Abstract:
OBJECTIVE:To evaluate the efficacy of metformin against placebo, diet, oral anti-diabetics, or insulin in type 2 diabetes mellitus. DESIGN:Systematic review. DATA SOURCES:MEDLINE (1966-2003), EMBASE (1974-2003), LILACS (1986-2003), Cochrane library (Issue 3, 2003). SELECTION OF STUDIES:29 randomized clinical trials of metformin in monotherapy, with results on mortality, morbidity, and biochemistry. EXTRACTION OF DATA: RevMan 4 computer program. Two reviewers extracted the data and evaluated the quality. MAIN VARIABLES:any clinical event related to diabetes (mortality, coronary disease, stroke, arterial disease, and retinopathy). Secondary variables: weight and biochemistry. RESULTS:29 clinical studies with 37 comparisons of metformin were analyzed (13 with sulphonylureas, 12 with placebo, 3 with diet, 3 with thiazolidinediones, 2 with alpha-glucosidase inhibitors, 2 with insulin, and 2 with meglitinides). Metformin was more beneficial than the sulphonylureas or insulin for any clinical event associated with diabetes (relative risk [RR]=0.78; 95% confidence interval [CI], 0.65-0.94) and than diet (RR=0.74; 95% CI, 0.60-0.90). Metformin decreased glycosylated hemoglobin A1 (weighted mean difference, -1.21%; 95% CI, -1.48 to -0.94), low density lipoprotein cholesterol (weighted mean difference, -0.24; 95% CI, -0.40 to -0.09), and weight (standardized mean difference, -0.11; 95% CI, -0.18 to -0.04). Metformin was more beneficial than the placebo, diet or the thiazolidinediones on glycosylated hemoglobin A1, and than the sulphonylureas or insulin on weight. CONCLUSIONS:In the long term metformin reduces the risks of clinical events associated with diabetes. There are no long term clinical trials which compare alpha-glucosidase inhibitors, meglitinides, and thiazolidinediones with metformin, in primary results. The different treatments compared with metformin did not obtain more benefit for the secondary results evaluated.
journal_name
Aten Primariajournal_title
Atencion primariaauthors
Sáenz Calvo A,Fernández Esteban I,Mataix Sanjuán A,Ausejo Segura M,Roqué M,Moher Ddoi
10.1157/13078602subject
Has Abstractpub_date
2005-09-15 00:00:00pages
183-91issue
4eissn
0212-6567issn
1578-1275pii
13078602journal_volume
36pub_type
杂志文章,meta分析,评审abstract:OBJECTIVE:To determine whether hypercholesterolaemia treatment with pravastatin causes modifications in plasma fibrinogen. DESIGN:Descriptive, prospective pharmacological intervention study, with two transversal cuts, one at the start and one after 6 months pravastatin treatment. SETTING:Health area located in the su...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1016/s0212-6567(01)78824-5
更新日期:2001-04-15 00:00:00
abstract:OBJECTIVE:To describe the evolution of the number of potential years of life lost (PYLL) because of AIDS in La Rioja between 1986 and 1993. DESIGN:Descriptive study. SETTING:Autonomous Community of La Rioja. PATIENTS AND OTHER PARTICIPANTS:Secondary data from the regional Register of AIDS cases in La Rioja, from the...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:
更新日期:1996-05-15 00:00:00
abstract:OBJECTIVE:To find the prevalence, characteristics, and consequences of falls in the elderly and related factors. DESIGN. Cross-sectional, descriptive study using personal interviews. SETTING:Three health districts in Cordoba city, Spain. PARTICIPANTS:A stratified sample of 362 people over 70. MAIN MEASUREMENTS:The a...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1157/13094802
更新日期:2006-11-15 00:00:00
abstract:OBJECTIVE:To describe the thyroid pathology seen at our health centre (HC) and its evolution. DESIGN:A longitudinal, retrospective study. SETTING:La Mina HC, Sant Adrià de Besòs, Barcelona. PATIENTS:Patients older than 14 who, between January 1985 and June 1993, had presented functional or morphological thyroid func...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:
更新日期:1995-04-30 00:00:00
abstract:OBJECTIVE:To measure with primary data the kinds of family doctor consultations, the reasons for them and the interruptions. DESIGN:Observational, transversal, and multi-centred study. SETTING:All the health centres in Area 17 of the Community of Valencia. PARTICIPANTS:Representative sample of 2051 patients belongin...
journal_title:Atencion primaria
pub_type: 杂志文章,多中心研究
doi:10.1157/13071914
更新日期:2005-02-15 00:00:00
abstract:OBJECTIVE:To analyse the impact of a formative / informative intervention on the treatment of non-oncological chronic pain in Primary Care. DESIGN:Quasi-experimental study before-after, and follow-up of the patient cohort. LOCATION:64 Primary Care teams/centres (770 physicians). PARTICIPANTS:Patients≥14 years withou...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1016/j.aprim.2019.09.001
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To evaluate, using a scheme to monitor arterial pressure in out-patients (MAPOP), how well patients were able to control their light arterial hypertension after hygienic-dietary measures had been found insufficient. DESIGN:Observational study. SITE. Urban health centre. PATIENTS:18 people suffering from lig...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:To critically analyse the concept of nursing prescription through the study of its background and a review of the scientific literature, in order to develop an accurate conception of this nursing activity and to identify the essential elements surrounding this concept. METHOD:Application of the concept analy...
journal_title:Atencion primaria
pub_type: 杂志文章,评审
doi:10.1016/j.aprim.2018.06.006
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:To determine the validity of the Centor score (cervical adenopathy, tonsillar exudate, fever, and absence of catarrh symptoms) in diagnosing streptococcal pharyngitis (gold standard: throat swab). DESIGN:Descriptive study. SETTING:San Fernando 2 Health Centre, Madrid (outer urban area), Spain. PARTICIPANTS...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1157/13107724
更新日期:2007-07-01 00:00:00
abstract:INTRODUCTION:On the centenary of the foundation of the Paediatrics Society of Madrid, a tribute is presented to rural medical practice of that time, although there are few documents on the history of rural medicine. The main objective is to describe the context of the rural medical practice in the late 19th and beginni...
journal_title:Atencion primaria
pub_type: 历史文章,杂志文章
doi:10.1016/j.aprim.2015.05.008
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of joining a home care program on primary caregivers of dependent elderly people. DESIGN:Non-randomised "before-after" intervention study. SETTING:Primary Care. PARTICIPANTS:Primary carers of elderly dependent people included in a home care program (n=156; 7.8% loss to follow up). I...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1016/j.aprim.2010.09.011
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:To discover the perception of health, social support and family function for asymptomatic HIV carriers. DESIGN:This was an observation crossover study, using validated questionnaires. SETTING:Almanjayar and Cartuja Health Centres in Granada. PATIENTS AND OTHER PARTICIPANTS:58 HIV+ patients belonging to the...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:
更新日期:1994-03-15 00:00:00
abstract:OBJECTIVE:1) To find the opinion of general practitioners working in primary care (GP in PC) regarding how they deal with neurological patients. 2) To find the effect on this question of intern training in family and community medicine (FCM). DESIGN AND SETTING:A survey filled out by a representative sample of GP in P...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:
更新日期:1995-04-15 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of the implementation of a mindfulness and self-care program to treat common mental health disorders in primary care. DESIGN:Quasi-experimental non-controlled, non-randomised study, with repeated measurements. SETTING:Seven health centres, in area v of the Principality of Astur...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1016/j.aprim.2019.05.015
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To describe the situations of risk and the prevalence of HIV in women with a heterosexual partner infected by HIV. DESIGN:Cross-sectional descriptive study. SETTING:Out-patient HIV diagnosis centre in Madrid. PATIENTS:229 women seen for the first time between 1993 and 2002 because they had a stable heteros...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1016/s0212-6567(04)78926-x
更新日期:2004-11-15 00:00:00
abstract:OBJECTIVES:With a system of qualitative indicators, to analyse the pharmaceutical prescription of general practitioners (GPs), and to evaluate the relationship of these indicators to the overall pharmaceutical prescription expenditure per inhabitant. DESIGN:Retrospective descriptive study. SETTING:Primary care. MEAS...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1016/s0212-6567(00)78545-3
更新日期:2000-04-30 00:00:00
abstract:OBJECTIVE:To determine what family doctors think about various aspects of patient involvement in clinical decision making in Primary Care. DESIGN:Qualitative study using focus groups. LOCATION:Primary Care. PARTICIPANTS:Family physicians with and without expertise in clinical communication. METHODS:Three focus grou...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1016/j.aprim.2011.07.007
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:To find out the perceptions of family doctors (FD) and psychiatrists (PS) on their inter-relationships in the health care of patients with depression. DESIGN:Qualitative methodology. Exploratory design based on FD and PS discussion groups (DG). SETTING:Primary health care centres (PHCC) and mental health c...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1016/j.aprim.2008.04.003
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To assess the frequency of Candida species others than Candida albicans isolation, in patients with chronic as well as relapsing vaginitis. To analyze the clinical pictures and the treatments routinely employed in patients with Candida albicans infection, compared to those with other Candida species infection...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:
更新日期:1998-04-15 00:00:00
abstract:OBJECTIVES:To study internal communication between primary care health professionals DESIGN:Cross-sectional, descriptive. SETTING:Catalan Health Institute Costa de Ponent Primary Care Area, Spain. PARTICIPANTS:All workers in the area (n=3565). MEASUREMENTS:Three part questionnaire: a) sociodemographic questions; b)...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1157/13125405
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVES:To explore intentions, motivations and country preferences related with professional emigration in a sample of advanced medical students. DESIGN:Cross sectional and descriptive study. SETTING:11 Universities in Spain. PARTICIPANTS:A total of 740 students in their two final courses. PRIMARY MEASUREMENTS:T...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1016/j.aprim.2010.01.017
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To identify the level of hypertension awareness, treatment and control in the adult population (14 years and older) at the Valencian Region. Type of treatment and associated factors to the hypertension awareness will be also explored. DESIGN:Cross-sectional study (population survey). SETTING:Valencian Regio...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:
更新日期:1998-05-15 00:00:00
abstract:OBJECTIVE:To determine the percentage of women aged 40 to 70 years who had had at least one preventive Pap test (cytological examination) during the preceding 5 years, and the factors associated with use of the test. DESIGN:Population survey.Setting. Home interviews during October 2000. PARTICIPANTS:2409 women aged 4...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1016/s0212-6567(04)79407-x
更新日期:2004-03-31 00:00:00
abstract:OBJECTIVE:To check whether the information in the written publicity that the pharmaceutical industry gives to family doctors really is based on the scientific studies that support it. DESIGN:Cross-sectional study. SETTING:Health centre on the outskirts of a big city. PARTICIPANTS:Over a year, all the scientific stud...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1157/13075926
更新日期:2005-06-15 00:00:00
abstract:OBJECTIVE:To quantify and describe the self-treatment existing among users requesting a consultation about an illness which had commenced in the previous 15 days. DESIGN:Observational prospective study. SETTING:Primary care in a semi-rural environment. Family Medicine Unit in Valls (Tarragona). PATIENTS AND OTHERS P...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:
更新日期:1993-03-15 00:00:00
abstract:OBJECTIVE:To identify and analyse the "theory" expressed by family doctors on the essential features of an effective and functional doctor-patient relationship and on how to achieve one ("stated theory" of Argyris and Schon). DESIGN:Qualitative, based on discourse analysis. SETTING:Primary care. METHOD:Interviews re...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1157/13106284
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:To describe the prevalence of iron deficiency anaemia in the Basque Country by age group and sex and to identify the main groups at risk. DESIGN:Cross-sectional study. SETTING:Basque Country. PARTICIPANTS:School-aged population of Bilbao (n = 762); further education students of San Sebastian (n = 372); adu...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:
更新日期:1998-10-15 00:00:00
abstract:OBJECTIVES:To assess the impact of the Law 42/2010, on the health measures on smoking, on the prevalence of the exposure to environmental tobacco smoke (ETS), the repercussions in frequently visited places, and support of the new legislation. DESIGN:A before-after evaluation by comparing two cross-sectional studies th...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1016/j.aprim.2012.02.010
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:To determine the relationship between some characteristics (cost, intensity, quality) of prescriptions issued by general practitioners in a health district and their patient loads, controlling for possible confounders. To analyze the intensity of prescription of certain groups of therapeutic drugs according ...
journal_title:Atencion primaria
pub_type: 杂志文章
doi:10.1016/j.aprim.2010.02.010
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVES:To determine the level of therapeutic inertia (TI), and the factors associated to the patient, doctor and the health organisation, in hypertensive patients treated in Primary Care (PC). DESIGN:Cross-sectional, multicentre study. SETTING:A sample of PC Teams from all over Spain. PARTICIPANTS:The study was ...
journal_title:Atencion primaria
pub_type: 杂志文章,多中心研究
doi:10.1016/j.aprim.2010.09.030
更新日期:2011-12-01 00:00:00