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Introducción: La menopausia puede originar distintos síntomas, siendo los vasomotores especialmente prevalentes y molestos. Este trabajo pretende conocer su impacto y los patrones/percepciones sobre el tratamiento en España, para lo que se han analizado las opiniones de clínicos y pacientes con síntomas vasomotores moderado-graves (SVM-MG). Métodos: Estudio transversal descriptivo de la subpoblación española del Programa de Enfermedades Específicas de Adelphi-VMS™. Médicos de atención primaria y de Ginecología y Obstetricia seleccionaron las pacientes. Estas fueron invitadas a rellenar una encuesta y los cuestionarios MENQOL y WPAI:SHP. Los datos se han presentado como porcentaje o media±desviación estándar. Resultados: Un total de 32 médicos de Atención Primaria y Ginecología y Obstetricia completaron los formularios de registro para 241 mujeres, de las cuales 143 experimentaban SVM-MG. A pesar del impacto global reportado en el trabajo (24,84%±17,49 presentismo) y en la calidad de vida (3,37±1,52 MENQOL), solo el 53,85% de las mujeres eran tratadas. El tratamiento hormonal de la menopausia era el más prescrito (77,92%), seguido de los inhibidores de la recaptación de serotonina (32,47%). El 59% de los clínicos estaba muy o completamente satisfecho con el tratamiento hormonal de la menopausia, mientras que solo el 19% lo estaba con los inhibidores de la recaptación de serotonina. Pacientes y especialistas indicaron un nivel de satisfacción inferior al 38% en el control de los SVM. Conclusiones: Los SVM-MG asociados a la menopausia tienen un importante impacto sobre la calidad de vida. Una mayor sensibilización en su manejo y mejores opciones terapéuticas contribuirían significativamente a mejorar la salud y bienestar de la mujer durante el climaterio.(AU)

Introduction: Menopause generates different symptoms, among which vasomotor symptoms are especially prevalent and bothersome. The aim of this work was to determine their impact and the treatment patterns and perceptions in Spain by analyzing the opinions of physicians and patients with moderate-to-severe vasomotor symptoms (MS-VMS). Methods: Descriptive cross-sectional study of the Spanish subpopulation from the Adelphi-VMS™ Disease-Specific Program. Primary Care and Gynecology and Obstetrics physicians selected the patients. These patients were invited to complete a survey and the MENQOL and WPAI:SHP questionnaires. Data are presented as percentage or mean±standard deviation. Results: Overall 32 Primary Care and Gynecology and Obstetrics physicians participated in the study, enrolling 241 women, of whom 143 experienced MS-VMS. Despite the reported impact on global work (24.84%±17.49 presentism) and quality of life (3.37±1.52 MENQOL score), only 53.85% of women with MS-VMS were treated. Menopausal hormone treatment was the most prescribed (77.92%), followed by serotonin reuptake inhibitors (32.47%). Fifty-nine percent of clinicians were very or completely satisfied with hormone treatment, whereas only 19% had this level of satisfaction with selective serotonin reuptake inhibitors. Less than 38% of patients and physicians were satisfied with the control of VMS. Conclusions: Menopause-associated MS-VMS have an important impact on quality of life. Increased awareness about their management and better therapeutic options would significantly contribute to improving women's health and well-being during their climacteric period.(AU)

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INTRODUCTION AND AIM: Overactive bladder (OAB) negatively impacts patient quality of life and may be associated with high resource use. Our aim was to describe the resource use, costs and persistence associated with mirabegron (MB) or antimuscarinic (AM) treatment in patients with OAB. MATERIALS AND METHODS: Observational retrospective study of medical records in adult patients initiating OAB treatment with MB or AM in Catalonia. Healthcare resource use (visits, hospital stays, tests, medication, absorbent pads) in the first year after treatment initiation was collected. Associated costs were estimated (є, reference year 2019), as well as treatment persistence. Treatment discontinuation was defined as the absence of prescription for at least 45 days or treatment change. RESULTS: The mean cost per patient (SD) was є 1,640.20 (є 1,227.60) with MB and є 2,159.20 (є 2,264.40) with AM; the associated healthcare resource use cost was lower with MB compared to AM, except for OAB drug costs. Persistence after 12 months of treatment initiation was higher in MB (42.1%) compared to AM (33.0%), as was the median time until treatment discontinuation: 299 (95% CI: 270-328) vs 240 days (95% CI: 230-250). CONCLUSIONS: Lower healthcare resource use was observed with MB compared to AM in the first year of index treatment, resulting in a lower mean direct cost per patient and year, despite its higher acquisition cost. Increased treatment persistence, as well as rational use of available treatments improves OAB management and, in return, patients' quality of life.

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OBJECTIVE: Investigating the extent to which providing children with free swimming access during school holidays increased participation in swimming and whether this effect differed according to the socioeconomic deprivation of the neighbourhoods in which children lived. SETTING: A highly disadvantaged local authority (LA) in North West England. INTERVENTION: Provision of children with free swimming during the summer holidays. OUTCOME MEASURES: Number of children swimming, and the number of swims, per 100 population in 2014. DESIGN: Comparative regression discontinuity investigating the extent to which participation rates amongst children aged 5-15 were greater in the intervention LA compared to a similar control LA. We estimated the differential effect of the intervention across five groups, defined by quintiles of area deprivation. RESULTS: Free swimming during the summer holidays was associated with an additional 6% of children swimming (95% CI: 4-9%) and an additional 33 swims per 100 children per year (95% CI: 21-44). The effects were greatest in areas with intermediate levels of deprivation (quintiles 3 and 4) within this deprived LA. CONCLUSION: Providing free facilities for children in disadvantaged areas is likely to increase swimming participation and may help reduce inequalities in physical activity.

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Background: Reducing or eliminating entrance charges for the public use of leisure facilities is one potential tool that local authorities (LA) have to reduce inequalities in physical activity (PA). Facility charges are likely to be a greater barrier to access for those who have lower incomes. Methods: Semi-structured 1-to-1 and group interviews were conducted with 33 leisure and public health professionals in seven LAs in north-west England. We investigated how approaches to pricing varied in these settings and rationales influencing decision making. Results: Welfare orientated (e.g. affordability) and commercial drivers (e.g. income generation) featured most prominently across areas. Pricing policies placed less direct focus on public health goals, although tackling inactivity was articulated as part of leisure's role more generally. Local targeting of free/concessionary offers was also defined and implemented differently. Decision makers described navigating competing pressures of providing services for the public 'good' yet remaining financially viable. Conclusion: Many LAs are reviewing the extent of subsidy for facilities or are considering whether to invest public health budgets in leisure. The findings offer evidence of how pricing decisions are made and the approaches adopted in practice as well as the conflicting priorities for decision makers within an austerity context.

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