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Goñi-Sarriés A, Pírez G, Yárnoz-Goñi N, Lahortiga-Ramos F, Iruin Á, Díez-Suárez A, Zorrilla I, Morata-Sampaio L, Oliver MJ, González-Pinto A, Sánchez-Villegas A. SESSAMO, follow-up of secondary students to assess mental health and obesity: a cohort study. Gac Sanit 2024; 38:102385. [PMID: 38613905 DOI: 10.1016/j.gaceta.2024.102385] [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] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 12/19/2023] [Accepted: 02/01/2024] [Indexed: 04/15/2024]
Abstract
During last decades, a departure from health-related lifestyles has been observed among adolescents. Evidence reports that healthy lifestyles could be predictors of better mental health status. The aims of the SESSAMO Project are: 1) to assess the association between lifestyles and physical and mental health; 2) to assess how self-concept and stressful life events can modulate these associations; and 3) to establish the role of social determinants in the lifestyle and in adolescents' health. The SESSAMO Project is a prospective cohort carried out in Spain. Students aged 14-16 years (2nd-4th ESO) and their parents are invited to participate. Baseline data are collected through on-line, validated, self-administered questionnaires through a digital platform. Information on lifestyles, stressful life events and self-concept are collected. Screening of depression, anxiety, eating disorders, suicide risk, psychotic experiences and COVID impact is assessed. Every three years, up to age of 25, participants will be contacted again to update relevant information.
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Affiliation(s)
- Adriana Goñi-Sarriés
- Red de Salud Mental de Navarra, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Guillermo Pírez
- Servicio de Psiquiatría, Complejo Hospitalario Universitario Insular-Materno Infantil, Servicio Canario de la Salud, Las Palmas de Gran Canaria, Spain
| | - Nora Yárnoz-Goñi
- Servicio de Psiquiatría, Hospital Clínico Universitario Lozano Blesa, Servicio Aragonés de Salud, Zaragoza, Spain
| | - Francisca Lahortiga-Ramos
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; Departamento de Psiquiatría y Psicología Médica, Universidad de Navarra, Pamplona, Spain
| | - Álvaro Iruin
- Biodonostia Health Research Institute, Donostia-San Sebastián, Spain; Red de Salud Mental de Gipuzkoa, Osakidetza, Spain
| | - Azucena Díez-Suárez
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; Unidad de Psiquiatría Infantil y Adolescente, Departamento de Psiquiatría y Psicología Médica, Clínica Universidad de Navarra, Pamplona, Spain
| | | | - Leticia Morata-Sampaio
- Departamento de Psicología y Sociología, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - M Jesús Oliver
- Research Institute of Biomedical and Health Sciencies, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | | | - Almudena Sánchez-Villegas
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain; Institute for Innovation & Sustainable Development in Food Chain, Universidad Pública de Navarra, Pamplona, Spain.
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Gabilondo A, Muela A, Belarra B, De Sayas A, García J, López P, Reich H, Iruin Á. [Evaluation of BIZI, a new Spanish-language online program for community-based suicide preventionAvaliação do BIZI, um novo programa on-line em espanhol para prevenção de suicídio com base na comunidade]. Rev Panam Salud Publica 2024; 48:e20. [PMID: 38562956 PMCID: PMC10984240 DOI: 10.26633/rpsp.2024.20] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/15/2023] [Indexed: 04/04/2024] Open
Abstract
Objective To evaluate the BIZI program, a Spanish-language gatekeeper training program with a novel online self-learning format that is brief and open-access. It was developed as part of the suicide prevention strategy in Euskadi (Spain) to improve community-based suicide prevention. Methods A group of experts from different fields created the program and tested its usability in a preliminary phase. A single-group design was used for the evaluation, with repeated measurements (before, immediately after, and after three months). Online questionnaires were used to evaluate the program's impact on core competencies for gatekeepers, as well as adherence to content and user satisfaction. Community agents (educators and social workers, among others) who responded to an invitation sent by regional public health coordinators were included in the study. Results In total, 728 people accessed the training, and 86% completed it; 569 people completed the assessment (81.2% women, mean age 41.4 years). The core gatekeeper competencies of attitude, self-efficacy, and knowledge improved significantly, and improvement was sustained ≥3 months in a subsample (P = 0.0001). Conclusions The results are promising and suggest that BIZI is useful in improving the capacity and willingness of community agents to identify people at risk and refer them to specialized resources. Its novel format gives it important advantages over other more common gatekeeper training programs, facilitating its dissemination in low-resource environments. It is the first program of its kind whose effectiveness has been demonstrated and also the first available in Spanish.
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Affiliation(s)
- Andrea Gabilondo
- Instituto de Investigación en Salud Biogipuzkoa Servicio Vasco de Salud (Osakidetza) Donostia-San Sebastián España Instituto de Investigación en Salud Biogipuzkoa, Servicio Vasco de Salud (Osakidetza), Donostia-San Sebastián, España
| | - Alexander Muela
- Facultad de Psicología Universidad del País Vasco Donostia-San Sebastián España Facultad de Psicología, Universidad del País Vasco, Donostia-San Sebastián, España
| | - Begoña Belarra
- Osasun Eskola Servicio Vasco de Salud (Osakidetza) Vitoria-Gasteiz España Osasun Eskola, Servicio Vasco de Salud (Osakidetza), Vitoria-Gasteiz, España
| | - Andrea De Sayas
- Osasun Eskola Servicio Vasco de Salud (Osakidetza) Vitoria-Gasteiz España Osasun Eskola, Servicio Vasco de Salud (Osakidetza), Vitoria-Gasteiz, España
| | - Jon García
- Instituto de Investigación en Salud Biogipuzkoa Servicio Vasco de Salud (Osakidetza) Bilbao España Instituto de Investigación en Salud Biogipuzkoa, Servicio Vasco de Salud (Osakidetza), Bilbao, España
| | - Puy López
- Osasun Eskola Servicio Vasco de Salud (Osakidetza) Vitoria-Gasteiz España Osasun Eskola, Servicio Vasco de Salud (Osakidetza), Vitoria-Gasteiz, España
| | - Hanna Reich
- Fundación Alemana contra la Depresión Frankfurt Alemania Fundación Alemana contra la Depresión, Frankfurt, Alemania
| | - Álvaro Iruin
- Instituto de Investigación en Salud Biogipuzkoa Servicio Vasco de Salud (Osakidetza) Donostia-San Sebastián España Instituto de Investigación en Salud Biogipuzkoa, Servicio Vasco de Salud (Osakidetza), Donostia-San Sebastián, España
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Mar J, Gorostiza A, Arrospide A, Larrañaga I, Alberdi A, Cernuda C, Iruin Á, Tainta M, Mar-Barrutia L, Ibarrondo O. Estimation of the epidemiology of dementia and associated neuropsychiatric symptoms by applying machine learning to real-world data. Rev Psiquiatr Salud Ment (Engl Ed) 2022; 15:167-175. [PMID: 36272739 DOI: 10.1016/j.rpsmen.2022.09.005] [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] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/14/2021] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Incidence rates of dementia-related neuropsychiatric symptoms (NPS) are not known and this hampers the assessment of their population burden. The objective of this study was to obtain an approximate estimate of the population incidence and prevalence of both dementia and NPS. METHODS Given the dynamic nature of the population with dementia, a retrospective study was conducted within the database of the Basque Health Service (real-world data) at the beginning and end of 2019. Validated random forest models were used to identify separately depressive and psychotic clusters according to their presence in the electronic health records of all patients diagnosed with dementia. RESULTS Among the 631,949 individuals over 60 years registered, 28,563 were diagnosed with dementia, of whom 15,828 (55.4%) showed psychotic symptoms and 19,461 (68.1%) depressive symptoms. The incidence of dementia in 2019 was 6.8/1000 person-years. Most incident cases of depressive (72.3%) and psychotic (51.9%) NPS occurred in cases of incident dementia. The risk of depressive-type NPS grows with years since dementia diagnosis, living in a nursing home, and female sex, but falls with older age. In the psychotic cluster model, the effects of male sex, and older age are inverted, both increasing the probability of this type of symptoms. CONCLUSIONS The stigmatization factor conditions the social and attitudinal environment, delaying the diagnosis of dementia, preventing patients from receiving adequate care and exacerbating families' suffering. This study evidences the synergy between big data and real-world data for psychiatric epidemiological research.
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Affiliation(s)
- Javier Mar
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Bizkaia, Spain.
| | - Ania Gorostiza
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain
| | - Arantzazu Arrospide
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Bizkaia, Spain
| | - Igor Larrañaga
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain
| | - Ane Alberdi
- Mondragon Unibertsitatea, Faculty of Engineering, Electronics and Computing Department, Arrasate-Mondragón, Gipuzkoa, Spain
| | - Carlos Cernuda
- Mondragon Unibertsitatea, Faculty of Engineering, Electronics and Computing Department, Arrasate-Mondragón, Gipuzkoa, Spain
| | - Álvaro Iruin
- Basque Health Service (Osakidetza), Gipuzkoa Mental Health Network, Donostia-San Sebastián, Gipuzkoa, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Mikel Tainta
- Basque Health Service (Osakidetza), Goierri-Urola Garaia Integrated Healthcare Organisation, Department of Neurology, Zumarraga, Gipuzkoa, Spain; Fundación CITA-Alzheimer Fundazioa, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Lorea Mar-Barrutia
- Psiquiatry Service, Hospital Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Oliver Ibarrondo
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain; RS-Statistics, Arrasate-Mondragón, Gipuzkoa, Spain
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Mar J, Gorostiza A, Arrospide A, Larrañaga I, Alberdi A, Cernuda C, Iruin Á, Tainta M, Mar-Barrutia L, Ibarrondo O. Estimation of the epidemiology of dementia and associated neuropsychiatric symptoms by applying machine learning to real-world data. Rev Psiquiatr Salud Ment (Engl Ed) 2021; 15:S1888-9891(21)00032-X. [PMID: 33774222 DOI: 10.1016/j.rpsm.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/14/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Incidence rates of dementia-related neuropsychiatric symptoms (NPS) are not known and this hampers the assessment of their population burden. The objective of this study was to obtain an approximate estimate of the population incidence and prevalence of both dementia and NPS. METHODS Given the dynamic nature of the population with dementia, a retrospective study was conducted within the database of the Basque Health Service (real-world data) at the beginning and end of 2019. Validated random forest models were used to identify separately depressive and psychotic clusters according to their presence in the electronic health records of all patients diagnosed with dementia. RESULTS Among the 631,949 individuals over 60 years registered, 28,563 were diagnosed with dementia, of whom 15,828 (55.4%) showed psychotic symptoms and 19,461 (68.1%) depressive symptoms. The incidence of dementia in 2019 was 6.8/1000 person-years. Most incident cases of depressive (72.3%) and psychotic (51.9%) NPS occurred in cases of incident dementia. The risk of depressive-type NPS grows with years since dementia diagnosis, living in a nursing home, and female sex, but falls with older age. In the psychotic cluster model, the effects of male sex, and older age are inverted, both increasing the probability of this type of symptoms. CONCLUSIONS The stigmatization factor conditions the social and attitudinal environment, delaying the diagnosis of dementia, preventing patients from receiving adequate care and exacerbating families' suffering. This study evidences the synergy between big data and real-world data for psychiatric epidemiological research.
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Affiliation(s)
- Javier Mar
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Bizkaia, Spain.
| | - Ania Gorostiza
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain
| | - Arantzazu Arrospide
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Bizkaia, Spain
| | - Igor Larrañaga
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain
| | - Ane Alberdi
- Mondragon Unibertsitatea, Faculty of Engineering, Electronics and Computing Department, Arrasate-Mondragón, Gipuzkoa, Spain
| | - Carlos Cernuda
- Mondragon Unibertsitatea, Faculty of Engineering, Electronics and Computing Department, Arrasate-Mondragón, Gipuzkoa, Spain
| | - Álvaro Iruin
- Basque Health Service (Osakidetza), Gipuzkoa Mental Health Network, Donostia-San Sebastián, Gipuzkoa, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Mikel Tainta
- Basque Health Service (Osakidetza), Goierri-Urola Garaia Integrated Healthcare Organisation, Department of Neurology, Zumarraga, Gipuzkoa, Spain; Fundación CITA-Alzheimer Fundazioa, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Lorea Mar-Barrutia
- Psiquiatry Service, Hospital Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Oliver Ibarrondo
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain; RS-Statistics, Arrasate-Mondragón, Gipuzkoa, Spain
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Mar J, Gorostiza A, Ibarrondo O, Cernuda C, Alberdi A, Iruin Á, Tainta M. Validation and calibration of machine‐learning predictive models aimed to identify dementia‐related neuropsychiatric symptoms on real‐world data (RWD). Alzheimers Dement 2020. [DOI: 10.1002/alz.039104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Javier Mar
- Alto Deba Hospital Arrasate‐Mondragón Spain
| | | | | | | | - Ane Alberdi
- Mondragon University Arrasate‐Mondragón Spain
| | - Álvaro Iruin
- Gipuzkoa Mental Health Network Donostia‐San Sebastian Spain
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Mar J, Arrospide A, Soto-Gordoa M, Machón M, Iruin Á, Martinez-Lage P, Gabilondo A, Moreno-Izco F, Gabilondo A, Arriola L. Validity of a computerised population registry of dementia based on clinical databases. Neurologia (Engl Ed) 2020; 36:418-425. [PMID: 34238524 DOI: 10.1016/j.nrleng.2018.03.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/01/2018] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The handling of information through digital media allows innovative approaches for identifying cases of dementia through computerised searches within the clinical databases that include systems for coding diagnoses. The aim of this study was to analyse the validity of a dementia registry in Gipuzkoa based on the administrative and clinical databases existing in the Basque Health Service. METHODS This is a descriptive study based on the evaluation of available data sources. First, through review of medical records, the diagnostic validity was evaluated in two samples of cases identified and not identified as dementia. The sensitivity, specificity and positive and negative predictive value of the diagnosis of dementia were measured. Subsequently, the cases of living dementia in December 31, 2016 were searched in the entire Gipuzkoa population to collect sociodemographic and clinical variables. RESULTS The validation samples included 986 cases and 327 no cases. The calculated sensitivity was 80.2% and the specificity was 99.9%. The negative predictive value was 99.4% and positive value was 95.1%. The cases in Gipuzkoa were 10 551, representing 65% of the cases predicted according to the literature. Antipsychotic medication were taken by a 40% and a 25% of the cases were institutionalised. CONCLUSIONS A registry of dementias based on clinical and administrative databases is valid and feasible. Its main contribution is to show the dimension of dementia in the health system.
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Affiliation(s)
- J Mar
- Unidad de Gestión Sanitaria, Hospital Alto Deba, Arrasate-Mondragón, Spain; Unidad de Investigación AP-OSIs Gipuzkoa, Organización Sanitaria Integrada Alto Deba, Arrasate-Mondragón, Spain; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC), Spain; Instituto Biodonostia, Donostia-San Sebastián, Spain.
| | - A Arrospide
- Unidad de Investigación AP-OSIs Gipuzkoa, Organización Sanitaria Integrada Alto Deba, Arrasate-Mondragón, Spain; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC), Spain; Instituto Biodonostia, Donostia-San Sebastián, Spain
| | - M Soto-Gordoa
- Unidad de Investigación AP-OSIs Gipuzkoa, Organización Sanitaria Integrada Alto Deba, Arrasate-Mondragón, Spain; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC), Spain; Instituto Biodonostia, Donostia-San Sebastián, Spain
| | - M Machón
- Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC), Spain; Instituto Biodonostia, Donostia-San Sebastián, Spain; Unidad de Investigación AP-OSIs Gipuzkoa, Donostia-San Sebastián, Spain
| | - Á Iruin
- Instituto Biodonostia, Donostia-San Sebastián, Spain; Red de Salud Mental Extrahospitalaria de Gipuzkoa, Donostia-San Sebastián, Spain
| | | | - A Gabilondo
- Servicio de Neurología, Organización Sanitaria Integrada Bidasoa, Irún, Spain
| | - F Moreno-Izco
- Instituto Biodonostia, Donostia-San Sebastián, Spain; Servicio de Neurología, Hospital Donostia, Donostia-San Sebastián, Spain
| | - A Gabilondo
- Instituto Biodonostia, Donostia-San Sebastián, Spain; Red de Salud Mental Extrahospitalaria de Gipuzkoa, Donostia-San Sebastián, Spain
| | - L Arriola
- Instituto Biodonostia, Donostia-San Sebastián, Spain; Subdirección de Salud Pública de Gipuzkoa, Gobierno Vasco, Donostia-San Sebastián, Spain; CIBERESP CIBER Epidemiología y Salud Pública, Donostia-San Sebastián, Spain
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Mar J, Gorostiza A, Ibarrondo O, Cernuda C, Arrospide A, Iruin Á, Larrañaga I, Tainta M, Ezpeleta E, Alberdi A. Validation of Random Forest Machine Learning Models to Predict Dementia-Related Neuropsychiatric Symptoms in Real-World Data. J Alzheimers Dis 2020; 77:855-864. [PMID: 32741825 PMCID: PMC7592688 DOI: 10.3233/jad-200345] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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] [Subscribe] [Scholar Register] [Accepted: 06/24/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are the leading cause of the social burden of dementia but their role is underestimated. OBJECTIVE The objective of the study was to validate predictive models to separately identify psychotic and depressive symptoms in patients diagnosed with dementia using clinical databases representing the whole population to inform decision-makers. METHODS First, we searched the electronic health records of 4,003 patients with dementia to identify NPS. Second, machine learning (random forest) algorithms were applied to build separate predictive models for psychotic and depressive symptom clusters in the training set (N = 3,003). Third, calibration and discrimination were assessed in the test set (N = 1,000) to assess the performance of the models. RESULTS Neuropsychiatric symptoms were noted in the electronic health record of 58% of patients. The area under the receiver operating curve reached 0.80 for the psychotic cluster model and 0.74 for the depressive cluster model. The Kappa index and accuracy also showed better discrimination in the psychotic model. Calibration plots indicated that both types of model had less predictive accuracy when the probability of neuropsychiatric symptoms was <25%. The most important variables in the psychotic cluster model were use of risperidone, level of sedation, use of quetiapine and haloperidol and the number of antipsychotics prescribed. In the depressive cluster model, the most important variables were number of antidepressants prescribed, escitalopram use, level of sedation, and age. CONCLUSION Given their relatively good performance, the predictive models can be used to estimate prevalence of NPS in population databases.
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Affiliation(s)
- Javier Mar
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Guipúzcoa, Spain
- Kronikgune Institute for Health Service Research, Barakaldo, Spain
- Biodonostia Health Research Institute, Donostia-San Sebastán, Guipúzcoa, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Vizcaya, Spain
| | - Ania Gorostiza
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Guipúzcoa, Spain
- Kronikgune Institute for Health Service Research, Barakaldo, Spain
| | - Oliver Ibarrondo
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Guipúzcoa, Spain
- Kronikgune Institute for Health Service Research, Barakaldo, Spain
- Biodonostia Health Research Institute, Donostia-San Sebastán, Guipúzcoa, Spain
| | - Carlos Cernuda
- Mondragon Unibertsitatea, Faculty of Engineering, Electronics and Computing Department, Arrasate-Mondragon, Gipuzkoa, Spain
| | - Arantzazu Arrospide
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Guipúzcoa, Spain
- Kronikgune Institute for Health Service Research, Barakaldo, Spain
- Biodonostia Health Research Institute, Donostia-San Sebastán, Guipúzcoa, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Vizcaya, Spain
| | - Álvaro Iruin
- Biodonostia Health Research Institute, Donostia-San Sebastán, Guipúzcoa, Spain
- Basque Health Service (Osakidetza), Gipuzkoa Mental Health Network, Donostia-San Sebastián, Guipúzcoa, Spain
| | - Igor Larrañaga
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Guipúzcoa, Spain
- Kronikgune Institute for Health Service Research, Barakaldo, Spain
| | - Mikel Tainta
- Kronikgune Institute for Health Service Research, Barakaldo, Spain
- Department of Neurology, Basque Health Service (Osakidetza), Goierri-Urola Garaia Integrated Healthcare Organisation, Zumarraga, Guipúzcoa, Spain
- Fundación CITA-Alzheimer Fundazioa, Donostia-San Sebastián, Guipúzcoa, Spain
| | - Enaitz Ezpeleta
- Mondragon Unibertsitatea, Faculty of Engineering, Electronics and Computing Department, Arrasate-Mondragon, Gipuzkoa, Spain
| | - Ane Alberdi
- Mondragon Unibertsitatea, Faculty of Engineering, Electronics and Computing Department, Arrasate-Mondragon, Gipuzkoa, Spain
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Ruiz-Iriondo M, Salaberría K, Polo-López R, Iruin Á, Echeburúa E. Improving clinical symptoms, functioning, and quality of life in chronic schizophrenia with an integrated psychological therapy (IPT) plus emotional management training (EMT): A controlled clinical trial. Psychother Res 2019; 30:1026-1038. [PMID: 31651213 DOI: 10.1080/10503307.2019.1683634] [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] [Indexed: 10/25/2022] Open
Abstract
Objective: This paper describes the results of testing a multi-component psychological therapy that includes integrated psychological therapy (IPT), together with an adaptation of emotional management therapy (EMT), versus treatment as usual (TAU), delivered in a community mental health setting for individual with chronic schizophrenia. We investigated the effectiveness of a psychological intervention on clinical symptoms, cognitive and social functioning, as well as the feasibility of treatment and its acceptance. Method: 77 outpatients were recruited, 42 in the experimental group, who were treated with IPT + EMT, and 35 participants in control condition (TAU), both during 8 months. The subjects of both groups were assessed pre and postreatment. Results: Treatment attendance was 98% in experimental group and none of patients required hospital admission during therapy, meanwhile 11 patients from the TAU group withdrew and 3 were hospitalized during therapy. After therapy, patients in the experimental group compared to TAU, reduced clinical symptoms and improved cognitive functioning and quality of life. Conclusion: Psychological therapy seems to be a feasible intervention even in the chronic stages of the disease.
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Affiliation(s)
- Maria Ruiz-Iriondo
- Mental Health and Psychiatric Assistance, Neuroscience Department, Biodonostia Health Research Institute, Gipuzkoa, Spain.,Department of Personality, Assessment and Psychological Treatment (UPV/EHU), Psychology School, Gipuzkoa, Spain
| | - Karmele Salaberría
- Mental Health and Psychiatric Assistance, Neuroscience Department, Biodonostia Health Research Institute, Gipuzkoa, Spain.,Department of Personality, Assessment and Psychological Treatment (UPV/EHU), Psychology School, Gipuzkoa, Spain
| | - Rocio Polo-López
- Mental Health and Psychiatric Assistance, Neuroscience Department, Biodonostia Health Research Institute, Gipuzkoa, Spain
| | - Álvaro Iruin
- Mental Health and Psychiatric Assistance, Neuroscience Department, Biodonostia Health Research Institute, Gipuzkoa, Spain.,Guipúzcoa Mental Health Network, Basque Health Service-Osakidetza, Gipuzkoa, Spain
| | - Enrique Echeburúa
- Mental Health and Psychiatric Assistance, Neuroscience Department, Biodonostia Health Research Institute, Gipuzkoa, Spain.,Department of Personality, Assessment and Psychological Treatment (UPV/EHU), Psychology School, Gipuzkoa, Spain
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Mar J, Arrospide A, Soto-Gordoa M, Iruin Á, Tainta M, Gabilondo A, Mar-Barrutia L, Calvo M, Mateos M, Ibarrondo O. Dementia-related neuropsychiatric symptoms: inequalities in pharmacological treatment and institutionalization. Neuropsychiatr Dis Treat 2019; 15:2027-2034. [PMID: 31413574 PMCID: PMC6657654 DOI: 10.2147/ndt.s209008] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 06/24/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Dementia-related neuropsychiatric symptoms (NPS) are the main determinant of family stress and institutionalization of patients. This study aimed to identify inequalities by gender and socioeconomic status in the management of NPS in patients diagnosed with dementia. METHODS An observational study was carried out to study all the cases of dementia in the corporate database of the Basque Health Service (29,864 patients). The prescription of antipsychotics and antidepressants and admission to a nursing home were used to establish the presence of NPS. The socioeconomic status of individuals was classified by a deprivation index. Logistic regressions were used to identify drivers for drug prescriptions and institutionalization. RESULTS NPS are poorly recorded in the clinical databases (12%). Neuropsychiatric symptoms were severe enough in two thirds of patients with dementia to be treated with psychoactive medication. Institutionalization showed an increase from those who did not receive medication to those who had been prescribed antidepressants (OR: 1.546), antipsychotics (OR: 2.075) or both (OR: 2.741). The resulting inequalities were the increased prescription of antidepressant drugs in women and more nursing-home admissions for women who were the least socioeconomically deprived and men who were the most deprived. CONCLUSIONS In large clinical databases, psychoactive drugs prescriptions can be useful to underscore the considerable burden of dementia-related NPS. Specific tools are needed to monitor social and health care programs targeted to dementia-related NPS from a population perspective. Programs aimed at reducing the family burden of care of dementia patients at home become the key elements in reducing inequalities in these patients' care. Socioeconomic status is the most important driver of inequality, and gender inequality may simply be hidden within the social environment. Integrated programs boosting the continuity of care are an objective for which compliance could be measured according to the NPS coding in the electronic health record.
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Affiliation(s)
- Javier Mar
- Clinical Management Unit, OSI Alto Deba, Arrasate-Mondragón, España
- AP-OSIs Gipuzkoa Research Unit, OSI Alto Deba, Arrasate-Mondragón, España
- Economic Evaluation Department, Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Spain
- Economic Evaluation Department, Biodonostia Health Research Institute, Donostia-San Sebastián, Spain
| | - Arantzazu Arrospide
- AP-OSIs Gipuzkoa Research Unit, OSI Alto Deba, Arrasate-Mondragón, España
- Economic Evaluation Department, Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Spain
- Economic Evaluation Department, Biodonostia Health Research Institute, Donostia-San Sebastián, Spain
| | - Myriam Soto-Gordoa
- Departamento de Ingeniería de Organización, Mondragón Unibertsitatea, Arrasate-Mondragón, España
| | - Álvaro Iruin
- Economic Evaluation Department, Biodonostia Health Research Institute, Donostia-San Sebastián, Spain
- Psychiatry Service, Gipuzkoa Mental Health Network, Donostia-San Sebastián, España
| | - Mikel Tainta
- Psychiatry Service, CITA Alzheimer Foundation, Donostia-San Sebastián, España
- Neurology Service, OSI Goierri-Alto Urola, Zumárraga, España
| | - Andrea Gabilondo
- Economic Evaluation Department, Biodonostia Health Research Institute, Donostia-San Sebastián, Spain
- Psychiatry Service, Gipuzkoa Mental Health Network, Donostia-San Sebastián, España
| | - Lore Mar-Barrutia
- Psychiatry Service, Hospital Bellvitge, Hospitalet de Llobregat, España
| | | | - Maider Mateos
- Health Department, Basque Government, Vitoria-Gasteiz, España
| | - Oliver Ibarrondo
- AP-OSIs Gipuzkoa Research Unit, OSI Alto Deba, Arrasate-Mondragón, España
- Economic Evaluation Department, Biodonostia Health Research Institute, Donostia-San Sebastián, Spain
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Mar J, Arrospide A, Soto-Gordoa M, Machón M, Iruin Á, Martinez-Lage P, Gabilondo A, Moreno-Izco F, Gabilondo A, Arriola L. Validity of a computerized population registry of dementia based on clinical databases. Neurologia 2018. [PMID: 29752034 DOI: 10.1016/j.nrl.2018.03.005] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The handling of information through digital media allows innovative approaches for identifying cases of dementia through computerized searches within the clinical databases that include systems for coding diagnoses. The aim of this study was to analyze the validity of a dementia registry in Gipuzkoa based on the administrative and clinical databases existing in the Basque Health Service. METHODS This is a descriptive study based on the evaluation of available data sources. First, through review of medical records, the diagnostic validity was evaluated in 2 samples of cases identified and not identified as dementia. The sensitivity, specificity and positive and negative predictive value of the diagnosis of dementia were measured. Subsequently, the cases of living dementia in December 31, 2016 were searched in the entire Gipuzkoa population to collect sociodemographic and clinical variables. RESULTS The validation samples included 986 cases and 327 no cases. The calculated sensitivity was 80.2% and the specificity was 99.9%. The negative predictive value was 99.4% and positive value was 95.1%. The cases in Gipuzkoa were 10,551, representing 65% of the cases predicted according to the literature. Antipsychotic medication were taken by a 40% and a 25% of the cases were institutionalized. CONCLUSIONS A registry of dementias based on clinical and administrative databases is valid and feasible. Its main contribution is to show the dimension of dementia in the health system.
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Affiliation(s)
- J Mar
- Unidad de Gestión Sanitaria, Hospital Alto Deba, Arrasate-Mondragón, España; Unidad de Investigación AP-OSIs Gipuzkoa, Organización Sanitaria Integrada Alto Deba, Arrasate-Mondragón, España; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC); Instituto Biodonostia, Donostia-San Sebastián, España.
| | - A Arrospide
- Unidad de Investigación AP-OSIs Gipuzkoa, Organización Sanitaria Integrada Alto Deba, Arrasate-Mondragón, España; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC); Instituto Biodonostia, Donostia-San Sebastián, España
| | - M Soto-Gordoa
- Unidad de Investigación AP-OSIs Gipuzkoa, Organización Sanitaria Integrada Alto Deba, Arrasate-Mondragón, España; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC); Instituto Biodonostia, Donostia-San Sebastián, España
| | - M Machón
- Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC); Instituto Biodonostia, Donostia-San Sebastián, España; Unidad de Investigación AP-OSIs Gipuzkoa, Donostia-San Sebastián, España
| | - Á Iruin
- Instituto Biodonostia, Donostia-San Sebastián, España; Red de Salud Mental Extrahospitalaria de Gipuzkoa, Donostia-San Sebastián, España
| | | | - A Gabilondo
- Servicio de Neurología, Organización Sanitaria Integrada Bidasoa, Irún, España
| | - F Moreno-Izco
- Instituto Biodonostia, Donostia-San Sebastián, España; Servicio de Neurología, Hospital Donostia, Donostia-San Sebastián, España
| | - A Gabilondo
- Instituto Biodonostia, Donostia-San Sebastián, España; Red de Salud Mental Extrahospitalaria de Gipuzkoa, Donostia-San Sebastián, España
| | - L Arriola
- Instituto Biodonostia, Donostia-San Sebastián, España; Subdirección de Salud Pública de Gipuzkoa, Gobierno Vasco, Donostia-San Sebastián, España; CIBERESP CIBER Epidemiología y Salud Pública, Donostia-San Sebastián, España
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Calderón C, Balagué L, Iruin Á, Retolaza A, Belaunzaran J, Basterrechea J, Mosquera I. [Primary care and mental health care collaboration in patients with depression: Evaluation of a pilot experience]. Aten Primaria 2015; 48:356-65. [PMID: 26522782 PMCID: PMC6877855 DOI: 10.1016/j.aprim.2015.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 03/09/2015] [Revised: 06/23/2015] [Accepted: 06/29/2015] [Indexed: 11/15/2022] Open
Abstract
Objetivo Implementar y evaluar una experiencia colaborativa entre Atención Primaria (AP) y Salud Mental (SM) para mejorar la asistencia a los pacientes con depresión. Diseño Proyecto colaborativo piloto con enfoque de investigación acción participativa (IAP) durante 2013. Emplazamiento : País Vasco. Osakidetza (Servicio Vasco de Salud). Bizkaia y Gipuzkoa. Participantes Doscientos siete profesionales de medicina de familia, enfermería, psiquiatría, enfermería psiquiátrica, psicología y trabajo social de 9 centros de salud y 6 centros de salud mental de Osakidetza. Intervenciones Diseño y desarrollo compartido de 4 ejes de intervención: 1) comunicación y conocimiento entre profesionales de AP y SM; 2) mejora en la codificación diagnóstica y derivación de pacientes; 3) formación compartida mediante sesiones y guías de práctica clínica comunes, y 4) evaluación. Mediciones principales Encuestas a profesionales de centros de intervención y control sobre conocimiento y satisfacción en la relación AP-SM, actividades formativas conjuntas y valoración de la experiencia. Registros de Osakidetza sobre prevalencias, derivaciones y tratamientos. Reuniones de seguimiento. Resultados Mejoría en los centros de intervención respecto a los de control en los 4 ejes de intervención. Identificación de factores a considerar en el desarrollo y la sostenibilidad de la colaboración AP-SM. Conclusiones La experiencia piloto confirma que los proyectos colaborativos promovidos por AP y SM pueden mejorar la asistencia y satisfacción de los profesionales. Son proyectos complejos que requieren intervenciones simultáneas adecuadas a las singularidades de los servicios de salud. La participación pluridisciplinaria y continuada, y el apoyo de la gestión y los sistemas de información, son condiciones necesarias para su implementación.
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Affiliation(s)
- Carlos Calderón
- Centro de Salud de Alza, OSI Donostia, Osakidetza, Donostia-San Sebastián, España; Unidad de Investigación de Atención Primaria-OSIs Gipuzkoa, Osakidetza, Donostia-San Sebastián, España.
| | - Laura Balagué
- Centro de Salud de Iztieta, OSI Donostia, Osakidetza, Errenteria, España; Unidad de Investigación de Atención Primaria-OSIs Gipuzkoa, Osakidetza, Donostia-San Sebastián, España
| | - Álvaro Iruin
- Red de Salud Mental de Gipuzkoa, Osakidetza, Donostia-San Sebastián, España
| | - Ander Retolaza
- Centro de Salud Mental de Basauri, Red de Salud Mental de Bizkaia, Osakidetza, Basauri, España
| | - Jon Belaunzaran
- Centro de Salud Mental de Zarautz, Red de Salud Mental de Gipuzkoa, Osakidetza, Zarautz, España
| | - Javier Basterrechea
- Unidad de Gestión Sanitaria, OSI Donostia, Osakidetza, Donostia-San Sebastián, España
| | - Isabel Mosquera
- Unidad de Investigación de Atención Primaria-OSIs Gipuzkoa, Osakidetza, Donostia-San Sebastián, España
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