class, co-morbidity and cardiovascular risk factors will be considered as potential
confounding and predictor variables.
Discussion: A key challenges of this study is to guarantee the safety of the patients; however, the current scientific
evidence supports the notion of there being no increase in the risk of decompensation, cardiac events,
hospitalizations and deaths associated with exercise, but rather the opposite. Safety assurance will be based on an
optimized standardised pharmacological therapy and health education for all the participants.
Trial Registration: Clinical Trials.gov Identifier: NCT01033591

“Evaluación Multicéntrica del Programa Experimental de Promoción de la Actividad Física (PEPAF)”
Proyecto
01/07/06
Área:
Promoción de la salud / Educación sanitaria
Ámbito:
Atención Primaria/Comunitaria
Metodología:
Experimental
Población:
Adultos > 18 años
Investigadores:
Marisol Arietaleanizbeascoa Sarabia
Financiación:
Nacional
Año:
2003 - 2006