DifusionSESCS

Predictores sociodemográficos y clínicos de la adherencia a los antidepresivos en los trastornos depresivos: una revisión sistemática con un metanálisis

SESCS Publication: Effectiveness and Safety of the Double Intracervical Balloon vs Dinoprostone in Patients with Previous Cesarean Section

Alicia Rodríguez-Zurita, Sara Caamiña Álvarez, Carolina Caballero García, María Gallego Paniagua, Alba Rodríguez González, Miguel Ángel García Bello, Elena Díez González, José Luis Trabado Montesino

ABSTRACT

To compare effectiveness and safety of the Cook’s balloon with vaginal dinoprostone to induce labor in patients with previous cesarean section.

Observational, and retrospective study that included pregnant women at ≥ 37 weeks’ gestation, with unfavorable cervix, singleton pregnancy, intact membranes, and a previous cesarean section, who had undergone labor induction in the period 2014-2019. 170 patients (86 balloon-84 dinoprostone) were analyzed.

The proportion of women achieving vaginal delivery within 24 h was higher in the dinoprostone than in double-balloon group (RR, 3.24; 95% CI, 1.36-7.72).

No significant differences were detected in the first 48 h in vaginal deliveries (P = .749) or in cesarean section rates (P = .634).

Nor were there differences in maternal or fetal safety profiles.

A body mass index > 35 increased the risk of cesarean section by 1.53 times (P = .017) and a Bishop’s test score < 3 by 1.91 times (P = .009).

A vaginal delivery following a cesarean section decreased the probability of another cesarean section by 0.46 times (P = .039).

Labor induction with vaginal dinoprostone achieves better vaginal delivery rates in the first 24 h vs Cook’s balloon. While the difference in uterine rupture rate did not reach significance, this was higher in women receiving prostaglandin.

Keywords: Cervical ripening; Dinoprostone; Double balloon catheter; Trial of labor after cesarean section.

You can read the full article here.

Predictores sociodemográficos y clínicos de la adherencia a los antidepresivos en los trastornos depresivos: una revisión sistemática con un metanálisis

SESCS PUBLICATION: Healthcare Professionals’ Perceptions about the Implementation of Shared Decision-Making in Primary Care: A Qualitative Study from a Virtual Community of Practice

Alezandra Torres-Castaño, Lilisbeth Perestelo-Pérez, Débora Koatz, Vanesa Ramos-García, Ana Isabel González-González, Ana Toledo-Chávarri, Carlos Jesús Bermejo-Caja, Himar Gonzalez-Pacheco, Analia Abt-Sack, Valeria Pacheco-Huergo, Carola Orrego

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.

You can read the full article (in English) here

XIII Conferencia Internacional de Toma de Decisiones Compartida (ISDM2024)

Last week, our team from the Canary Islands Health Service Evaluation (SESCS) participated in the XIII International Shared Decision-Making Conference (ISDM2024) in Lausanne, Switzerland. Our lead, Lilisbeth Perestelo Pérez, was part of the scientific committee, and our researchers stood out with their presentations.

Below is a photographic summary of our participation in this extraordinary event:

Our lead, Lilisbeth Perestelo Pérez, with an incredible group of participants in a workshop on AI-enabled shared decision-making. An enriching experience!

Our four researchers, Andrea Duarte Díaz, Yolanda Álvarez Pérez, Vanesa Ramos García and Alezandra Torres Castaño, are ready for the start of the ISDM 2024 conference. Proud of their participation and contribution!

Lilisbeth Perestelo Pérez with her poster: “A virtual community of practice for the empowerment of patients with ischemic heart disease (e-mpodera2): A randomized controlled trial.”

Vanesa Ramos García presents her poster: “Phase one of a randomized controlled trial to analyze the effectiveness and cost-effectiveness of a virtual community of practice to empower middle-aged patients with multimorbidity: co-creation PROCESS”

Lilisbeth Perestelo Pérez, SESCS lead, after her participation in the SIG 4 meeting: Spanish speaking / PCC network.

Yolanda Álvarez Pérez, with her poster: “Digital Health Literacy and Person-Centered Care: a Massive Open Online Course (MOOC) for women with breast cancer.”

Alezandra Torres Castaño presents her poster: “Health professionals’ perceptions about the implementation of shared decision-making in primary care: a qualitative study from a virtual community of practice.”

Andrea Duarte Díaz, with her poster: “Subgroups of Type 2 Diabetes Patients Based On Affective Symptoms and Patient Empowerment: A Latent Class Analysis.”

Vanesa Ramos García presents her poster: “Effectiveness of a web-based decision aid for patients with generalized anxiety disorder in Spain: a randomized controlled trial.”

Vanesa Ramos García, also with her poster: “Information and research needs in diabetic macular edema.”

Yolanda Álvarez Pérez, with her poster: “Preliminary health outcomes of caregivers of individuals with chronic diseases following a group educational intervention.”

We wrap up an amazing XIII International Shared Decision-Making Conference ISDM2024!

We thank all participants, organizers, and attendees for making this event an exceptional experience and look forward with excitement to the next opportunity to share more advancements.

ESPERANZA VARELA MORENO es Licenciada en Psicología, Máster en Psicología de la Salud y Doctora en Psicología por la Universidad de Málaga

Scientific visit: Esperanza Varela Moreno

Esperanza Varela Moreno holds a degree in Psychology, a Master’s in Health Psychology, and a Ph.D. in Psychology from the University of Málaga. She currently works as a researcher in the Research and Innovation Unit of the Costa del Sol University Hospital, within the BA-14 group on Translational Research in Cancer and Other Prevalent Chronic Diseases at IBIMA, led by Dr. Maximino Redondo Bautista. Her doctoral thesis focused on the cost-effectiveness analysis of a web-based psychological intervention program, “Sonreír es Divertido,” for treating depression in individuals with type 2 diabetes (PI16/01746). Her research focuses on mental health, chronic illness, and eHealth treatments, with a well-established track record of collaborating on research projects with competitive funding at both the national and European levels. Notably, she has been and continues to be a member of various national research networks, such as the Health Services Research Network for Chronic Diseases (REDISSEC), which concluded in 2002, and the current Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), both accredited by the Carlos III Health Institute. Furthermore, her ongoing involvement since 2011 in “Psychoeducational Support Groups for People with Type 1 Diabetes Mellitus” with the Patient School (Andalusian Health Service), alongside Dr. Ruiz de Adana Navas, has enabled her to provide psychoeducational support to these patients and to participate as Co-PI in adapting this program to an online format during the COVID-19 lockdown, an effort recognized with a Young Researchers Grant from the Spanish Diabetes Society in 2022. Currently, she collaborates as a researcher on national and international projects such as the “MyDiaMate (SRA-2023-1286-M-B)” project funded by the Juvenile Diabetes Research Foundation, which examines the efficacy of a web application to reduce distress in patients with type 1 diabetes; oncology projects (PI22/00020; PI21/00252); and projects on the implementation of online therapies in mental health (PI21/01328; PI19/01131).

What was the purpose of your visit?

To establish synergies and collaborations between two research groups within the RICAPPS. Additionally, to draw upon the extensive experience of this research group in working on projects related to chronic diseases, new technologies, and their notable focus on shared decision-making and person-centered care.

Why did you choose SESCS?

I chose SESCS because of our shared research interests in eHealth, diabetes, and breast cancer.

How will the activities conducted in collaboration with SESCS be useful in your current professional work?

The activities have influenced my understanding of developing and implementing health projects from a more person-centered perspective, focusing on the needs and experiences of the individual.

Were your expectations met during this visit?

My expectations have been exceeded during this visit, so I would highly recommend that other researchers with similar interests consider spending a week working at SESCS.

Comments or suggestions:

I only have words of gratitude for the warm welcome and treatment I received.

DM1; proyectos en el área de oncología (PI22/00020; PI21/00252) y proyectos sobre la implementación de terapias online en salud mental (PI21/01328; PI19/01131).

Gina Domínguez Armengol, graduada en Farmacia en la Universidad de Barcelona

Scientific visit: Gina Domínguez Armengol

Gina Domínguez Armengol graduated in Pharmacy from the University of Barcelona in 2018 and later completed a Master’s in Global Health Research at the Vrije Universiteit Amsterdam in 2021. She gained experience working in public health at the Epidemiological Surveillance Service of the Barcelonés Nord i Maresme region. Currently, she serves as a research technician at IDIAP Jordi Gol in Girona, where, in addition to participating in research projects, she is also involved in coordinating the implementation of projects related to cardiovascular health, such as the HELENA Project (a cardiovascular disease prevention program based on risk screening with the Ankle-Brachial Index).

What was the purpose of your visit?

We are currently developing a shared decision-making tool (HATDC) for peripheral arterial disease (PAD) as part of the HELENA Project. We are in the initial phase of exploring the needs of people with PAD and from the perspective of healthcare professionals. The purpose of the visit was to conduct a preliminary thematic qualitative analysis of the interviews and to determine how to translate this information for the development of the HATDC. Additionally, we aimed to define the publications that could arise from this initial phase.

Why did you choose SESCS?

I chose SESCS because we were already collaborating on the HELENA-HATDC project due to the group’s expertise in the development of HATDC and patient-centered research, as well as their extensive experience with qualitative research studies.

How will the activities conducted in collaboration with SESCS be useful in your current professional work?

The activities we carried out in recent days with the SESCS group, particularly with Analía Abt Sacks, will equip me with the necessary skills to conduct a thematic analysis during this initial phase of the HELENA-HATDC Project. Additionally, it will boost my confidence and experience in this type of analysis, allowing me to apply it to other qualitative projects my team is developing. Furthermore, the insights provided by my expert colleagues in HATDC development will be crucial in advancing this project.

Were your expectations met during this visit?

Absolutely. Besides giving me a clear understanding of how to conduct the study and develop the HATDC, they also prompted me to reflect on certain aspects of the project design. This includes identifying areas where we need to gather more information or considering additional studies, such as the cost-effectiveness analysis of the HATDC. These reflections are key to developing this project and ensuring its quality.

Comments or suggestions:

I want to express how much I enjoyed my time at SESCS. It has been a true pleasure to meet almost the entire team. I felt incredibly welcomed and enjoyed every moment of my stay. I want to extend a special thanks to Analía for her dedication over these past days. Thank you for answering all my questions and for motivating me to reflect and acquire new knowledge. Your support has been invaluable, and I truly appreciate it.

David Abbad Gómez es un graduado en Medicina por la Universidad Autónoma de Barcelona

Scientific visit: David Abbad Gómez

David Abbad Gómez is a graduate in Medicine from the Autonomous University of Barcelona (2020) and holds a Master’s in Public Health from Pompeu Fabra University in Barcelona (2023). He is currently pursuing a PhD in Biomedicine at the same institution. He is currently working as a Resident Physician in Preventive Medicine and Public Health at Hospital del Mar in Barcelona. His responsibilities include actively collaborating with the research team of the Epidemiology and Evaluation Service at the hospital, through the Hospital del Mar Research Institute, with a focus on multimorbidity and long-term survivors of breast cancer.

What was the purpose of your visit?

As part of my training as a resident and researcher, I wanted to understand the work of a team specializing in economic evaluation, explore the possibilities of incorporating concepts and methodologies into my current projects, and use this experience as a starting point to delve deeper into the field of Economic Evaluation. After some theoretical training on the topic, I had a personal curiosity to gain deeper knowledge, actively participate in a related project, and enhance my skills. The opportunity to include a partial economic analysis in my thesis arose, and I aimed to improve and apply it extensively in my future career.

We also used my visit to discuss and share, in person, the possibilities we saw in the joint CONCEPT-SURBCAN project and to collaborate more closely.

Why did you choose SESCS?

Currently, both institutions are working together on the CONCEPT-SURBCAN project to conduct the cost analysis of the cohort, and on the qualitative aspect of the FOLLOW-UP SURBCAN project. Additionally, both are part of RICAPPS, which had already established communication between the two parties. My mentors and supervisors, who were somewhat familiar with the team, encouraged me to plan a visit as they considered it an ideal place to learn and to satisfy my curiosity on the subject.

Moreover, due to the joint CONCEPT-SURBCAN project, my experience with the cohort could contribute to mutual support and benefit both parties from my visit.

How will the activities carried out in collaboration with SESCS be useful in your current professional work?

What I have observed in these days will help me address the partial economic analysis proposed for my thesis. In addition to this initial assistance, seeing the types of projects, methodologies, and materials used has broadened my perspective on economic evaluation and has opened up possibilities for my future. My interest in the topic has only increased, and I am convinced that it will help me conduct more complex analyses in the future.

Did your expectations for this visit meet?

Completely.

Comments or suggestions:

One thing I would like to highlight from these days, which is not reflected in the previous questions, is the great human quality of the team and the immense pleasure of meeting everyone. I am eager to continue collaborating in the future.