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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">En 2009 se aprob&#243; la Estrategia Nacional de EPOC<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">1</span></a>&#46; Ya alcanzado 2020 este dec&#225;logo &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41; va m&#225;s all&#225; de las gu&#237;as y la complejidad del proceso y su situaci&#243;n&#44; pues pretende identificar sus problemas y posibles soluciones en Espa&#241;a&#44; con un enfoque hacia la pol&#237;tica sanitaria y las administraciones&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">La EPOC es una enfermedad prevenible y tratable<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">2&#44;3</span></a>&#44; y el tabaquismo es su principal causante en Espa&#241;a&#46; Las tendencias recientes de tabaquismo en mujeres y ni&#241;os&#44; adem&#225;s de los nuevos vapeadores y dispositivos de calentar el tabaco&#44; generan nuevos desaf&#237;os&#46; En Espa&#241;a el tabaco causa la p&#233;rdida de un mill&#243;n de a&#241;os de vida cada a&#241;o&#44; y hay 28&#46;766 muertes anuales por EPOC<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a>&#46; Sigue siendo muy prevalente&#44; y EPISCAN II concluye que tienen EPOC el 11&#44;8&#37; de espa&#241;oles de 40 o m&#225;s a&#241;os &#40;14&#44;6&#37; hombres y 9&#44;4&#37; mujeres&#41;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a>&#44; y se est&#225; rejuveneciendo y feminizando<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a>&#46; Desgraciadamente&#44; sigue infradiagnosticada y tratada de forma tard&#237;a&#46; A pesar de los esfuerzos y recursos dedicados a implementar espirometr&#237;a en atenci&#243;n primaria&#44; el infradiagn&#243;stico asciende al 74&#44;7&#37;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a>&#46; EPISCAN II tambi&#233;n confirma la denominada &#171;paradoja espa&#241;ola&#187;&#44; pues el infradiagn&#243;stico es mayor en mujeres<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">7</span></a>&#46; Es la enfermedad paradigma de la cronicidad&#44; progresiva e invalidante&#44; con frecuentes manifestaciones extrapulmonares y comorbilidades&#46; Adem&#225;s su prevalencia aumenta con la edad&#46; Se hace necesario un abordaje integral y multidisciplinar e incorporar la perspectiva de g&#233;nero&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Supone un elevado consumo de recursos&#44; que alcanza los 3&#46;000 millones al a&#241;o &#40;0&#44;2&#37; del PIB&#41;&#46; La partida m&#225;s importante corresponde a los gastos hospitalarios&#44; y un 15&#37; de los pacientes consume el 80&#37; de los recursos<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a>&#46; Ciertamente&#44; su atenci&#243;n sanitaria es mejorable&#44; destacando que no se realiza suficiente espirometr&#237;a de calidad<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a>&#44; y son necesarias una enfermer&#237;a de competencias avanzadas&#44; una gesti&#243;n integral del proceso<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a> y la priorizaci&#243;n con indicadores de salud&#46; Deben potenciarse alternativas a la hospitalizaci&#243;n convencional<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a>&#44; como la atenci&#243;n domiciliaria y las nuevas tecnolog&#237;as&#44; con colaboraci&#243;n p&#250;blico-privada y la coordinaci&#243;n interinstitucional&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Creemos que debe cambiar la relaci&#243;n m&#233;dico-paciente-cuidador en una verdadera &#171;alianza terap&#233;utica&#187;&#46; Nuevas palabras clave en EPOC son autocuidado&#44; adherencia&#44; uso apropiado de recursos y potenciar las asociaciones de pacientes&#44; y para ello la calidad asistencial es clave&#46; Es necesario establecer una pol&#237;tica cient&#237;fico-t&#233;cnica de calidad&#44; y las gu&#237;as deben establecer est&#225;ndares de calidad&#44; garantizar un tratamiento personalizado y actualizarse regularmente&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">No debe olvidarse potenciar la investigaci&#243;n traslacional en aspectos de prevenci&#243;n y atenci&#243;n integral&#46; Finalmente&#44; todos los agentes implicados debemos facilitar su difusi&#243;n a la sociedad y entre los profesionales&#46; La EPOC &#171;cambia&#187; y sigue siendo una gran desconocida<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a>&#44; pero debe ser m&#225;s conocida<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">13&#44;14</span></a>&#44; y proponemos usar desde ya el acr&#243;nimo <span class="elsevierStyleItalic">epoc</span> en min&#250;sculas para resaltar que es una enfermedad con may&#250;sculas&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En resumen&#44; el paciente con epoc es un paciente &#171;de primera&#187; al que podemos ofrecer m&#225;s cantidad y calidad de vida&#46; Es necesario atajar el problema y sus causas de una manera m&#225;s efectiva en esta nueva d&#233;cada&#44; y quiz&#225;s todos juntos podremos acabar con la epoc<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">15</span></a>&#46;</p></span>"
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                  \t\t\t\t">1&#46; Es una enfermedad prevenible&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46; Tiene una elevada prevalencia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46; Est&#225; infradiagnosticada y se trata de forma tard&#237;a&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46; Paradigma de cronicidad&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#46; Supone un elevado consumo de recursos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#46; La atenci&#243;n sanitaria sigue siendo claramente mejorable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#46; Un nuevo modelo en la relaci&#243;n m&#233;dico-paciente-cuidador&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&#46; La calidad asistencial es clave&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9&#46; Requiere m&#225;s investigaci&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10&#46; Necesita ser difundida en nuestra sociedad y que se potencie la formaci&#243;n de los profesionales&nbsp;\t\t\t\t\t\t\n
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Editorial
La EPOC en España al inicio de una nueva década
COPD in Spain at the Start of a New Decade
Julio Ancocheaa,b, Joan B. Sorianoa,b,
Corresponding author
jbsoriano2@gmail.com

Autor para correspondencia.
a Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IP), Universidad Autónoma de Madrid, Madrid, España
b Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">En 2009 se aprob&#243; la Estrategia Nacional de EPOC<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">1</span></a>&#46; Ya alcanzado 2020 este dec&#225;logo &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41; va m&#225;s all&#225; de las gu&#237;as y la complejidad del proceso y su situaci&#243;n&#44; pues pretende identificar sus problemas y posibles soluciones en Espa&#241;a&#44; con un enfoque hacia la pol&#237;tica sanitaria y las administraciones&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">La EPOC es una enfermedad prevenible y tratable<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">2&#44;3</span></a>&#44; y el tabaquismo es su principal causante en Espa&#241;a&#46; Las tendencias recientes de tabaquismo en mujeres y ni&#241;os&#44; adem&#225;s de los nuevos vapeadores y dispositivos de calentar el tabaco&#44; generan nuevos desaf&#237;os&#46; En Espa&#241;a el tabaco causa la p&#233;rdida de un mill&#243;n de a&#241;os de vida cada a&#241;o&#44; y hay 28&#46;766 muertes anuales por EPOC<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a>&#46; Sigue siendo muy prevalente&#44; y EPISCAN II concluye que tienen EPOC el 11&#44;8&#37; de espa&#241;oles de 40 o m&#225;s a&#241;os &#40;14&#44;6&#37; hombres y 9&#44;4&#37; mujeres&#41;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a>&#44; y se est&#225; rejuveneciendo y feminizando<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a>&#46; Desgraciadamente&#44; sigue infradiagnosticada y tratada de forma tard&#237;a&#46; A pesar de los esfuerzos y recursos dedicados a implementar espirometr&#237;a en atenci&#243;n primaria&#44; el infradiagn&#243;stico asciende al 74&#44;7&#37;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a>&#46; EPISCAN II tambi&#233;n confirma la denominada &#171;paradoja espa&#241;ola&#187;&#44; pues el infradiagn&#243;stico es mayor en mujeres<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">7</span></a>&#46; Es la enfermedad paradigma de la cronicidad&#44; progresiva e invalidante&#44; con frecuentes manifestaciones extrapulmonares y comorbilidades&#46; Adem&#225;s su prevalencia aumenta con la edad&#46; Se hace necesario un abordaje integral y multidisciplinar e incorporar la perspectiva de g&#233;nero&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Supone un elevado consumo de recursos&#44; que alcanza los 3&#46;000 millones al a&#241;o &#40;0&#44;2&#37; del PIB&#41;&#46; La partida m&#225;s importante corresponde a los gastos hospitalarios&#44; y un 15&#37; de los pacientes consume el 80&#37; de los recursos<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a>&#46; Ciertamente&#44; su atenci&#243;n sanitaria es mejorable&#44; destacando que no se realiza suficiente espirometr&#237;a de calidad<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a>&#44; y son necesarias una enfermer&#237;a de competencias avanzadas&#44; una gesti&#243;n integral del proceso<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a> y la priorizaci&#243;n con indicadores de salud&#46; Deben potenciarse alternativas a la hospitalizaci&#243;n convencional<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a>&#44; como la atenci&#243;n domiciliaria y las nuevas tecnolog&#237;as&#44; con colaboraci&#243;n p&#250;blico-privada y la coordinaci&#243;n interinstitucional&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Creemos que debe cambiar la relaci&#243;n m&#233;dico-paciente-cuidador en una verdadera &#171;alianza terap&#233;utica&#187;&#46; Nuevas palabras clave en EPOC son autocuidado&#44; adherencia&#44; uso apropiado de recursos y potenciar las asociaciones de pacientes&#44; y para ello la calidad asistencial es clave&#46; Es necesario establecer una pol&#237;tica cient&#237;fico-t&#233;cnica de calidad&#44; y las gu&#237;as deben establecer est&#225;ndares de calidad&#44; garantizar un tratamiento personalizado y actualizarse regularmente&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">No debe olvidarse potenciar la investigaci&#243;n traslacional en aspectos de prevenci&#243;n y atenci&#243;n integral&#46; Finalmente&#44; todos los agentes implicados debemos facilitar su difusi&#243;n a la sociedad y entre los profesionales&#46; La EPOC &#171;cambia&#187; y sigue siendo una gran desconocida<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a>&#44; pero debe ser m&#225;s conocida<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">13&#44;14</span></a>&#44; y proponemos usar desde ya el acr&#243;nimo <span class="elsevierStyleItalic">epoc</span> en min&#250;sculas para resaltar que es una enfermedad con may&#250;sculas&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En resumen&#44; el paciente con epoc es un paciente &#171;de primera&#187; al que podemos ofrecer m&#225;s cantidad y calidad de vida&#46; Es necesario atajar el problema y sus causas de una manera m&#225;s efectiva en esta nueva d&#233;cada&#44; y quiz&#225;s todos juntos podremos acabar con la epoc<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">15</span></a>&#46;</p></span>"
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                  <table border="0" frame="\n
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                  \t\t\t\t">1&#46; Es una enfermedad prevenible&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46; Tiene una elevada prevalencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">3&#46; Est&#225; infradiagnosticada y se trata de forma tard&#237;a&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">4&#46; Paradigma de cronicidad&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">5&#46; Supone un elevado consumo de recursos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">6&#46; La atenci&#243;n sanitaria sigue siendo claramente mejorable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#46; Un nuevo modelo en la relaci&#243;n m&#233;dico-paciente-cuidador&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">8&#46; La calidad asistencial es clave&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9&#46; Requiere m&#225;s investigaci&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10&#46; Necesita ser difundida en nuestra sociedad y que se potencie la formaci&#243;n de los profesionales&nbsp;\t\t\t\t\t\t\n
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Article information
ISSN: 03002896
Original language: Spanish
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