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            0 => "Chronic Obstructive Pulmonary Disease &#40;COPD&#41;"
            1 => "Asthma"
            2 => "Drug use"
            3 => "Defined daily dose"
            4 => "Primary care"
          ]
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            0 => "Enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41;"
            1 => "Asma"
            2 => "Utilizaci&#243;n de medicamentos"
            3 => "Dosis diaria definida"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To identify trends in the drug prescription used to treat chronic obstructive pulmonary disease &#40;COPD&#41; and asthma at the primary care level in Madrid between 1996 and 2002&#44; and to assess the repercussion of new treatments&#46;</p> <span class="elsevierStyleSectionTitle">Patients and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We analyzed information on primary care general practitioners&#39; and pediatricians&#39; drug prescription from the R03 group &#40;drugs for obstructive airway diseases&#41; of the Anatomical Therapeutic Chemical Classification System&#46; Drug consumption was measured by recording the number of packages charged to the Spanish National Health Service and dispensed in pharmacies in the Spanish autonomous community of Madrid between 1999 and 2002&#46; Consumption was expressed as defined daily dose per 1000 inhabitants per day&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Drug use expressed as defined daily dose per 1000 inhabitants per day for COPD and asthma in Madrid increased by 18&#46;48&#37; between 1996 and 2002&#46; The use of inhalants increased by 33&#46;5&#37; over the same period&#46; The most marked differences were the increase in the number of patients treated with selective &#946;<span class="elsevierStyleInf">2</span> adrenergic agonists&#44; anticholinergics&#44; and combinations of fixed doses of long acting &#946;<span class="elsevierStyleInf">2</span> agonists with corticosteroids&#46; The most-used drugs in 2002 were selective &#946;<span class="elsevierStyleInf">2</span> adrenergic agonist inhalants &#40;37&#46;7&#37;&#41;&#44; anticholinergics &#40;22&#46;5&#37;&#41;&#44; corticosteroids &#40;19&#46;5&#37;&#41;&#44; and combinations of fixed doses of long acting &#946;<span class="elsevierStyleInf">2</span> adrenergic agonists with corticosteroids &#40;10&#46;5&#37;&#41;&#44; and xanthines &#40;5&#46;03&#37;&#41;&#46; In 2002&#44; the prescription of 5 new treatments amounted to 15&#46;76&#37; of total use of COPD and asthma drugs &#40;R03 group&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Drug use for obstructive diseases of the airways showed a sharp increase between 1996 and 2002&#46; Changes in patterns of use were observed&#44; new treatments being quickly adopted&#44; modifying the profile of drug prescription for the management of COPD and asthma&#46;</p>"
      ]
      "es" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Conocer la tendencia en la utilizaci&#243;n de los medicamentos para el tratamiento de la enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41; y el asma en atenci&#243;n primaria de Madrid entre 1996 y 2002&#44; y evaluar la repercusi&#243;n de las novedades terap&#233;uticas&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha analizado la informaci&#243;n sobre el consumo&#44; en n&#250;mero de envases&#44; de los medicamentos incluidos en el grupo R03 &#40;&#8220;Medicamentos para enfermedades obstructivas de las v&#237;as a&#233;reas&#8221;&#41; que prescribieron m&#233;dicos de familia y pediatras de atenci&#243;n primaria&#44; y que&#44; facturados con cargo al Sistema Nacional de Salud&#44; se dispensaron en las oficinas de farmacia de la Comunidad de Madrid en el per&#237;odo 1996-2002&#46; El consumo se expresa en dosis diarias definidas por 1&#46;000 habitantes y d&#237;a&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El consumo de medicamentos&#44; expresado en dosis diarias definidas por 1&#46;000 habitantes y d&#237;a&#44; para la EPOC y el asma en Madrid aument&#243; un 18&#44;48&#37; entre 1996 y 2002&#46; La utilizaci&#243;n de la v&#237;a inhalada creci&#243; un 33&#44;5&#37; en dicho per&#237;odo&#46; Las variaciones m&#225;s destacables se centraron en el incremento del n&#250;mero de pacientes tratados con agonistas adren&#233;rgicos &#946;<span class="elsevierStyleInf">2</span> selectivos&#44; anticolin&#233;rgicos y asociaciones a dosis fijas de agonistas &#946;<span class="elsevierStyleInf">2</span> de acci&#243;n larga con glucocorticoides&#46; Los grupos m&#225;s consumidos en 2002 fueron los agonistas adren&#233;rgicos &#946;<span class="elsevierStyleInf">2</span> selectivos por v&#237;a inhalada &#40;37&#44;7&#37;&#41;&#44; anticolin&#233;rgicos &#40;22&#44;5&#37;&#41;&#44; glucocorticoides &#40;19&#44;5&#37;&#41;&#44; asociaciones a dosis fijas de agonistas adren&#233;rgicos &#946;<span class="elsevierStyleInf">2</span> de acci&#243;n larga junto con glucocorticoides &#40;10&#44;5&#37;&#41; y xantinas &#40;5&#44;03&#37;&#41;&#46; En 2002 la prescripci&#243;n de 5 novedades terap&#233;uticas gener&#243; el 15&#44;76&#37; del total del consumo de los f&#225;rmacos utilizados en la EPOC y el asma &#40;grupo R03&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El consumo de medicamentos para enfermedades obstructivas de las v&#237;as a&#233;reas muestra un notable crecimiento entre 1996 y 2002&#46; Se observan cambios en los patrones de utilizaci&#243;n&#44; incorpor&#225;ndose a gran velocidad nuevas opciones terap&#233;uticas que modifican el perfil de prescripci&#243;n de los medicamentos utilizados en el manejo de la EPOC y el asma&#46;</p>"
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                      "titulo" => "Standards for the diagnosis and treatment of patients with COPD&#58; a summary of the ATS&#47;ERS position paper"
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                        0 => array:2 [
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                            3 => "R Gabriel"
                            4 => "JL Viejo"
                            5 => "JF Masa"
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