Consensus Document on COVID-19 from the Spanish Society of Primary Care Physicians (SEMERGEN). Current Situation. SEMERGEN's Position in 2025 J. Cabrera Gómez, E. Navarro Matías, L. Ginel Mendoza, A. Cano Espín, Á. Morán Bayón, V. Martín Sánchez, A. Serrano-Cumplido Semergen, 2025 La infección por el virus SARS-CoV-2 es actualmente uno de los motivos de consulta más frecuentes en Atención Primaria. Es necesario un documento práctico que establezca las líneas generales de actuación ante esta infección, desde la Medicina Familiar y Comunitaria, tanto en la prevención como en la atención a los pacientes y familiares. Infection with the SARS-CoV-2 virus is currently one of the most frequent reasons for consultation in Primary Care. A practical document is necessary that establishes the general lines of action against this infection, from Family and Community Medicine, both in prevention and in the care of patients and relatives
Estimation of the population atributable fraction due a to excess body fat in primary care patients: IBERICAN study Jesús Iturralde-Iriso, Aitana Lertxundi-Manterola, Iosu Delgado-Naranjo, Alfonso Barquilla-García, Rafael Manuel Micó-Pérez, José Polo-García, Sonsoles M. Velilla-Zancada, Naiara Cubelos-Fernández, Antonio Segura-Fragoso, Leovigildo Ginel-Mendoza, Vicente Pallares-Carratala, Miguel A. Prieto-Díaz, Sergio Cinza-Sanjurjo, Vicente Martín-Sanchez Primary Care Diabetes, 2025
Prevalence of obesity in primary care patients: The IBERICAN study Sergio Cinza-Sanjurjo, Miguel A. Prieto-Díaz, Vicente Pallares-Carratala, Rafael Manuel Mico-Pérez, Alfonso Barquilla-García, Sonsoles M. Velilla-Zancada, José Polo-García, Verónica Ortiz-Ainaga, Antonio Segura-Fragoso, Leovigildo Ginel-Mendoza, Vicente Martín-Sánchez Nutrition Metabolism and Cardiovascular Diseases, 2025
Advancing clinical research in the Spanish primary care service: Challenges, opportunities, and lessons from other European models Jose Cárdenas-Quesada, Ángela Remesal-Doblado, Vanesa Garrido-Rodríguez, M. Isabel Lucena, Leovigildo Ginel-Mendoza, Salvador León Cárdenas-Viedma, Judith Sanabria-Cabrera European Journal of General Practice, 2025 BACKGROUND: As the first point of contact with the healthcare system, primary care (PC) provides a unique setting for clinical research, enabling longitudinal follow-up, early disease detection, and study of prevalent illnesses. In Spain, however, PC research remains largely untapped, despite the country's leadership in overall clinical trial initiations within the European Union. OBJECTIVES: To analyse the main challenges and opportunities of PC research in Spain and to draw lessons from successful European models to inform future priorities. METHODS: This opinion paper presents a narrative, cross-country comparative synthesis (1993-2025) of peer-reviewed and gray literature. RESULTS: European models demonstrate how interoperable data, dedicated infrastructure, and protected research time enable pragmatic and decentralised trials with high external validity. In Spain, major barriers include heavy workloads, limited research training, uneven infrastructure, and regulatory hurdles. Nevertheless, opportunities are emerging through digital platforms, interoperable registries, remote monitoring, and the integration of patient-reported outcomes (PROs). CONCLUSION: Spain can unlock the untapped research capacity of PC by prioritising four reforms: (1) interoperable registries across care levels; (2) protected time and support roles for PC professionals; (3) targeted, sustained funding and minimum viable infrastructure; and (4) streamlined ethical/regulatory pathways for multicentre and decentralised trials. These steps would align research with daily practice, enhance inclusivity and equity, and strengthen PC as a hub for patient-centered innovation.
Physical activity and metabolic syndrome in primary care patients in Spain Rafael Manuel Micó-Pérez, Natalia Hernández Segura, Vicente Martín-Sánchez, Alfonso Barquilla-García, Sonsoles M. Velilla-Zancada, José Polo-García, Miguel Ángel Prieto-Díaz, Vicente Pallares-Carratala, Antonio Segura-Fragoso, Leovigildo Ginel-Mendoza, Sergio Cinza-Sanjurjo Plos One, 2025 Purpose To determine the relationship between self-reported physical activity and the components of premorbid metabolic syndrome in patients treated in primary care according to sex. Methods Cross-sectional descriptive study conducted on a sample of 2,359 patients without cardiovascular disease or diabetes, included in the cohort of the IBERICAN study. Using ANOVA models and adjusting for age, economic status, employment situation, level of education, adherence to a Mediterranean diet, tobacco use and alcohol consumption, we estimated the association of the variables blood pressure, triglycerides, HDL cholesterol, blood glucose and waist circumference with the self-reported level of physical activity (sedentary, moderate, high, very high). The analyses were performed stratifying by sex. Results A total of 854 men and 1,505 women with no identified diseases were included. Women were more sedentary than men (p<0.004; OR = 1,35; IC95% = 1,10–1,65) and presented lower values in all the components of the metabolic syndrome, except for HDL-cholesterol, which was higher (p<0.001). The adjusted ANOVA model shows that diastolic blood pressure, triglycerides, fasting blood glucose, and waist circumference were significantly lower the higher the level of physical activity in both men and women (p<0.05). Conclusions Patients served in primary care clinics without diabetes or cardiovascular disease and with high levels of physical activity showed better metabolic syndrome profiles. Given that women are more sedentary, gender approaches are needed in the promotion of physical activity to prevent metabolic syndrome and cardiovascular disease.
Characteristics of the phenotypes in prevalent and incident cases of heart failure in primary care: IBERICAN study Sergio Cinza-Sanjurjo, Miguel Ángel Prieto-Díaz, Vicente Pallarés-Carratalá, Rafael M. Micó-Pérez, Sonsoles Velilla-Zancada, Alfonso Barquilla-García, Leovigildo Ginel-Mendoza, Antonio Segura-Fragoso, Vicente Martín-Sánchez, José Polo-García BMC Primary Care, 2024 Background The management in primary care (PC) of the patients with Heart Failure (HF) is different from the management hospital, in a special way compared to cardiology departments. Objective To define the characteristics in both phenotypes of HF in prevalent and incident cases of HF in patients recruited in a large PC sample. Methods We proposed a and longitudinal analyses, in patients of the IBERICAN cohort, that recruited 8,066 patients in the Spanish primary care system, with 15,488 patients-years of follow-up. Of them, 252 patients (3.1%) had diagnoses of HF. HF was classified according to the 2014 guidelines in two groups: HF with a reduced eject fraction or HFrEF (LVEF < 50%) and HF with preserved eject fraction or HFpEF (LVEF ≥ 50%). Recommended treatment was defined as the patient receiving drug treatment with Renin-Angiotensin-System (RAS) blockers with beta-blockers and, optionally, spironolactone. The incidence of new cases of HF was calculated in the 7,814 patients without HF in the inclusion visit. Finally, we analysed which variables associated the onset new cases and get the hazard ratio (HR) with the confidence interval at 95% ([95%CI]). Clinical trials register: NCT02261441 (02/05/2017). Results The HFpEF was the most frequent phenotype in prevalent cases (61.1%) and incident cases (73.9%). Patients with HFrEF had a higher prevalence of coronary heart disease (p = 0.008) and PAD (p = 0.028), and no statistically significant differences was observed in the therapeutic groups used between both groups. The incidence of HF was 12.8 cases/1000 inhabitants/year, 35.6% of them was diagnosed in PC. The renin-angiotensin system blockers were more used in PC (60%) and beta-blockers (100%) and spironolactone (60%) in hospital. The female sex showed a protective effect for incident cases (0.51 [0.28–0.92]); and AF (HR [95%CI]: 2.90 [1.51–5.54]), coronary heart disease (HR [95%CI]: 2.18 [1.19-4.00]) and hypertension (HR [95%CI]: 1.91 [1.00-3.64]) increased the risk of developing HF. Conclusions HF phenotype more frequent and incident in PC was the HFpEF, but only one third of them are diagnosed in PC level. The female sex showed a protective effect and atrial fibrillation, ischaemic heart disease and hypertension increased the risk of develop HF.
Urate Levels as a Predictor of the Prevalence and Level of Cardiovascular Risk Factors: An Identificación de La PoBlación Española de Riesgo Cardiovascular y Renal Study Paula Antelo-Pais, Miguel Ángel Prieto-Díaz, Rafael M. Micó-Pérez, Vicente Pallarés-Carratalá, Sonsoles Velilla-Zancada, José Polo-García, Alfonso Barquilla-García, Leovigildo Ginel-Mendoza, Antonio Segura-Fragoso, Facundo Vitelli-Storelli, Vicente Martín-Sánchez, Álvaro Hermida-Ameijerias, Sergio Cinza-Sanjurjo, and Biomolecules, 2024 (1) Background: Urate levels lower than the classical cut-off point for defining hyperuricemia can increase cardiovascular risks. The aim of this study is to determine if there is a relationship between different urate levels and classic cardiovascular risk factors (CVRFs). (2) Methods: A cross-sectional study of the inclusion visits of the patients recruited to the IBERICAN study was conducted. The patients were classified into quartiles according to their distribution of urate levels and separated by sex; the three lower points corresponded to normal levels of urate, and the highest quartile was determined according to the classical definition of HU. Multivariate analysis models, adjusted for epidemiological variables, were used to analyze the association of urate levels with CVRFs. (3) Results: The presence of CVRFs was higher across the quartiles of urate, with a continuous increase along the quartiles in both sexes in accordance with body mass index (p < 0.01), waist circumference (p < 0.01), blood pressure (p < 0.01), and LDL cholesterol (p < 0.01). The CV risk estimated by SCORE was associated with an increase along the quartiles in women (p = 0.02). (4) Conclusions: A progressive increase in the frequency of CVRFs, as well as in their levels, was observed across the quartiles of uricemia, which reflects an increase in the CVRs associated with uricemia.
Influence of social determinants of health on quality of life in patients with multimorbidity and polypharmacy José María Ruiz-Baena, Aida Moreno-Juste, Beatriz Poblador-Plou, Marcos Castillo-Jimena, Amaia Calderón-Larrañaga, Cristina Lozano-Hernández, Antonio Gimeno-Miguel, Luis A. Gimeno-Feliú, and Plos One, 2024 Background Multimorbidity is one of the biggest challenges faced by modern medicine, especially when managing older patients who are also often taking multiple medications. Multimorbidity is influenced by social determinants of health, giving rise to health inequalities in the population. Here, we sought to determine the influence of social determinants of health on quality of life in patients with multimorbidity and polypharmacy. Methods and materials This cross-sectional observational study included 573 patients aged 65–74 with multimorbidity (≥3 diseases) and polypharmacy (≥5 drugs). Corresponding data was taken drawn from the Spanish MULTIPAP study, and included social and demographic variables, and data on health-related quality of life and overall self-perceived health status, assessed using the 5-level version of the EuroQol 5-dimensional questionnaire (EQ-5D-5L). Descriptive, bivariate and multivariate analyses with logistic regression models were performed. Results Mean patient age was 69.7 years, 55.8% of patients were female, 59.7% belonged to low social classes (V, VI), a monthly income of €1051–€1850 predominated, and the median number of diseases in the same patient was 6. Factors associated with higher quality of life were (odds ratio, OR) male gender (OR = 1.599, p = 0.013), a higher educational level (OR = 1.991, p = 0.036), an absence of urban vulnerability (OR = 1.605, p = 0.017), and the presence of medium social support (OR = 1.689, p = 0.017). Having a higher number of diseases was associated with poorer quality of life (OR = 0.912, p = 0.017). Conclusions Our findings describe associations between social determinants of health and quality of life in patients aged 65–74 years with multimorbidity and polypharmacy. More illnesses, female gender, a lower education level, urban vulnerability, and less social support are associated with poorer quality of life, underscoring the need for a biopsychosocial approach in patient care.
Prevalence of Hyperuricemia and Its Association with Cardiovascular Risk Factors and Subclinical Target Organ Damage Paula Antelo-Pais, Miguel Ángel Prieto-Díaz, Rafael M. Micó-Pérez, Vicente Pallarés-Carratalá, Sonsoles Velilla-Zancada, José Polo-García, Alfonso Barquilla-García, Leovigildo Ginel-Mendoza, Antonio Segura-Fragoso, Facundo Vitelli-Storelli, Vicente Martín-Sánchez, Álvaro Hermida-Ameijerias, Sergio Cinza-Sanjurjo Journal of Clinical Medicine, 2023
Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial Isabel del Cura-González, Juan A. López-Rodríguez, Francisca Leiva-Fernández, Luis A. Gimeno-Feliu, Victoria Pico-Soler, Mª. Josefa Bujalance-Zafra, Miguel Domínguez-Santaella, Elena Polentinos-Castro, Beatriz Poblador-Plou, Paula Ara-Bardají, Mercedes Aza-Pascual-Salcedo, Marisa Rogero-Blanco, Marcos Castillo-Jiménez, Cristina Lozano-Hernández, Antonio Gimeno-Miguel, Francisca González-Rubio, Rodrigo Medina-García, Alba González-Hevilla, Mario Gil-Conesa, Jesús Martín-Fernández, José M. Valderas, Alessandra Marengoni, Christiane Muth, J. Daniel Prados-Torres, Alexandra Prados-Torres, Francisco Javier Orellana-Lozano, Jesús Sepúlveda-Muñoz, Rafael Sánchez-Jordán, Amparo Escobar-Pérez, Concepción Rodríguez-García, Trinidad Peñuela-Ruiz, José Antonio Navarro-Martín, María Rosario Rodríguez-Rivera, Yolanda Aguilar-Heredia, Antonio Ignacio Martínez-Sarmiento, Beatriz Pascual-de-la-Pisa, María José García-Lozano, Alejandro García-Carrera, Noelia Juan-Tordesillas, María Isabel Márquez-Chamizo, José Manuel Navarro-Jiménez, María Carmen Ruiz-Ciudad, Rubén Luciano Vázquez-Alarcón, María Isabel Navarro-Gallego, Leovigildo Ginel-Mendoza, José María Ruiz-San-Basilio, Elena Barceló-Garach, Elisa María Alcantarilla-Reyes, Marta Álvarez de Cienfuegos Hernández, Irene Martínez-Ríos, Laura Orellana-Martín, María Dolores Merino-Moyano, Nuria Segura-Domínguez, María Cristina Moral-Merchán, Esther Martín-Aurioles, María Inmaculada Rodríguez-González, Sylvia Hazañas-Ruiz, Eva Noelia Gallego-Castillo, Esperanza Mora-García, Estefanía Cámara-Sola, Sergio Fons-Cañizares, María Paz Ortigosa-Arrabal, Teresa Quesada-Fernández, Silvia Rodríguez-Moreno, Ana Sánchez-Silvestre, María Jesús Torrubia-Fernández, María José González-Vega, María Victoria Almagro-Martín-Lomeña, Caridad Serrano-González, José Leiva-Fernández, Virginia Castillo-Romero, Ana María Fernández-Vargas, Francisco José Serrano-Guerra, Gabriel Francisco Narbona-Carrión, Hervé Michel-Bertevas, Rafael Ángel Maqueda, Miguel Domínguez-Santaella, Nuria García-Agua-Soler, Maria del Pilar Barnestein-Fonseca, María Begoña Abadía-Taira, Carmen Sánchez-Celaya-del-Pozo, Ana Carmen Giménez-Baratech, Lara Sanz-Burgos, Mercedes Abad-Royo, Carmen Camats-Franco, José Manuel Cortés-Pellicer, Paula Herrero-Solsona, Aida Moreno-Juste, Miguel Guiu-Campos, Nima Peyman-Fard-Shafi-Tabatabaei, Ma Teresa Delgado-Marroquín, Mercedes López-Echevarría, Jonás Carmona-Pírez, Fernando Barrera-Linares, Sandro Daniel Carrillo-Soria, Ana Belén Esteban-Gimeno, Beatriz López-Alonso, Anabel Hernández-Bono, Enrique Martínez-Ayala, Adriana Martínez-Manero, Raquel Martínez-Sánchez, Yolanda Naya-Mateu, María Lourdes Clemente-Jiménez, María Paz Leon-Martínez, Liliana Mahuela, Ma Rosario Sanjuan-Cortés, Elisa Pilar Salazar-González, Ma Elena Charte-Alegre, Ma Jesús Mur-Lazuela, Mónica Pascual-Franco, Pilar Arizon-Deza, Carmen García-Gutiérrez-Muñoz, Teresa García-Ruiz, Gloria Navarro-Aznárez, Carlos Alcober-Pérez, María Paz Navarro-Tausiet, Ma Elena Lacasa-Serrano, Ana Cristina Maza-Invernón, Jaime Peleato-Sánchez, José Miguel Buñuel-Granados, Ainara Alonso-Valbuena, Mónica Lasheras-Barrio, Isabel Ibarrondo-Fernández-Ladreda, Rosa Ma López-Aylon, María José Rodríguez-Fabre, Isabel Rubio-Gutiérrez, Selma Valverde-Aranda, Ana Cristina Bandrés-Liso, Antonio Poncel-Falcó, Kevin Bliek-Bueno, Mabel Cano-del-Pozo, Mercedes Clerencia-Sierra, Jesús Díez-Manglano, Inmaculada Guerrero-Fernández-de-Alba, Ignatios Ioakeim-Skoufa, Javier Marta-Moreno, David Santos-Muñoz, María Elisa Viñuela-Benéitez, María De Los Angeles Miguel-Abanto, Francisca García-De-Blas, Juan Carlos García-Álvarez, Sonia Redondo-de-Pedro, Carlos Fernando González-García, Carolina Peláez-Laguno, Esther Gomez-Suarez, Fernanda Morales-Ortiz, Isabel Ferrer-Zapata, Yolanda Beatriz Sánchez-Fernández, Yolanda Fernández-Fernández, Esther Barrio-Higelmo, Eva María Rioja-Delgado, Irina Lopez-Larrayoz, María Luz Seara-Lozano, Julio Cesar Fernández-Sánchez, María Teresa San-Miguel-Marinero, María Jesus Fidalgo-Baz, Sara Ares-Blanco, Jorge Ignacio Gómez-Ciriano, José Damián Garcés-Ranz, Laura Santos-Franco, María Celeste García-Galeano, Raquel Mateo-Fernández, Sara Morcillo-Cebolla, Tomás Rossignoli-Fernández, Jorge Olmedo-Galindo, Marta Pinel-González, Rosa María Redondo-Romero, Adnaloy Helena Estrada-Leon, Belén Muñoz-Gómez, Blanca Sanz-Pozo, Claudia López-Marcos, Enrique Rodríguez-De-Mingo, Juan Carlos Moreno-Fernández, Luis Enrique Morales-Cobos, María Del Prado Garcia-Garcia-Alcañiz, Marisol Lorenzo-Borda, Vera González-García, María Del Pilar Muñoz-Molina, Yasmin Drak-Hernández, Alejandro Rabanal-Basalo, Ana María Abad-Esteban, María De Los Ángeles Rollan-Hernández, Mónica Fuster-Tozer, Raquel Carretero-Ramos, Rebeca Mielgo-Salvador, Ana Sosa-Alonso, Carmen María Muros-Muñoz, Jeannet Dolores Sánchez-Yépez, María Cristina Cáceres-Cortés, María Paloma Morso-Peláez, María Pastor-Estebanez, Mercedes Fernández-Girón, Antonia Pérez-De-Colosia-Zuil, Esteban Pérez-Gutiérrez, Isabel Tejero-García, Jaime Innerarity-Martínez, Mar Álvarez-Villalba, Margarita Gómez-Barroso, María Del Mar Escobar-Gallegos, María Jesus Bedoya-Frutos, Marta Inmaculada Del-Olmo-Ribagorda, Petra María Cortés-Durán, Pilar Tardáguila-Lobato, Raquel Yolanda Terrón-Barbosa, Antonio Ramos-Blanco, Aránzazu López-Villalvilla, Beatriz Cinta-Bella, Cristian Varela-Varela, Francisca Garcia-Rodriguez, Gema María Saiz-Ladera, Guillermina López-Fernández, Lourdes Orozco-Barrenechea, María Begoña Zafra-De-Gea, Nuria García-Arpa, Tamara Ewa-Barnas, Ana Isabel Carbonero-Martín, María José Rojas-Giraldo, Alberto Cotillas-Rodero, Beatriz López-Serrano, María Del Carmen Rodriguez-Fernández, Carmelina Sanz-Velasco, Jose Ignacio Aza-Pascual-Salcedo, Carolina Lopez-Olmeda, Estrella Gutiérrez-Ocana, Raquel García-Ocaña, Teresa Sanz-Cuesta, Ricardo Rodríguez-Barrientos, Milagros Rico-Blázquez, Ma Gloria Ariza-Cardiel, Angel Mataix-San-Juan, Marta Alcaraz-Borrajo, Mercedes Rumayor-Zarzuelo, Luis Sánchez-Perruca, Amaya Azcoaga-Lorenzo, Virginia Hernández-Santiago, Rafael Rotaeche-del-Campo, and Trials, 2022
The management of asthma as a chronic inflammatory disease and global health problem: A position paper from the scientific societies J. Domínguez-Ortega, F.J. Sáez-Martínez, J.T. Gómez-Sáenz, J. Molina-París, F.J. Álvarez-Gutiérrez, Francisco Álvarez Gutiérrez, Mario Bárcena Caamaño, Marina Blanco Aparicio, Julio Delgado Romero, Javier Domínguez Ortega, Leovigildo Ginel Mendoza, José Tomás Gómez Saenz, Antonio Hidalgo Requena, Jesús Molina París, Daniel Ocaña Rodríguez, Vicente Plaza Moral, Mercedes Rodríguez Rodríguez, Miguel Román Rodríguez, Francisco José Sáez Martínez, Juan Antonio Trigueros Carrero Semergen, 2020
Mortality due to asthma in Spain, 1990-2015 J.T. Gómez Sáenz, M.J. Gérez Callejas, A. Hidalgo Requena, L. Ginel Mendoza, J. González Aguilera, J.A. Quintano Jiménez Semergen, 2019
Validation of the 'Test of the Adherence to Inhalers' (TAI) for Asthma and COPD Patients Vicente Plaza, Concepción Fernández-Rodríguez, Carlos Melero, Borja G. Cosío, Luís Manuel Entrenas, Luis Pérez de Llano, Fernando Gutiérrez-Pereyra, Eduard Tarragona, Rosa Palomino, Antolín López-Viña, and Journal of Aerosol Medicine and Pulmonary Drug Delivery, 2016
Psychometric characteristics of the Spanish version of instruments to measure neck pain disability Francisco M Kovacs, Joan Bagó, Ana Royuela, Jesús Seco, Sergio Giménez, Alfonso Muriel, Víctor Abraira, José Luis Martín, José Luis Peña, Mario Gestoso, Nicole Mufraggi, Montserrat Núñez, Josep Corcoll, Ignacio Gómez-Ochoa, Ma José Ramírez, Eva Calvo, Ma Dolores Castillo, David Martí, Salvador Fuster, Carmen Fernández, Nuria Gimeno, Alejandro Carballo, Álvaro Milán, Dolores Vázquez, Montserrat Cañellas, Ricardo Blanco, Pilar Brieva, Ma Trinidad Rueda, Luis Álvarez, María Teresa Gil del Real, Joaquín Ayerbe, Luis González, Leovigildo Ginel, Mariano Ortega, Miryam Bernal, Gonzalo Bolado, Anna Vidal, Ana Ausín, Domingo Ramón, María Antonia Mir, Miquel Tomás, Javier Zamora, Alejandra Cano BMC Musculoskeletal Disorders, 2008
