title: Clustering of unhealthy lifestyle behaviors is associated with a low adherence to recommended preventive practices among COPD patients in Spain.
abstract: OBJECTIVE
  To analyze clustering of unhealthy lifestyle behavior and its relationship with non-adherence to recommended clinical preventive care services among Spanish COPD patients.
  
  
  METHODS
  Cross-sectional study including 2,575 COPD subjects from the 2006 Spanish National Health Survey (NHS) and 2009 European Health Survey for Spain (EHISS). Subjects were asked about the following recommended preventive practices: uptake of blood pressure (BP) measurement, lipid profile, influenza vaccination and dental examination. Lifestyle behaviors included: smoking status, physical activity, alcohol consumption and obesity. Logistic regression models were built to assess the association between clustering of unhealthy lifestyle and the uptake of preventive activities.
  
  
  RESULTS
  Blood pressure measurement in the previous 6 months and a blood lipid test in the last year had not been taken by 11.74% and 23.26% of the subjects, respectively, in 2006 NHS and by 11.16% and 16.33% of the subjects, respectively, in EHISS 2009. Then, 36.36% percent had not been vaccinated and 70.61% had not received dental examination in 2006 NHS and these percentages decreased to 27.33% and 66.22%, respectively, in 2009 EHISS. A higher number of unhealthy lifestyle behaviors increased the probability of not being vaccinated and not having a dental examination. Clustering of unhealthy lifestyle behaviors is linearly associated with a greater number of preventive measures unfulfilled.
  
  
  CONCLUSIONS
  Compliance with healthy lifestyles and adherence to recommended clinical preventive services is under desirable levels among Spanish COPD patients. Patients with lifestyles considered as "worse" are those who also have lower uptake of recommended preventive activities.
authors.affiliation: 1Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Universidad Complutense , Madrid , Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: de Miguel-Díez
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jiménez-García
authors.forename: Valentín
authors.initials: V
authors.lastname: Hernández-Barrera
authors.forename: Luis Puente
authors.initials: LP
authors.lastname: Maestu
authors.forename: Irene Jarana
authors.initials: IJ
authors.lastname: Aparicio
authors.forename: Alicia Oliva
authors.initials: AO
authors.lastname: Ramos
authors.forename: Ana
authors.initials: A
authors.lastname: López de Andrés
authors.forename: Pilar
authors.initials: P
authors.lastname: Carrasco-Garrido
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D001795:Blood Pressure Determination; D003430:Cross-Sectional Studies; D003729:Dental Care; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000517:prevention & control*; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000517:prevention & control*; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D008055:Lipids
keywords: COPD; alcohol consumption; blood pressure control; dental care; epidemiology; food habits; influenza vaccine; lifestyle; lipid profiles; national health surveys; physical activity; preventive medicine; smoking