Browsing by Author "Rodríguez, Victoria"

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    Factorial Structure and Diagnostic Accuracy of a Digital Version of the Alcohol Use Disorders Identification Test (d-AUDIT) to Detect Hazardous and Problematic Drinking in Primary Care
    (2023) Barticevic Lantadilla, Nicolás A.; Poblete A., Fernando; Zuzulich Pavez, María Soledad; Rodríguez, Victoria; Pedro, Jaime San; Bradshaw, Laura; Norambuena, Pablo
    Objective: We studied the factorial structure and diagnostic performance in primary care of a digital version of the Alcohol Use Disorders Identification Test (d-AUDIT) for screening for excessive drinking. Method: In two primary care centers in Santiago, Chile, we conducted a cross-sectional study involving 330 people 18 years of age or older who had drunk alcohol six or more times in the last year. The d-AUDIT was developed from the paper version validated in Chile and was self-administered on 7-inch tablets. Trained psychologists evaluated the participants using a 1-year Timeline Followback and the alcohol use disorders section from the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We used confirmatory factorial analysis to examine the structure of the d-AUDIT and areas under the receiver operating characteristic curves (AUCs) to examine the diagnostic performance of the d-AUDIT. Results: A two-factor model presented good overall fit, with item loads in the 0.53–0.88 range. The correlation among factors was.74, reflecting a good discrimi-nant validity. The total score and the Fast Alcohol Screening Test (FAST) score (i.e., bingeing, role failure, blackouts, and others’ concern items) obtained the best diagnostic performance for problematic drinking, with AUCs of 0.94 (CI [0.91, 0.97]) and 0.92 (CI [0.88, 0.96]), respectively. The FAST could differentiate hazardous drinking (cut point three in men and one in women) from problematic drinking (cut point four in men and two in women). Conclusions: We replicated prior factor analysis findings of a two-factor structure for the d-AUDIT with a good discrimi-nant validity. The FAST obtained excellent diagnostic performance and retained some ability to discriminate between hazardous and problematic drinking.
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    Impact evaluation of an interdisciplinary approach to patients with chronic non-cancer pain in Chilean primary care
    (2025) Zamorano, Paula; Varela Yuraszeck, Teresita Ines; Salvatierra Matzner, Isidora; Tellez, Álvaro; Espinoza Sepúlveda, Manuel Antonio; Torres Riveros, Gustavo Andrés; Rodríguez, Victoria; Figueroa, María José; Rodríguez, Alejandro; Figueroa, Denisse; Silva, Leonardo; Salazar, Sheila; Lucero, Víctor; Suarez, Francisco
    Introduction Chronic non-cancer pain affects one-third of the global population. In Chile, its prevalence is estimated at 34%, surpassing the prevalence of diabetes mellitus and hypertension. Its high costs reveal that clinical treatment causes the greatest economic impact, followed by days of work absenteeism. Objective This study aims to evaluate the impact on resource consumption, quality of life, and pain perception in patients with CNCP, an interdisciplinary approach implemented in Chilean primary care public health. Methods A concurrent cohort study was conducted with patients aged 25 to 64 with chronic non-cancer musculoskeletal pain. The population studied was 698 patients receiving primary health services in centers with similar size and territorial proximity. The clinical intervention introduced patient-centered care, psychotherapy and physiotherapy from the perspective of the neuroscience of pain. The impact analysis was conducted using negative binomial regression models, generalized linear models, and ordered logistic regressions. Results Results show that the patients who were intervened increased the number of physician consultations at primary care (IRR: 1.56; 95% CI 1.30–1.87) and increased medication consumption (coef 2.38; 95% CI 2.10–2.67) compared to control patients. Intervened patients improved their quality of life (COEF 0.14; 95% CI 0.09–0.19), and pain perception was statistically significant. Despite the health system’s structural, cultural, and organizational barriers, the intervention was implemented and consolidated in daily operation, providing learnings for a further scale-up. Conclusion The study demonstrates that an interdisciplinary approach to chronic non-cancer pain management in Chilean primary care improves quality of life and pain perception while increasing healthcare resource use. Despite system barriers, the intervention was successfully implemented and sustained within patient-centered care. These findings highlight the need for resource reallocation to ensure long-term sustainability and scalability through the public health system.