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Torres-Castaño A, Perestelo-Pérez L, Koatz D, Ramos-García V, González-González AI, Toledo-Chávarri A, Bermejo-Caja CJ, Gonzalez-Pacheco H, Abt-Sack A, Pacheco-Huergo V, Orrego C. Healthcare Professionals' Perceptions about the Implementation of Shared Decision-Making in Primary Care: A Qualitative Study from a Virtual Community of Practice. Int J Integr Care 2024; 24:8. [PMID: 38638611 PMCID: PMC11025573 DOI: 10.5334/ijic.6554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 03/11/2024] [Indexed: 04/20/2024] Open
Abstract
Background The incorporation of shared decision making (SDM) is a central part of empowerment processes, as it facilitates greater activation on the part of patients, increasing the likelihood of them gaining control over their healthcare and developing skills to solve their health problems. Despite these benefits, there are still difficulties in the implementation of SDM among healthcare professionals due to internal and external factors related to the context and health systems. Aim To explore primary care professionals (PCPs)' perceptions of the SDM model, based on their preconceptions and experience in clinical practice. Methods A framework analysis was conducted on qualitative data derived from a virtual community practice forum, within a cluster-randomized clinical trial developed in the e-MPODERA project. Results The most important points in the opinions of the PCPs were: exploring the patients' values, preferences and expectations, providing them with and checking their understanding of up-to-date and evidence-based health information. The analysis revealed three themes: determinants of the implementation process of SDM, lack of consistency and dilemmas and benefits of PCP active listening, motivation and positive expectations of SDM. Discussion In our initial analysis, we examined the connections between the categories of the TDC model and its application in the primary care context. The categories related to the model reflect the theoretical understanding of professionals, while those related to perceptions of its application and use show certain discrepancies. These discrepancies could indicate a lack of understanding of the model and its real-world implications or insufficient commitment on the part of professionals or the organization to ensure its effective implementation. Conclusions Specific targeted training that addresses knowledge, attitudes and practice may resolve the aforementioned findings.
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Affiliation(s)
- Alezandra Torres-Castaño
- Canary Islands Health Research Institute Foundation, Tenerife, Spain
- Evaluation Unit of the Canary Island Health Service (SESCS), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain
| | - Lilisbeth Perestelo-Pérez
- Evaluation Unit of the Canary Island Health Service (SESCS), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain
| | - Débora Koatz
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Avedis Donabedian Research Institute (FAD), Spain
- Universidad Autónoma de Barcelona, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation, Tenerife, Spain
- Evaluation Unit of the Canary Island Health Service (SESCS), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain
| | - Ana Isabel González-González
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Innovation and International Projects Unit. Vice-Directorate for Health Research and Documentation. Directorate General for Research, Education and Innovation. Madrid Health Ministry, Spain
| | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation, Tenerife, Spain
- Evaluation Unit of the Canary Island Health Service (SESCS), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain
| | - Carlos Jesús Bermejo-Caja
- Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
- Departamento de Enfermería, Universidad Autónoma de Madrid, Madrid, Spain
| | - Himar Gonzalez-Pacheco
- Canary Islands Health Research Institute Foundation, Tenerife, Spain
- Evaluation Unit of the Canary Island Health Service (SESCS), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | - Analia Abt-Sack
- Canary Islands Health Research Institute Foundation, Tenerife, Spain
- Evaluation Unit of the Canary Island Health Service (SESCS), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain
| | - Valeria Pacheco-Huergo
- Avedis Donabedian Research Institute (FAD), Spain
- Centro de Atención Primaria Turó-Vilapicina, Institut Català de la Salut, Barcelona, Spain
| | - Carola Orrego
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Avedis Donabedian Research Institute (FAD), Spain
- Universidad Autónoma de Barcelona, Spain
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Koatz D, Torres-Castaño A, Salrach-Arnau C, Perestelo-Pérez L, Ramos-García V, González-González AI, Pacheco-Huergo V, Toledo-Chávarri A, González-Pacheco H, Orrego C. Exploring value creation in a virtual community of practice: a framework analysis for knowledge and skills development among primary care professionals. BMC Med Educ 2024; 24:121. [PMID: 38326814 PMCID: PMC10848396 DOI: 10.1186/s12909-024-05061-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/15/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Healthcare professionals traditional education reflects constraints to face the complex needs of people with chronic diseases in primary care settings. Since more innovative and practical solutions are required, Virtual Community of Practices (vCoP) seem to better respond to learning updates, improving professional and organizational knowledge. However, little is known about the value created in vCoPs as social learning environments. The objective of this project was to explore the value creation process of a gamified vCoP ("e-mpodera vCoP") aimed at improving the knowledge and attitudes of primary healthcare professionals (PCPs) (nurses and general practitioners) to the empowerment of people with chronic conditions. METHODS A framework analysis assessed the value creation process using a mixed methods approach. The framework provided awareness about knowledge and usefulness in a learning community through five cycles: (1) immediate value, (2) potential value, (3) applied value, (4) realized value, and (5) reframing value. Quantitative data included vCoP analytics such as logins, contributions, points, badges, and performance metrics. Qualitative data consisted of PCPs' forum contributions from Madrid, Catalonia, and Canary Islands over 14 months. RESULTS A total of 185 PCPs had access to the e-mpodera vCoPs. The vCoP showed the dynamic participation of 146 PCPs, along 63 content activities posted, including a total of 3,571 contributions (including text, images, links to webpages, and other files). Regarding the value creation process, the e-mpodera vCoP seems to encompass a broad spectrum of value cycles, with indicators mostly related to cycle 1 (immediate value - activities and interactions) and cycle 2 (potential value - knowledge capital); and to a lesser extent for cycle 3 (applied value - changes in practice) and for cycle 4 (realized value - performance improvement). The presence of indicators related to cycle 5 (reframing value), was minimal, due to few individual redefinitions of success. CONCLUSION To reach a wider range of value possibilities, a combination of learning objectives, competence framework, challenged-based gamified platform, and pathway model of skill development seems crucial. However, additional research is required to gain clearer insights into organizational values, professionals' lifelong educational needs in healthcare, and the long-term sustainability of performance improvement. TRIAL REGISTRATION ClinicalTrials.gov, NCT02757781. Registered on 02/05/2016.
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Affiliation(s)
- Débora Koatz
- Avedis Donabedian Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain.
| | - Alezandra Torres-Castaño
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Cristina Salrach-Arnau
- Avedis Donabedian Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Lilisbeth Perestelo-Pérez
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Ana Isabel González-González
- Innovation and International Research Unit, Directorate-General for Research and Education, Madrid Health Ministry, Madrid, Spain
- Research Institute of University Hospital Gregorio Marañón, Madrid, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Valeria Pacheco-Huergo
- Avedis Donabedian Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Atención Primaria Turó-Vilapicina, Instituto Catalán de la Salud, Barcelona, Spain
| | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Himar González-Pacheco
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Carola Orrego
- Avedis Donabedian Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
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Álvarez-Pérez Y, Duarte-Díaz A, Toledo-Chávarri A, Abt-Sacks A, Ramos-García V, Torres-Castaño A, Rivero-Santana A, Perestelo-Pérez L. Digital Health Literacy and Person-Centred Care: Co-Creation of a Massive Open Online Course for Women with Breast Cancer. Int J Environ Res Public Health 2023; 20:3922. [PMID: 36900935 PMCID: PMC10001393 DOI: 10.3390/ijerph20053922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
The diagnosis of breast cancer (BC) can make the affected person vulnerable to suffering the possible consequences of the use of low-quality health information. Massive open online courses (MOOCs) may be a useful and efficient resource to improve digital health literacy and person-centred care in this population. The aim of this study is to co-create a MOOC for women with BC, using a modified design approach based on patients' experience. Co-creation was divided into three sequential phases: exploratory, development and evaluation. Seventeen women in any stage of BC and two healthcare professionals participated. In the exploratory phase, a patient journey map was carried out and empowerment needs related to emotional management strategies and self-care guidelines were identified, as well as information needs related to understanding medical terminology. In the development phase, participants designed the structure and contents of the MOOC through a Moodle platform. A MOOC with five units was developed. In the evaluation phase, participants strongly agreed that their participation was useful for the MOOC's development and participating in the co-creation process made the content more relevant to them (experience in the co-creation); most of the participants positively evaluated the content or interface of the MOOC (acceptability pilot). Educational interventions designed by women with BC is a viable strategy to generate higher-quality, useful resources for this population.
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Affiliation(s)
- Yolanda Álvarez-Pérez
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Analía Abt-Sacks
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Alezandra Torres-Castaño
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Amado Rivero-Santana
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
| | - Lilisbeth Perestelo-Pérez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 38109 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28029 Madrid, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain
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4
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Torres-Castaño A, Abt-Sacks A, Toledo-Chávarri A, Suarez-Herrera JC, Delgado-Rodríguez J, León-Salas B, González-Hernández Y, Carmona-Rodríguez M, Serrano-Aguilar P. Ethical, Legal, Organisational and Social Issues of Teleneurology: A Scoping Review. Int J Environ Res Public Health 2023; 20:3694. [PMID: 36834388 PMCID: PMC9962592 DOI: 10.3390/ijerph20043694] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Neurological disorders are the leading cause of disability and the second leading cause of death worldwide. Teleneurology (TN) allows neurology to be applied when the doctor and patient are not present in the same place, and sometimes not at the same time. In February 2021, the Spanish Ministry of Health requested a health technology assessment report on the implementation of TN as a complement to face-to-face neurological care. METHODS A scoping review was conducted to answer the question on the ethical, legal, social, organisational, patient (ELSI) and environmental impact of TN. The assessment of these aspects was carried out by adapting the EUnetHTA Core Model 3.0 framework, the criteria established by the Spanish Network of Health Technology Assessment Agencies and the analysis criteria of the European Validate (VALues In Doing Assessments of healthcare TEchnologies) project. Key stakeholders were invited to discuss their concerns about TN in an online meeting. Subsequently, the following electronic databases were consulted from 2016 to 10 June 2021: MEDLINE and EMBASE. RESULTS 79 studies met the inclusion criteria. This scoping review includes 37 studies related to acceptability and equity, 15 studies developed during COVID and 1 study on environmental aspects. Overall, the reported results reaffirm the necessary complementarity of TN with the usual face-to-face care. CONCLUSIONS This need for complementarity relates to factors such as acceptability, feasibility, risk of dehumanisation and aspects related to privacy and the confidentiality of sensitive data.
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Affiliation(s)
- Alezandra Torres-Castaño
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
| | - Analía Abt-Sacks
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
| | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
| | - José Carlos Suarez-Herrera
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain
- UNITWIN/UNESCO Chair, Research, Planning and Development of Local Health Systems, Department of Clinical Sciences, University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
| | - Janet Delgado-Rodríguez
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
- Department of Philosophy I, University of Granada, 18071 Granada, Spain
| | - Beatriz León-Salas
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
| | - Yadira González-Hernández
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
| | - Montserrat Carmona-Rodríguez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
- Health Technology Assessment Agency, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pedro Serrano-Aguilar
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- Institute of Biomedical Technologies, University of La Laguna, 38200 Tenerife, Spain
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5
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Bas-Sarmiento P, Fernández-Gutiérrez M, Poza-Méndez M, Carrasco-Bernal MÁ, Cuenca-García M, Díaz-Rodríguez M, Gómez-Jiménez MP, Paloma-Castro O, Torres-Castaño A, Marín-Paz AJ. Needs of patients with multi-morbidity and heart failure for the development of a mHealth to improve their self-management: A qualitative analysis. Digit Health 2023; 9:20552076231180466. [PMID: 37325072 PMCID: PMC10267885 DOI: 10.1177/20552076231180466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/19/2023] [Indexed: 06/17/2023] Open
Abstract
Objective To provide practical information regarding needs, preferences of content and format of an app to assist the self-management in patients with multi-morbidity and heart failure (HF). Methods The three-phase study was conducted in Spain. Six integrative reviews, a qualitative methodology based on Van Manen's hermeneutic phenomenology through semi-structured interviews and user stories were used. Data collection continued until data saturation was reached. All data were transcribed verbatim and analysed using a framework approach. Thematic analysis technique following the methods of Braun and Clarke was used for emerging themes. Results Integrative reviews conducted included practical recommendations to include in the content and format of the App and helped create the interview guide. Interviews revealed 15 subthemes that captured the meaning of narratives offering contextual insights into the development of the App. The main effective mechanisms of multicomponent interventions for patients with HF must contain (a) components that increase the patient's understanding of HF, (b) self-care, (c) self-efficacy and participation of the family/informal caregiver, (4) psychosocial well-being and (5) professional support and use of technology. User stories revealed that patients prioritized improvements in direct contact with health services in case of emergency (90%), nutritional information (70%), type of exercises in order to improve their physical condition (75%) and information about food and drug interaction (60%). The importance of motivation messages (60%) was highlighted by transversal way. Conclusions The three-phase process integrating theoretical basis, evidence from integrative reviews and research findings from target users has been considered a guide for future app development.
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Affiliation(s)
- Pilar Bas-Sarmiento
- Department of Nursing and
Physiotherapy, University of Cadiz, Cadiz, Spain
- Instituto de Investigación e Innovación
Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - Martina Fernández-Gutiérrez
- Department of Nursing and
Physiotherapy, University of Cadiz, Cadiz, Spain
- Instituto de Investigación e Innovación
Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - Miriam Poza-Méndez
- Department of Nursing and
Physiotherapy, University of Cadiz, Cadiz, Spain
- The University Research Institute for
Sustainable Social Development (INDESS), University of Cadiz, Cadiz, Spain
| | | | - Magdalena Cuenca-García
- Instituto de Investigación e Innovación
Biomédica de Cádiz (INiBICA), Cadiz, Spain
- GALENO Research Group, Department of
Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain
| | - Mercedes Díaz-Rodríguez
- Department of Nursing and
Physiotherapy, University of Cadiz, Cadiz, Spain
- The University Research Institute for
Sustainable Social Development (INDESS), University of Cadiz, Cadiz, Spain
| | - Mª Paz Gómez-Jiménez
- Department of Nursing and
Physiotherapy, University of Cadiz, Cadiz, Spain
- Puerta del Mar University Hospital,
Andalusian Health Service, Cadiz, Spain
| | - Olga Paloma-Castro
- Department of Nursing and
Physiotherapy, University of Cadiz, Cadiz, Spain
- Instituto de Investigación e Innovación
Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - Alezandra Torres-Castaño
- Evaluation Unit of the Canary Islands
Health Service (SESCS), Canary Islands Health Research Institute Foundation (FIISC),
Tenerife, Spain
| | - Antonio-Jesús Marín-Paz
- Department of Nursing and
Physiotherapy, University of Cadiz, Cadiz, Spain
- The University Research Institute for
Sustainable Social Development (INDESS), University of Cadiz, Cadiz, Spain
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Torrente-Jimenez RS, Feijoo-Cid M, Rivero-Santana AJ, Perestelo-Pérez L, Torres-Castaño A, Ramos-García V, Bilbao A, Serrano-Aguilar P. Gender differences in the decision-making process for undergoing total knee replacement. Patient Educ Couns 2022; 105:3459-3465. [PMID: 36075809 DOI: 10.1016/j.pec.2022.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/18/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To assess gender differences in the decision-making process for treatment of knee osteoarthritis (OA). METHODS A secondary analysis of a randomized trial was conducted (n = 193). Knowledge of OA and total knee replacement (TKR), decisional conflict, satisfaction with the decision-making process, treatment preference and TKR uptake 6 months later were compared by gender. Multivariate regression models were developed to identify gender-specific predictors. RESULTS Women showed less knowledge (MD = -7.68, 95% CI: -13.9, -1.46, p = 0.016), reported less satisfaction (MD = -6.95, 95% CI: -11.7, -2.23, p = 0.004) and gave more importance to avoiding surgery (U = 2.09, p = 0.019). In women, more importance attributed to the time needed to relieve symptoms significantly reduced the odds of surgery (OR = 0.76, p = 0.016). CONCLUSION The provision of information and/or promotion of shared decision-making could be of lower quality in female patients, although other explanations such as differences in information needs or preference for involvement in decision-making cannot be ruled out with the current evidence. Given the study's limitations, especially regarding the sample size, further confirmation is needed. PRACTICE IMPLICATIONS A systematic, shared decision-making approach in consultation is needed to avoid potential gender-based biases.
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Affiliation(s)
| | - Maria Feijoo-Cid
- Department of Nursing, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Grup de Recerca Multidisciplinar en Salut i Societat (GREMSAS), (2017 SGR 917), Barcelona, Spain.
| | - Amado Javier Rivero-Santana
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Canary Islands, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain.
| | - Lilisbeth Perestelo-Pérez
- Health Services Research on Chronic Patients Network (REDISSEC), Spain; Evaluation Unit of the Canary Islands Health Service (SESCS), Canary Islands, Spain.
| | - Alezandra Torres-Castaño
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Canary Islands, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain.
| | - Vanesa Ramos-García
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Canary Islands, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain.
| | - Amaia Bilbao
- Health Services Research on Chronic Patients Network (REDISSEC), Spain; Osakidetza Basque Health Service, Basurto University Hospital, Research and Innovation Unit, Bilbao, Spain; Kronikgune Institute for Health Services Research, Barakaldo, Spain.
| | - Pedro Serrano-Aguilar
- Health Services Research on Chronic Patients Network (REDISSEC), Spain; Evaluation Unit of the Canary Islands Health Service (SESCS), Canary Islands, Spain.
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Peters LJ, Torres-Castaño A, van Etten-Jamaludin FS, Perestelo Perez L, Ubbink DT. What helps the successful implementation of digital decision aids supporting shared decision-making in cardiovascular diseases? A systematic review. Eur Heart J Digit Health 2022; 4:53-62. [PMID: 36743877 PMCID: PMC9890083 DOI: 10.1093/ehjdh/ztac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/31/2022] [Indexed: 11/12/2022]
Abstract
Aims Although digital decision aids (DAs) have been developed to improve shared decision-making (SDM), also in the cardiovascular realm, its implementation seems challenging. This study aims to systematically review the predictors of successful implementation of digital DAs for cardiovascular diseases. Methods and results Searches were conducted in MEDLINE, Embase, PsycInfo, CINAHL, and the Cochrane Library from inception to November 2021. Two reviewers independently assessed study eligibility and risk of bias. Data were extracted by using a predefined list of variables. Five good-quality studies were included, involving data of 215 patients and 235 clinicians. Studies focused on DAs for coronary artery disease, atrial fibrillation, and end-stage heart failure patients. Clinicians reported DA content, its effectivity, and a lack of knowledge on SDM and DA use as implementation barriers. Patients reported preference for another format, the way clinicians used the DA and anxiety for the upcoming intervention as barriers. In addition, barriers were related to the timing and Information and Communication Technology (ICT) integration of the DA, the limited duration of a consultation, a lack of communication among the team members, and maintaining the hospital's number of treatments. Clinicians' positive attitude towards preference elicitation and implementation of DAs in existing structures were reported as facilitators. Conclusion To improve digital DA use in cardiovascular diseases, the optimum timing of the DA, training healthcare professionals in SDM and DA usage, and integrating DAs into existing ICT structures need special effort. Current evidence, albeit limited, already offers advice on how to improve DA implementation in cardiovascular medicine.
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Affiliation(s)
| | | | - Faridi S van Etten-Jamaludin
- Research Support Medical Library, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, The Netherlands
| | | | - Dirk T Ubbink
- Department of Surgery, Location Academic Medical Center, Amsterdam University Medical Center, Amsterdam, The Netherlands
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8
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Perestelo-Perez L, Rivero-Santana A, Alvarez-Perez Y, Duarte-Díaz A, Ramos-García V, Torres-Castaño A, Abt-Sacks A, Toledo-Chavarri A, Alonso-Coello P, Orrego C, Serrano-Aguilar P. Shared decision-making in Spain in 2022: An updated revision of the current situation. Z Evid Fortbild Qual Gesundhwes 2022; 171:122-128. [PMID: 35624010 DOI: 10.1016/j.zefq.2022.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 06/15/2023]
Abstract
In Spain, there is not a national strategy to promote shared decision making (SDM) in clinical practice, and it is still not a requisite for improving the quality of health services, in either the legal norms or professionals' educational curricula. However, several national strategies in specific health areas increasingly include the principles of person centred care (PCC) and SDM into their objectives, promoting patients' empowerment and activation. Furthermore, several institutions continue to develop Patient Decision Aids (PtDAs) and other resources to facilitate patients' involvement in their own care; training programs for professionals; links between PtDAs and clinical practice guidelines; as well as interventional studies assessing the impact of PCC and SDM interventions in clinical practice. Initiatives to involve patients in health research design and health technology assessment are also being developed. We describe an update of the current state of research, policy and implementation of SDM after five years of substantial advances in Spain. Many challenges remain regarding national and regional policies on PCC and SDM, implementation of SDM in real practice and educational curricula, development of quality indicators and evaluation procedures.
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Affiliation(s)
- Lilisbeth Perestelo-Perez
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain; Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Tenerife, Spain.
| | - Amado Rivero-Santana
- Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain; Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Tenerife, Spain; Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
| | - Yolanda Alvarez-Perez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain; Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Tenerife, Spain; Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
| | - Andrea Duarte-Díaz
- Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Tenerife, Spain; Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
| | - Vanesa Ramos-García
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain; Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Tenerife, Spain; Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
| | - Alezandra Torres-Castaño
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain; Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Tenerife, Spain; Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
| | - Analía Abt-Sacks
- Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Tenerife, Spain; Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
| | - Ana Toledo-Chavarri
- Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain; Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Tenerife, Spain; Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau (IIB Sant Pau-CIBERESP), Barcelona, Spain; Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Canada
| | - Carola Orrego
- Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain; Fundació Avedis Donavedian, Barcelona, Spain
| | - Pedro Serrano-Aguilar
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain; Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Tenerife, Spain
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9
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Orrego C, Perestelo-Pérez L, González-González AI, Ballester-Santiago M, Koatz D, Pacheco-Huergo V, Rivero-Santana A, Ramos-García V, Fernández NM, Torres-Castaño A, Bermejo-Caja C. A Virtual Community of Practice to Improve Primary Health Care Professionals' Attitudes Toward Patient Empowerment (e-MPODERA): A Cluster Randomized Trial. Ann Fam Med 2022; 20:204-210. [PMID: 35606139 PMCID: PMC9199051 DOI: 10.1370/afm.2799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 09/24/2021] [Accepted: 09/30/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE We aimed to evaluate the effectiveness of a virtual community of practice (vCoP) in improving primary health care professionals' (HCPs') attitudes toward empowering patients with chronic disease. METHODS We conducted a cluster randomized controlled trial. Practices were units of randomization, and primary HCPs and patients were units of analysis. Sixty-three practices in Madrid, Catalonia, and the Canary Islands were randomly allocated to the intervention or control groups. Randominzation of practices was performed after HCP and patient recruitment. The patients and statistician were anonymized to group allocation; it was not possible to anonymize HCPs. The intervention was a 12-month multicomponent tailored vCoP built on the Web 2.0 concept and focused on skills toward patient empowerment. The primary outcome was Patient-Provider Orientation Scale (PPOS) score at baseline and at 12 months. The secondary outcome was the Patient Activation Measure (PAM) score. RESULTS A total of 321 HCPs and 1,921 patients were assessed. The intervention had a positive effect on PPOS total score (0.14 points higher in the vCoP arm; 95% CI, 0.03-0.25; P = .011) and the PPOS Sharing subscale (0.3 points higher in the vCoP arm; 95% CI, 0.15-0.44; P < .001). No effect was found for the PPOS Caring subscale, and no significant differences were found for PAM scores. CONCLUSIONS A vCoP led to a minor increase in the PPOS Sharing component and the total score but not in the Caring component. However, considerable uncertainty remains, given the observed attrition and other limitations of the study. Further research is needed on the effectiveness of the vCoP model and on how to improve HCP engagement.VISUAL ABSTRACT.
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Affiliation(s)
- Carola Orrego
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain .,Universitat Autònoma de Barcelona, Barcelona, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
| | - Lilisbeth Perestelo-Pérez
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain.,Servicio de Evaluación y Planificación del Servicio Canario de la Salud (SESCS), Tenerife, Spain
| | - Ana Isabel González-González
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain.,Institute of General Practice, Goethe University, Frankfurt, Germany.,Subdirección General de Investigación Sanitaria y Documentación, Dirección General Investigación, Docencia y Documentación, Consejería de Sanidad, Madrid, Spain
| | - Marta Ballester-Santiago
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
| | - Débora Koatz
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
| | - Valeria Pacheco-Huergo
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain.,Centro de Atención Primaria Turó, Instituto Catalán de la Salud, Barcelona, Spain
| | - Amado Rivero-Santana
- Servicio de Evaluación y Planificación del Servicio Canario de la Salud (SESCS), Tenerife, Spain.,Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FISC), Tenerife, Spain
| | - Vanesa Ramos-García
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FISC), Tenerife, Spain
| | - Nuria Mora Fernández
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Carlos Bermejo-Caja
- Universitat Autònoma de Barcelona, Barcelona, Spain.,Unidad de Apoyo Técnico, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
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10
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Torres-Castaño A, Delgado-Rodríguez J, Pino-Sedeño TD, Estaña Malaret D, de Pascual AM, Toledo-Chávarri A, Serrano-Aguilar P. Universal programs to prevent eating disorders in children and adolescents: A scoping review of ethical, legal, organizational and social impacts. Eur Eat Disord Rev 2022; 30:706-722. [PMID: 35484693 DOI: 10.1002/erv.2909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/23/2022] [Accepted: 04/04/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Appropriate and timely consideration of ethical, legal, organizational, and social issues in universal preventive programs for eating disorders (UPPED) are relevant for the approval, funding and implementation of health-policy decision making. OBJECTIVE To identify and analyse the ethical, legal, organizational, and social aspects involved in interventions aimed at the universal prevention of eating disorders (ED) in children, pre-adolescents and adolescents in the school settings. METHOD A scoping review of the literature was carried out. MEDLINE, EMBASE, CENTRAL, PsycINFO, and Social Science Citation Index were searched for studies published in English or Spanish. The quality of the studies was assessed using specific scales for each study design. RESULTS Fourteen studies were included: one scoping review; four narrative reviews, six observational studies, two qualitative studies, and one mixed methods study. Results were narratively synthesised according to: (1) equity; (2) gender perspective; (3) potential harm; (4) participants and facilitators profile; (5) feasibility; and (6) acceptability. CONCLUSIONS Interactive programs with relevant contents for participants have greater acceptability. Programs focussed on developing competencies can reduce the risk of potential harm. Incorporating a gender perspective contributes to improving equity. Teachers with prior training in ED are well suited as facilitators of these programs.
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Affiliation(s)
- Alezandra Torres-Castaño
- Canary Islands Health Research Insitute Foundation (FIISC), Tenerife, Spain.,The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | | | - Tasmania Del Pino-Sedeño
- Canary Islands Health Research Insitute Foundation (FIISC), Tenerife, Spain.,The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
| | | | | | - Ana Toledo-Chávarri
- Canary Islands Health Research Insitute Foundation (FIISC), Tenerife, Spain.,The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
| | - Pedro Serrano-Aguilar
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
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11
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Álvarez-Pérez Y, Rivero-Santana A, Perestelo-Pérez L, Duarte-Díaz A, Ramos-García V, Toledo-Chávarri A, Torres-Castaño A, León-Salas B, Infante-Ventura D, González-Hernández N, Rodríguez-Rodríguez L, Serrano-Aguilar P. Effectiveness of Mantra-Based Meditation on Mental Health: A Systematic Review and Meta-Analysis. IJERPH 2022; 19:ijerph19063380. [PMID: 35329068 PMCID: PMC8949812 DOI: 10.3390/ijerph19063380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/24/2022] [Accepted: 03/09/2022] [Indexed: 11/16/2022]
Abstract
Background: Meditation is defined as a form of cognitive training that aims to improve attentional and emotional self-regulation. This systematic review aims to evaluate the available scientific evidence on the effectiveness and safety of mantra-based meditation techniques (MBM), in comparison to passive or active controls, or other active treatment, for the management of mental health symptoms. Methods: MEDLINE, EMBASE, Cochrane Library, and PsycINFO databases were consulted up to April 2021. Randomised controlled trials regarding meditation techniques mainly based on the repetition of mantras, such as transcendental meditation or others, were included. Results: MBM, compared to control conditions, was found to produce significant small-to-moderate effect sizes in the reduction of anxiety (g = −0.46, IC95%: −0.60, −0.32; I2 = 33%), depression (g = −0.33, 95% CI: −0.48, −0.19; I2 = 12%), stress (g = −0.45, 95% CI: −0.65, −0.24; I2 = 46%), post-traumatic stress (g = −0.59, 95% CI: −0.79, −0.38; I2 = 0%), and mental health-related quality of life (g = 0.32, 95% CI: 0.15, 0.49; I2 = 0%). Conclusions: MBM appears to produce small-to-moderate significant reductions in mental health; however, this evidence is weakened by the risk of study bias and the paucity of studies with psychiatric samples and long-term follow-up.
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Affiliation(s)
- Yolanda Álvarez-Pérez
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.D.-D.); (V.R.-G.); (A.T.-C.); (A.T.-C.); (B.L.-S.); (D.I.-V.); (L.R.-R.)
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Spanish Network of Agencies for Health Technology Assessment for the National Health Service (RedETS), 28071 Madrid, Spain
- Correspondence:
| | - Amado Rivero-Santana
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.D.-D.); (V.R.-G.); (A.T.-C.); (A.T.-C.); (B.L.-S.); (D.I.-V.); (L.R.-R.)
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Spanish Network of Agencies for Health Technology Assessment for the National Health Service (RedETS), 28071 Madrid, Spain
| | - Lilisbeth Perestelo-Pérez
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Spanish Network of Agencies for Health Technology Assessment for the National Health Service (RedETS), 28071 Madrid, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), 38109 Tenerife, Spain;
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.D.-D.); (V.R.-G.); (A.T.-C.); (A.T.-C.); (B.L.-S.); (D.I.-V.); (L.R.-R.)
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Spanish Network of Agencies for Health Technology Assessment for the National Health Service (RedETS), 28071 Madrid, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.D.-D.); (V.R.-G.); (A.T.-C.); (A.T.-C.); (B.L.-S.); (D.I.-V.); (L.R.-R.)
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Spanish Network of Agencies for Health Technology Assessment for the National Health Service (RedETS), 28071 Madrid, Spain
| | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.D.-D.); (V.R.-G.); (A.T.-C.); (A.T.-C.); (B.L.-S.); (D.I.-V.); (L.R.-R.)
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Spanish Network of Agencies for Health Technology Assessment for the National Health Service (RedETS), 28071 Madrid, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), 38109 Tenerife, Spain;
| | - Alezandra Torres-Castaño
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.D.-D.); (V.R.-G.); (A.T.-C.); (A.T.-C.); (B.L.-S.); (D.I.-V.); (L.R.-R.)
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Spanish Network of Agencies for Health Technology Assessment for the National Health Service (RedETS), 28071 Madrid, Spain
| | - Beatriz León-Salas
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.D.-D.); (V.R.-G.); (A.T.-C.); (A.T.-C.); (B.L.-S.); (D.I.-V.); (L.R.-R.)
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Spanish Network of Agencies for Health Technology Assessment for the National Health Service (RedETS), 28071 Madrid, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), 38109 Tenerife, Spain;
| | - Diego Infante-Ventura
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.D.-D.); (V.R.-G.); (A.T.-C.); (A.T.-C.); (B.L.-S.); (D.I.-V.); (L.R.-R.)
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Spanish Network of Agencies for Health Technology Assessment for the National Health Service (RedETS), 28071 Madrid, Spain
| | - Nerea González-Hernández
- Research Network on Health Services in Chronic Diseases (REDISSEC), 38109 Tenerife, Spain;
- Osakidetza Basque Health Service, Barrualde-Galdakao Integrated Health Organisation, 48960 Galdakao, Spain
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1 torre del Bilbao Exhibition Centre, 48902 Barakaldo, Spain
| | - Leticia Rodríguez-Rodríguez
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.D.-D.); (V.R.-G.); (A.T.-C.); (A.T.-C.); (B.L.-S.); (D.I.-V.); (L.R.-R.)
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Spanish Network of Agencies for Health Technology Assessment for the National Health Service (RedETS), 28071 Madrid, Spain
| | - Pedro Serrano-Aguilar
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Spanish Network of Agencies for Health Technology Assessment for the National Health Service (RedETS), 28071 Madrid, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), 38109 Tenerife, Spain;
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12
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Álvarez-Pérez Y, Perestelo-Pérez L, Rivero-Santanta A, Torres-Castaño A, Toledo-Chávarri A, Duarte-Díaz A, Mahtani-Chugani V, Marrero-Díaz MD, Montanari A, Tangerini S, González-González C, Perello M, Serrano-Aguilar P. Co-Creation of Massive Open Online Courses to Improve Digital Health Literacy in Pregnant and Lactating Women. Int J Environ Res Public Health 2022; 19:ijerph19020913. [PMID: 35055733 PMCID: PMC8775560 DOI: 10.3390/ijerph19020913] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/17/2021] [Accepted: 01/11/2022] [Indexed: 11/17/2022]
Abstract
Background: Digital health literacy (DHL) increases the self-efficacy and empowerment of pregnant and lactating women (PLW) in using the Internet for health issues. The European project IC-Health aimed to improve DHL among PLW, through the co-creation of Massive Open Online Courses (MOOCs). Methods: The co-creation of the MOOCs included focus groups and the creation of communities of practice (CoPs) with PLW and healthcare professionals aimed to co-design the MOOCs. The quantitative measures of MOOCs’ acceptability, experience in the co-creation process and increase in DHL (dimensions of finding, understanding and appraisal) were assessed. Results: 17 PLW participated in focus groups, 113 participants were included in CoPs and 68 participants evaluated the acceptability of MOOCs. A total of 6 MOOCs aimed at improving PLW’s DHL were co-designed. There was a significant improvement in self-perceived DHL after using MOOCs (p-value < 0.001). The acceptability of MOOCs and co-creation experience were positively valued. Conclusions: The preliminary results of the quantitative assessment showed a higher self-perceived DHL after the IC-Health MOOCs. These results suggest that IC-Health MOOCs and the co-creation methodology appear to be a viable process to carry out an intervention aimed to improve DHL levels in European PLW.
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Affiliation(s)
- Yolanda Álvarez-Pérez
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.T.-C.); (A.T.-C.); (A.D.-D.)
- Correspondence:
| | - Lilisbeth Perestelo-Pérez
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Research Network on Health Services in Chronic Diseases (REDISSEC), 38109 Tenerife, Spain
- Center for Biomedical Research of the Canary Islands (CIBICAN), 38320 Tenerife, Spain
| | - Amado Rivero-Santanta
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.T.-C.); (A.T.-C.); (A.D.-D.)
- Research Network on Health Services in Chronic Diseases (REDISSEC), 38109 Tenerife, Spain
| | - Alezandra Torres-Castaño
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.T.-C.); (A.T.-C.); (A.D.-D.)
| | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.T.-C.); (A.T.-C.); (A.D.-D.)
- Research Network on Health Services in Chronic Diseases (REDISSEC), 38109 Tenerife, Spain
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain; (A.R.-S.); (A.T.-C.); (A.T.-C.); (A.D.-D.)
| | - Vinita Mahtani-Chugani
- Gerencia de Atención Primaria de Tenerife, 38004 Tenerife, Spain; (V.M.-C.); (M.D.M.-D.)
| | | | - Alessia Montanari
- Associazione Comitato Collaborazione Medica (CCM), 10152 Torino, Italy; (A.M.); (S.T.)
| | - Sabina Tangerini
- Associazione Comitato Collaborazione Medica (CCM), 10152 Torino, Italy; (A.M.); (S.T.)
| | - Carina González-González
- ITED Research Group, Department of Computer Science and Engineering, University of La Laguna (ULL), 38200 Tenerife, Spain;
| | | | - Pedro Serrano-Aguilar
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 Tenerife, Spain; (L.P.-P.); (P.S.-A.)
- Research Network on Health Services in Chronic Diseases (REDISSEC), 38109 Tenerife, Spain
- Center for Biomedical Research of the Canary Islands (CIBICAN), 38320 Tenerife, Spain
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Alvarez-Perez Y, Perestelo-Perez L, Rivero-Santana A, Wagner AM, Torres-Castaño A, Toledo-Chávarri A, Duarte-Díaz A, Alvarado-Martel D, Piccini B, Van den Broucke S, Vandenbosch J, González-González C, Perello M, Serrano-Aguilar P. Cocreation of Massive Open Online Courses to Improve Digital Health Literacy in Diabetes: Pilot Mixed Methods Study. JMIR Diabetes 2021; 6:e30603. [PMID: 34898453 PMCID: PMC8713090 DOI: 10.2196/30603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/12/2021] [Accepted: 09/19/2021] [Indexed: 12/19/2022] Open
Abstract
Background Self-management education is a fundamental aspect in the health care of people with diabetes to develop the necessary skills for the improvement of health outcomes. Patients are required to have the competencies to manage electronic information resources—that is, an appropriate level of digital health literacy. The European project IC-Health aimed to improve digital health literacy among people with diabetes through the cocreation of massive open online courses (MOOCs). Objective We report the preliminary results obtained in 3 participating countries in the IC-Health project (Italy, Spain, and Sweden) regarding (1) experience of the participants during the cocreation process of MOOCs, (2) perceived changes in their digital health literacy level after using MOOCs, and (3) a preliminary assessment of the acceptability of MOOCs. Methods The cocreation of the MOOCs included focus groups with adults and adolescents with diabetes and the creation of independent communities of practice for type 1 diabetes and type 2 diabetes participants aimed to co-design the MOOCs. Quantitative measures of the acceptability of MOOCs, experience in the cocreation process, and increase in digital health literacy (dimensions of finding, understanding, and appraisal) were assessed. Results A total of 28 participants with diabetes participated in focus groups. Adults and adolescents agreed that the internet is a secondary source of health-related information. A total of 149 participants comprised the diabetes communities of practice. A total of 9 MOOCs were developed. Acceptability of the MOOCs and the cocreation experience were positively valued. There was a significant improvement in digital health literacy in both adults and adolescents after using MOOCs (P<.001). Conclusions Although the results presented on self-perceived digital health literacy are preliminary and exploratory, this pilot study suggests that IC-Health MOOCs represent a promising tool for the medical care of diabetes, being able to help reduce the limitations associated with low digital health literacy and other communication barriers in the diabetes population.
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Affiliation(s)
| | - Lilisbeth Perestelo-Perez
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain
| | - Amado Rivero-Santana
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain
| | - Ana M Wagner
- Department of Endocrinology and Nutrition, University Hospital Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | | | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
| | - Dácil Alvarado-Martel
- Department of Endocrinology and Nutrition, University Hospital Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Barbara Piccini
- Diabetology Unit, Meyer University Children's Hospital, Florence, Italy
| | | | | | - Carina González-González
- Interaction, Technology, and Education Research Group, Department of Computer Science and Engineering, University of La Laguna, La Laguna, Spain
| | - Michelle Perello
- Consulta Europa Projects and Innovation, Las Palmas de Gran Canaria, Spain
| | - Pedro Serrano-Aguilar
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain
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14
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Torres-Castaño A, Rivero-Santana A, Perestelo-Pérez L, Duarte-Díaz A, Toledo-Chávarri A, Ramos-García V, Álvarez-Pérez Y, Cudeiro-Mazaira J, Padrón-González I, Serrano-Pérez P. Transcranial Magnetic Stimulation for the Treatment of Cocaine Addiction: A Systematic Review. J Clin Med 2021; 10:jcm10235595. [PMID: 34884297 PMCID: PMC8658408 DOI: 10.3390/jcm10235595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/19/2021] [Accepted: 11/26/2021] [Indexed: 12/26/2022] Open
Abstract
Long-term cocaine use is associated with cognitive deficits and neuro-psychiatric pathologies. Repetitive transcranial magnetic stimulation (rTMS) is an emerging therapeutic strategy relating to changes in brain activity. It stimulates the prefrontal cortex and is involved in inhibitory cognitive control, decision making and care. This systematic review aims to evaluate and synthesize the evidence on the safety, effectiveness, and cost-effectiveness of rTMS for the treatment of cocaine addiction. A systematic review of the literature was carried out. The following electronic databases were consulted from inception to October 2020: MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and Web of Science. Randomised controlled trials, non-randomised controlled trials and case-series and full economic evaluations were included. Twelve studies were included. No identified study reported data on cost-effectiveness. Significant results of the efficacy of TMS have been observed in terms of the reduction of craving to consume and the number of doses consumed. No serious adverse effects have been observed. Despite the low quality of the studies, the first results were observed in terms of reduction of cocaine use and craving. In any case, this effect is considered moderate. Studies with larger sample sizes and longer follow-ups are required.
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Affiliation(s)
- Alezandra Torres-Castaño
- Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain; (A.R.-S.); (A.D.-D.); (A.T.-C.); (V.R.-G.); (Y.Á.-P.)
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38019 El Rosario, Spain;
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
- Correspondence:
| | - Amado Rivero-Santana
- Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain; (A.R.-S.); (A.D.-D.); (A.T.-C.); (V.R.-G.); (Y.Á.-P.)
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38019 El Rosario, Spain;
| | | | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain; (A.R.-S.); (A.D.-D.); (A.T.-C.); (V.R.-G.); (Y.Á.-P.)
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38019 El Rosario, Spain;
| | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain; (A.R.-S.); (A.D.-D.); (A.T.-C.); (V.R.-G.); (Y.Á.-P.)
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38019 El Rosario, Spain;
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain; (A.R.-S.); (A.D.-D.); (A.T.-C.); (V.R.-G.); (Y.Á.-P.)
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38019 El Rosario, Spain;
| | - Yolanda Álvarez-Pérez
- Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain; (A.R.-S.); (A.D.-D.); (A.T.-C.); (V.R.-G.); (Y.Á.-P.)
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38019 El Rosario, Spain;
| | - Javier Cudeiro-Mazaira
- Galician Brain Stimulation Center, 15009 A Coruña, Spain;
- Neuroscience and Motor Control Group (NEUROcom), Instituto Biomédico de A Coruña (INIBIC), Universidad de A Coruña, 15006 Oza, Spain
| | - Iván Padrón-González
- Institute of Neuroscience, University of La Laguna, Guajara Campus, 38200 San Cristobal de La Laguna, Spain;
| | - Pedro Serrano-Pérez
- Group of Psychiatry, Mental Health and Addictions at the Vall d’Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain;
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15
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Rivero-Santana A, Torrente-Jiménez RS, Perestelo-Pérez L, Torres-Castaño A, Ramos-García V, Bilbao A, Escobar A, Serrano-Aguilar P, Feijoo-Cid M. Effectiveness of a decision aid for patients with knee osteoarthritis: a randomized controlled trial. Osteoarthritis Cartilage 2021; 29:1265-1274. [PMID: 34174455 DOI: 10.1016/j.joca.2021.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 06/03/2021] [Accepted: 06/13/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the effectiveness of a Patient Decision Aid (PtDA) for knee osteoarthritis. METHOD Randomized controlled trial, in which 193 patients were allocated to the PtDA or usual care. Outcome measures were the Decisional Conflict Scale (DCS), knowledge of osteoarthritis and arthroplasty, satisfaction with the decision-making process (SDMP) and treatment preference, assessed immediately after the intervention. At 6 months, the same measures were applied in non-operated patients, whereas those who underwent arthroplasty completed the SDMP and the Decisional Regret Scale (DRS). RESULTS The PtDA produced a significant immediate improvement of decisional conflict (MD = -11.65, 95%CI: -14.93, -8.37), objective knowledge (MD = 10.37, 99%IC: 3.15, 17.70) and satisfaction (MD = 6.77, 99%CI: 1.19, 12.34), and a different distribution of preferences (χ2 = 8.74, p = 0.033). Patients with less than secondary education obtained a stronger effect on decisional conflict (p = 0.015 for the interaction) but weaker for knowledge (p = 0.051). At 6 months, there were no significant differences in any variable, including the rate of total knee replacement. Operated patients showed a low level of regret, which was not affected by the intervention. CONCLUSION The PtDA is effective immediately after its application, but it shows no effects in the medium-term. Future research should investigate which subgroups of patients could benefit more from this intervention, as well as the longitudinal evolution of decision-related psychological variables.
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Affiliation(s)
- A Rivero-Santana
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Canary Islands, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain.
| | - R S Torrente-Jiménez
- Department of Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - L Perestelo-Pérez
- Health Services Research on Chronic Patients Network (REDISSEC), Spain; Evaluation Unit of the Canary Islands Health Service (SESCS), Canary Islands, Spain.
| | - A Torres-Castaño
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Canary Islands, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain.
| | - V Ramos-García
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Canary Islands, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain.
| | - A Bilbao
- Health Services Research on Chronic Patients Network (REDISSEC), Spain; Osakidetza/Basque Health Service, Research Unit, Basurto University Hospital, Bilbao, Bizkaia, Spain.
| | - A Escobar
- Health Services Research on Chronic Patients Network (REDISSEC), Spain; Osakidetza/Basque Health Service, Research Unit, Basurto University Hospital, Bilbao, Bizkaia, Spain
| | - P Serrano-Aguilar
- Health Services Research on Chronic Patients Network (REDISSEC), Spain; Evaluation Unit of the Canary Islands Health Service (SESCS), Canary Islands, Spain.
| | - M Feijoo-Cid
- Department of Nursing, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Grup de Recerca Multidisciplinar en Salut i Societat (GREMSAS), (2017SGR 917), Barcelona, Spain.
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16
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Perestelo-Pérez L, Rivero-Santana A, Ramos-García V, Álvarez-Pérez Y, Duarte-Díaz A, Torres-Castaño A, Trujillo-Martín MDM, Del Pino-Sedeño T, González-González AI, Serrano-Aguilar P. Effectiveness of a web-based decision aid for patients with generalised anxiety disorder: a protocol for a randomised controlled trial. BMJ Open 2020; 10:e039956. [PMID: 33303445 PMCID: PMC7733176 DOI: 10.1136/bmjopen-2020-039956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Patients with generalised anxiety disorder (GAD) have concerns and needs about their health and the healthcare they receive. Patient decision aids (PtDAs) are tools that assist patients in making health decisions, when there is uncertainty about treatment choice, incorporating their personal preferences and values about the available treatment options. PtDAs can improve shared decision-making and lead to better treatment outcomes. The aim of this study is to evaluate the effectiveness of a web-based PtDA for patients with GAD in primary care (PC). METHODS AND ANALYSIS The general study design is comprised of two stages: (1) development of a web-based PtDA for patients with GAD, derived from an evidence-based Clinical Practice Guideline and (2) assessment of the effectiveness of the PtDA in a randomised controlled trial (RCT) design, in PC centres in Tenerife (Spain). This RCT will be carried out with 124 patients with GAD, comparing the PtDA to a fact sheet with general information on mental health. Patients will review the PtDA in one session accompanied by a researcher. Post-intervention measures will be administered immediately after the intervention and at 3-month follow-up. The primary outcome will be decisional conflict. Secondary outcomes will include knowledge about GAD and its treatment, treatment preference, concordance between treatment preference and choice, and decision quality (knowledge ≥60% and concordant decision). ETHICS AND DISSEMINATION The project received ethics approval from the local committee at Nuestra Señora de la Candelaria (HUNSC) University Hospital in Santa Cruz de Tenerife (code: CHUNSC_2019_58). Informed consent will be obtained from each participant before randomisation. Results from the trial will be submitted for publication in international peer-reviewed scientific journals and will be disseminated through workshops and local and international conferences. TRIAL REGISTRATION NUMBER NCT04364958.
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Affiliation(s)
- Lilisbeth Perestelo-Pérez
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain
| | - Amado Rivero-Santana
- Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain
- Canary Islands Health Research Institute Foundation, Tenerife, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation, Tenerife, Spain
- University of La Laguna, Tenerife, Spain
| | | | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation, Tenerife, Spain
- University of La Laguna, Tenerife, Spain
| | | | - Maria Del Mar Trujillo-Martín
- Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain
- Canary Islands Health Research Institute Foundation, Tenerife, Spain
| | | | - Ana Isabel González-González
- Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain
- Goethe-Universitat Frankfurt am Main Institut fur Allgemeinmedizin, Frankfurt am Main, Germany
- Centro de Salud Vicente Muzas, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Pedro Serrano-Aguilar
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain
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17
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Toledo-Chávarri A, Ramos-García V, Torres-Castaño A, Trujillo-Martín MM, Peñate Castro W, Del Cura-Castro I, Serrano-Aguilar P, Perestelo-Pérez L. Framing the process in the implementation of care for people with generalized anxiety disorder in primary care: a qualitative evidence synthesis. BMC Fam Pract 2020; 21:237. [PMID: 33218311 PMCID: PMC7678131 DOI: 10.1186/s12875-020-01307-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 11/09/2020] [Indexed: 11/27/2022]
Abstract
Background Generalized anxiety disorder (GAD) is one of the most common mental disorders in primary care (PC). GAD has low remission and high relapse rates over long follow-up periods. Qualitative evidence was synthesized to understand the implementation of care and treatment options for people with GAD in PC. Methods Research published from 2008 to September 2020 was searched in five databases (MEDLINE, EMBASE, CINAHL, WOS and PsycArticles). Studies that used qualitative methods for data collection and analysis to investigate the implementation of care and treatment options for people with GAD in PC and outpatient settings were included. Non-qualitative studies, mixed methods studies that did not separately report qualitative findings and studies in languages other than English or Spanish were excluded. We used the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) framework to assess the overall confidence in the findings. Results The results with a moderate level of confidence showed that the trajectory of care for people with GAD in PC and outpatient settings is long and fluctuates over time, involving multiple difficulties in accessing and maintaining initial treatment or successive treatment options. In addition, there are wide variations in the preferences for and acceptability of different treatment options. The results with a high level of confidence indicated that more information on GAD and its treatment options is needed for PC practitioners, GAD patients and their carers. The results with a low level of confidence suggested that patients use antidepressants for longer than recommended and that the interruption of treatment is not usually planned. Conclusions Initial resistance to new treatments among people with GAD can make access and adherence to treatment difficult. Improving care may require patients to be informed of possible trajectories in stepped care pathways before the initiation of treatment so they are aware that they may need to try a number of options until the most effective treatment for them is found. Increased awareness of and information materials on GAD may facilitate both appropriate diagnosis and long-term care. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-020-01307-6.
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Affiliation(s)
- Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation, Tenerife, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain.,The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation, Tenerife, Spain. .,The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain.
| | - Alezandra Torres-Castaño
- Canary Islands Health Research Institute Foundation, Tenerife, Spain.,The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain
| | - María M Trujillo-Martín
- Canary Islands Health Research Institute Foundation, Tenerife, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain.,The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain
| | - Wenceslao Peñate Castro
- Facultad de Ciencias de la Salud - Sección de Psicología, University of La Laguna, Tenerife, Spain
| | - Isabel Del Cura-Castro
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Unidad de Apoyo a la Investigación, Gerencia Asistencial de Atención Primaria, Madrid, Spain.,Department Preventive Medicine and Public Health, University Rey Juan Carlos, Madrid, Spain
| | - Pedro Serrano-Aguilar
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain.,The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain.,Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
| | - Lilisbeth Perestelo-Pérez
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain.,The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain.,Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
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18
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Torres-Castaño A, Perestelo-Pérez L, Duarte-Díaz A, Toledo-Chávarri A, Ramos-García V, Álvarez-Pérez Y, Serrano-Aguilar P. Information needs and research priorities for fertility preservation in women with breast cancer: patients and experts' perspectives. Eur J Cancer Care (Engl) 2020; 30:e13359. [PMID: 33191537 DOI: 10.1111/ecc.13359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/02/2020] [Accepted: 10/14/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify the information needs and research priorities that women with breast cancer (BC), their families and BC experts perceive on the fertility preservation. METHODS We conducted two Delphi-based studies through three online rounds. The first was aimed to identify information and research needs; the second one to assess the importance of those needs and the third one to obtain consensus, defined as an interquartile range ≤2. RESULTS The participation rate was 76.2% in study 1 and 53.7% in study 2. The most important information needs were the referral protocol, pregnancy options for women with BC, side effects of tamoxifen and menopause as a consequence of treatment. The most important research priorities were the participation of different health professionals to provide oncofertility information, referral protocols and efficacy and safety of FP options. CONCLUSION Information about fertility preservation in the context of BC and different ways to get pregnant, considering risks and benefits, has emerged as an unmet need for patients and careers. The need for a participatory and coordinated approach to the provision of information on oncofertility has been agreed. Other research needs are described in an attempt to focus future research in the most necessary areas.
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Affiliation(s)
| | - Lilisbeth Perestelo-Pérez
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Evaluation Unit of Canary Islands Health Service (SESCS), Sant Cruz de Tenerife, Spain
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), Santa Cruz de Tenerife, Spain
| | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation (FIISC), Santa Cruz de Tenerife, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation (FIISC), Santa Cruz de Tenerife, Spain
| | - Yolanda Álvarez-Pérez
- Canary Islands Health Research Institute Foundation (FIISC), Santa Cruz de Tenerife, Spain
| | - Pedro Serrano-Aguilar
- Canary Islands Health Research Institute Foundation (FIISC), Santa Cruz de Tenerife, Spain
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19
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Perestelo-Pérez L, Rivero-Santana A, González-González AI, Bermejo-Caja CJ, Ramos-García V, Koatz D, Torres-Castaño A, Ballester M, Muñoz-Balsa M, Del Rey-Granado Y, Pérez-Rivas FJ, Canellas-Criado Y, Ramírez-Puerta AB, Pacheco-Huergo V, Orrego C. Cross-cultural validation of the patient-practitioner orientation scale among primary care professionals in Spain. Health Expect 2020; 24:33-41. [PMID: 33124759 PMCID: PMC7879539 DOI: 10.1111/hex.13135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/18/2020] [Accepted: 09/05/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND In recent decades, many self-report instruments have been developed to assess the extent to which patients want to be informed and involved in decisions about their health as part of the concept of person-centred care (PCC). The main objective of this research was to translate, adapt and validate the Patient-Practitioner Orientation Scale (PPOS) using a sample of primary care health-care professionals in Spain. METHODS Baseline analysis of PPOS scores for 321 primary care professionals (general practitioners and nurses) from 63 centres and 3 Spanish regions participating in a randomized controlled trial. We analysed missing values, distributions and descriptive statistics, item-to-scale correlations and internal consistency. Performed were confirmatory factor analysis (CFA) of the 2-factor model (sharing and caring dimensions), scale depuration and principal component analysis (PCA). RESULTS Low inter-item correlations were observed, and the CFA 2-factor model only obtained a good fit to the data after excluding 8 items. Internal consistency of the 10-item PPOS was acceptable (0.77), but low for individual subscales (0.70 and 0.55). PCA results suggest a possible 3-factor structure. Participants showed a patient-oriented style (mean = 4.46, SD = 0.73), with higher scores for caring than sharing. CONCLUSION Although the 2-factor model obtained empirical support, measurement indicators of the PPOS (caring dimension) could be improved. Spanish primary care health-care professionals overall show a patient-oriented attitude, although less marked in issues such as patients' need for and management of medical information.
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Affiliation(s)
- Lilisbeth Perestelo-Pérez
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Centre for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain
| | - Amado Rivero-Santana
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Centre for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain.,Canary Islands Foundation and Institute for Health Research (FIISC), Tenerife, Spain
| | - Ana Isabel González-González
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Primary Care Centre Vicente Muzas, Community of Madrid Health Service, Madrid, Spain.,Institute of General Medicine, Johann Wolfgang Goethe University, Frankfurt-am-Main, Germany
| | - Carlos Jesús Bermejo-Caja
- Support Unit for Primary Care, Community of Madrid Health Service, Madrid, Spain.,Nursing Department, Autonomus University of Madrid, Madrid, Spain
| | - Vanesa Ramos-García
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Canary Islands Foundation and Institute for Health Research (FIISC), Tenerife, Spain
| | - Débora Koatz
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Avedis Donabedian Institute, Autonomous University of Barcelona, Barcelona, Spain
| | - Alezandra Torres-Castaño
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Canary Islands Foundation and Institute for Health Research (FIISC), Tenerife, Spain
| | - Marta Ballester
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Avedis Donabedian Institute, Autonomous University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | - Carola Orrego
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Avedis Donabedian Institute, Autonomous University of Barcelona, Barcelona, Spain
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González-González AI, Perestelo-Pérez L, Koatz D, Ballester M, Pacheco-Huergo V, Ramos-García V, Torres-Castaño A, Rivero-Santana A, Toledo-Chávarri A, Valcárcel-Nazco C, Mateos-Rodilla J, Obaya-Rebollar JC, García-García J, Díaz-Sánchez S, Morales-Cobos L, Bosch-Fontcuberta JM, Vallejo-Camazón N, Rodríguez-Almodovar A, Del Castillo JC, Muñoz-Balsa M, Del Rey-Granado Y, Garrido-Elustondo S, Tello-Bernabé ME, Ramírez-Puerta AB, Orrego C. Effectiveness and cost-effectiveness of a virtual community of practice to improve the empowerment of patients with ischaemic heart disease: study protocol of a randomised controlled trial. BMJ Open 2020; 10:e037374. [PMID: 33046465 PMCID: PMC7552830 DOI: 10.1136/bmjopen-2020-037374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Virtual Communities of Practice (VCoP) or knowledge-sharing virtual communities offer ubiquitous access to information and exchange possibilities for people in similar situations, which might be especially valuable for the self-management of patients with chronic diseases. In view of the scarce evidence on the clinical and economic impact of these interventions on chronic conditions, we aim to evaluate the effectiveness and cost-effectiveness of a VCoP in the improvement of the activation and other patient empowerment measures in patients with ischaemic heart disease (IHD). METHODS AND ANALYSIS A pragmatic randomised controlled trial will be performed in Catalonia, Madrid and Canary Islands, Spain. Two hundred and fifty patients with a recent diagnosis of IHD attending the participating centres will be selected and randomised to the intervention or control group. The intervention group will be offered participation for 12 months in a VCoP based on a gamified web 2.0 platform where there is interaction with other patients and a multidisciplinary professional team. Intervention and control groups will receive usual care. The primary outcome will be measured with the Patient Activation Measure questionnaire at baseline, 6, 12 and 18 months. Secondary outcomes will include: clinical variables; knowledge (Questionnaire of Cardiovascular Risk Factors), attitudes (Self-efficacy Managing Chronic Disease Scale), adherence to the Mediterranean diet (Mediterranean Diet Questionnaire), level of physical activity (International Physical Activity Questionnaire), depression (Patient Health Questionnaire), anxiety (Hospital Anxiety Scale-A), medication adherence (Adherence to Refill Medication Scale), quality of life (EQ-5D-5L) and health resources use. Data will be collected from self-reported questionnaires and electronic medical records. ETHICS AND DISSEMINATION The trial was approved by Clinical Research Ethics Committee of Gregorio Marañón University Hospital in Madrid, Nuestra Señora de Candelaria University Hospital in Santa Cruz de Tenerife and IDIAP Jordi Gol in Barcelona. The results will be disseminated through workshops, policy briefs, peer-reviewed publications, local/international conferences. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT03959631). Pre-results.
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Affiliation(s)
- Ana Isabel González-González
- Goethe-Universitat Frankfurt am Main Institut fur Allgemeinmedizin, Frankfurt am Main, Hessen, Germany
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Madrid, Madrid, Spain
| | - Lilisbeth Perestelo-Pérez
- Servicio de Evaluación y Planificación del Servicio Canario de la Salud, Tenerife, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Tenerife, Spain
| | - Débora Koatz
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Barcelona, Spain
| | - Marta Ballester
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Barcelona, Spain
| | - Valeria Pacheco-Huergo
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Centro de Atención Primaria Turó, Instituto Catalán de la Salud, Barcelona, Spain
| | - Vanesa Ramos-García
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FISC), Tenerife, Spain
| | | | - Amado Rivero-Santana
- Servicio de Evaluación y Planificación del Servicio Canario de la Salud, Tenerife, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Tenerife, Spain
| | - Ana Toledo-Chávarri
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Tenerife, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FISC), Tenerife, Spain
| | | | - Juana Mateos-Rodilla
- Escuela Madrileña de Salud, Dirección General de Humanización y Atención al Paciente, Madrid, Spain
| | | | - Javier García-García
- Unidad de Calidad y Seguridad del Paciente. Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain
| | | | - Luis Morales-Cobos
- Centro de Salud Las Américas, Gerencia Asistencial de Atención Primaria, Madrid, Spain
| | - Josep María Bosch-Fontcuberta
- Centro de Atención Primaria Encants, Instituto Catalán de la Salud, Barcelona, Spain
- Departament de Medicina Area de Medicina, Universitat Autonoma de Barcelona, Barcelona, Catalunya, Spain
| | | | | | | | - Marcos Muñoz-Balsa
- Unidad de Apoyo Técnico, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Yolanda Del Rey-Granado
- Unidad de Apoyo Técnico, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Sofía Garrido-Elustondo
- Centre Family and Community Care Teaching Multiprofessional Unit, Comunidad de Madrid Consejeria de Sanidad, Madrid, Spain
| | - María-Eugenia Tello-Bernabé
- Centro de Salud El Naranjo, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Ana Belén Ramírez-Puerta
- Unidad de Apoyo Técnico, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Carola Orrego
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Barcelona, Spain
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Perestelo-Pérez L, Álvarez-Pérez Y, Rivero-Santana A, Ramos-García V, Duarte-Díaz A, Torres-Castaño A, Toledo-Chávarri A, Herrera-Perez M, País-Brito JL, Del Castillo JC, Vázquez JR, Orrego C, Serrano-Aguilar P. The effectiveness of a web-based decision aid for patients with hip osteoarthritis: study protocol for a randomized controlled trial. Trials 2020; 21:736. [PMID: 32838800 PMCID: PMC7445920 DOI: 10.1186/s13063-020-04661-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/07/2020] [Indexed: 11/23/2022] Open
Abstract
Background Osteoarthritis (OA) is a health condition sensitive to patient’s preferences and values regarding the benefits and risks of the different treatment options. In this sense, patient decision aids (PtDA) can play an important role in helping patients to incorporate their values, needs, and preferences into the decision-making process, thus improving person-centered care. Previous research has focused almost exclusively on knee OA, and therefore, the aim of this study is to develop and evaluate the effectiveness of a PtDA for patients with hip OA. Methods The general design consists of two phases: (1) design a web-based PtDA for patients with hip OA, following the recommended procedures: systematic review of safety/effectiveness of treatments, and an iterative process of development with the help of an Advisory Committee composed of health professionals and patients, and (2) to evaluate the impact of the PtDA on hip OA patients’ decision-making process related with their treatment. For that aim, a multicenter randomized controlled trial will be carried out with 124 patients with hip OA in Tenerife (Spain) comparing intervention or usual care. Discussion PtDAs have been recommended as a useful and effective resource for improving PCC in many health conditions. The intervention is intended to empower patients by fostering their active participation during the decision-making process about their treatment and by ensuring they make informed decisions congruent with their values and preferences. This study will contribute to the scientific knowledge about effectiveness of PtDAs in hip OA, in order to improve the quality of health care offered to these patients. Trial registration ClinicalTrials.gov NCT04241978. Registered on 24 January 2020.
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Affiliation(s)
- Lilisbeth Perestelo-Pérez
- Evaluation Unit of the Canary Islands Health Service (SESCS), Camino Candelaria, s/n. 38109, El Rosario, S/C de Tenerife, Spain. .,Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain. .,Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain.
| | - Yolanda Álvarez-Pérez
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Tenerife, Spain
| | - Amado Rivero-Santana
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain.,Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Tenerife, Spain
| | - Vanesa Ramos-García
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Tenerife, Spain
| | - Andrea Duarte-Díaz
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Tenerife, Spain
| | | | - Ana Toledo-Chávarri
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Tenerife, Spain
| | | | - José Luis País-Brito
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Hospital Universitario de Canarias (HUC), Tenerife, Spain
| | | | - José Ramón Vázquez
- Gerencia de Atención Primaria de Tenerife del Servicio Canario de la Salud, Tenerife, Spain
| | - Carola Orrego
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Avedis Donabedian Research Institute (FAD), Barcelona, Spain
| | - Pedro Serrano-Aguilar
- Evaluation Unit of the Canary Islands Health Service (SESCS), Camino Candelaria, s/n. 38109, El Rosario, S/C de Tenerife, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain
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Perestelo-Perez L, Rivero-Santana A, Torres-Castaño A, Ramos-Garcia V, Alvarez-Perez Y, Gonzalez-Hernandez N, Buron A, Pignone M, Serrano-Aguilar P. Effectiveness of a decision aid for promoting colorectal cancer screening in Spain: a randomized trial. BMC Med Inform Decis Mak 2019; 19:8. [PMID: 30630487 PMCID: PMC6327535 DOI: 10.1186/s12911-019-0739-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/02/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) screening has shown to reduce incidence and mortality rates, and therefore is widely recommended for people above 50 years-old. However, despite the implementation of population-based screening programs in several countries, uptake rates are still low. Decision aids (DAs) may help patients to make informed decisions about CRC screening. METHODS We performed a randomized controlled trial to assess the effectiveness of a DA developed to promote CRC screening, with patients from two primary care centers in Spain who never had underwent CRC screening. Contrary to center B (n = 24), Center A (n = 83) attended patients from an area where the population-based screening program was not implemented at that moment. Outcome measures were decisional conflict, knowledge of the disease and available screening options, intention to uptake the test, and concordance between patients' goals/concerns and intention. RESULTS In center A, there were significant differences favoring the DA in decisional conflict (p < 0.001) and knowledge (p < 0.001). The absolute differences favoring DA group in intention to undergo fecal occult blood test (10.5%) and colonoscopy (13.7%) were significant only before correction for attenuation. In center B the differences were significant only for knowledge (p < 0.001). Patients' goals and concerns regarding the screening did not significantly predict their intention, and therefore we could not calculate a measure of concordance between the two constructs. CONCLUSIONS A DA improved the decisional process of participants who had never been invited to participate in the Spanish public CRC screening program, replicating previous results in this field. Future research is needed to identify subgroups that could benefit more from these interventions. TRIAL REGISTRATION International Standard Registered Clinical/social Study Number: ISRCTN98108615 (Retrospectively registered on 27 December 2018).
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Affiliation(s)
- Lilisbeth Perestelo-Perez
- Evaluation Unit of the Canary Islands Health Service (SESCS), s/n. 38109. El Rosario. S/C de Tenerife, Tenerife, Spain.
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain.
- Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain.
- Canary Islands Foundation of Health Research (FUNCANIS), Tenerife, Spain.
| | - Amado Rivero-Santana
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain
- Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain
- Canary Islands Foundation of Health Research (FUNCANIS), Tenerife, Spain
| | | | | | | | - Nerea Gonzalez-Hernandez
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain
- Research Unit. Hospital Galdakao-Usansolo, Bilbao, Bizkaia, Spain
| | - Andrea Buron
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain
- Epidemiology and Evaluation Unit. Hospital del Mar, Barcelona, Spain
| | | | - Pedro Serrano-Aguilar
- Evaluation Unit of the Canary Islands Health Service (SESCS), s/n. 38109. El Rosario. S/C de Tenerife, Tenerife, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Tenerife, Spain
- Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain
- Canary Islands Foundation of Health Research (FUNCANIS), Tenerife, Spain
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