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Mitigación de la enfermedad respiratoria crónica a través de la lente de la multimorbilidad: el protocolo del estudio
Renata Gonçalves Mendes1, Naiara Tais Leonardi2, Viviane Castello-Simões2
1Physical Therapy Department, Federal University of São Carlos, São Carlos, Brazil renatamendes@ufscar.br.
BMJ open
|January 16, 2026
Resumen
El cuestionario COPD in Low-Income and Middle-Income Countries Assessment (COLA-6) muestra ser prometedor para identificar enfermedades respiratorias crónicas (ERC) en la atención primaria brasileña. Esta herramienta simple puede ayudar en el diagnóstico y manejo temprano de las ERC dentro de los servicios de enfermedades no transmisibles.
Área de la Ciencia:
- Salud Pública
- Medicina Respiratoria
- Investigación en Atención Primaria
Sus antecedentes:
- Las enfermedades respiratorias crónicas (ERC), como el asma y la EPOC, se encuentran entre las principales enfermedades no transmisibles (ENT) a nivel mundial.
- El diagnóstico de ERC en países de ingresos bajos y medianos (PIMB) es difícil debido al acceso y la experiencia limitados en espirometría.
- Las ERC a menudo coexisten con otras ENT, lo que aumenta la morbilidad, la mortalidad y los costos de atención médica.
Objetivo del estudio:
- Evaluar la precisión, viabilidad e implementación del cuestionario COLA-6 para la identificación de ERC en la atención primaria de salud (APS) brasileña.
- Evaluar el papel de COLA-6 en el manejo de las ERC dentro de los servicios de ECNT en países de ingresos bajos y medianos (PIMB).
Principales métodos:
- El estudio Multimorbidity Approach for REspiratory Solutions (MARES) involucra tres paquetes de trabajo en la APS brasileña.
- MARES-1: Estudio transversal (859 individuos) que compara COLA-6 con espirometría, CAAT, ACQ-7 y FeNO para el diagnóstico de ERC.
- MARES-2: Profesionales de la salud (20) implementan COLA-6 con 1000 pacientes; entrevistas cualitativas exploran las barreras/facilitadores de la implementación.
- MARES-3: Seguimiento longitudinal (473 participantes) que evalúa los cambios en la espirometría y las experiencias de atención médica.
Principales resultados:
- El rendimiento diagnóstico de COLA-6 para diversas ERC se evaluará utilizando curvas ROC.
- Se explorarán la viabilidad y las barreras para la implementación de COLA-6 en la atención rutinaria de ECNT.
- Se analizarán los cambios en los marcadores de función respiratoria y las experiencias del paciente durante 6 meses.
Conclusiones:
- El cuestionario COLA-6 ofrece una solución potencial para mejorar la detección de casos de ERC en entornos con recursos limitados.
- La implementación exitosa podría mejorar la identificación y el manejo tempranos de las ERC dentro de los servicios integrados de ECNT.
- Los hallazgos abordarán una brecha crítica en la atención primaria para el diagnóstico y la atención de las ERC en los PIMB.
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