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Predictores sociodemográficos y clínicos de la adherencia a los antidepresivos en los trastornos depresivos: una revisión sistemática con un metanálisis
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SESCS PUBLICATION: Scoping review indicates heterogeneous methods for developing and integrating patient decision aids in the context of clinical practice guidelines

Fischer L, Schewe LV, Scheibler F, Wollny R, Schaefer C, Karge T, Langer T, Berghold J, Florez ID, Hutchinson A, Li S, Maes-Carballo M, Munn Z, Perestelo-Perez L, Puljak L, Stiggelbout A, Pieper D

ABSTRACT

Objectives

To review the methods used to develop and integrate patient decision aids (PDAs) based on the recommendations of clinical practice guidelines (CPGs).

Study Design and Setting

We conducted a scoping review covering bibliographic databases (PubMed, Embase; searched until December 2023), gray literature, references, and expert consultations to identify eligible documents. Documents published from 2000 onwards and describing methods related to guideline-based PDA development or linking CPGs and PDAs were included. Two reviewers independently selected and analyzed the documents. Results were synthesized and presented narratively.

Results

Based on 24 included documents, we categorized their methods into 4 topics. For topic (1), the selection of CPG recommendations for which PDAs are (most) needed, we found a total of 14 selection factors across n = 11 documents, with uncertainty/variability in patient preferences and trade-offs between options being the most frequently mentioned. Topic (2) (n = 24) covers methods for developing and/or updating guideline-based PDAs, such as forming a multidisciplinary development group, using CPGs and their evidence summaries along with other sources as the evidence base, and using digital solutions for semi-automated development and updating. Topic (3) (n = 12) covers methods for PDA quality assessment and/or user testing, such as finalizing and approving the PDAs after a review and feedback process from the CPG group and an iterative user testing process. Topic (4) (n = 20) covers methods for linking CPGs and PDAs, often through digital strategies.

Conclusion

We identified heterogeneous methods for developing and integrating PDAs based on CPG recommendations. Empirical testing is required to determine the most useful and practically feasible (combination of) methods. CPG organizations should focus on establishing adequate methods for linking CPG and PDA development to foster shared decision-making.

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
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SESCS PUBLICATION: Prognostic Factors for Survival in Adults With Burkitt Lymphoma: A Systematic Review

Aythami de Armas-Castellano, Diego Infante Ventura, Tasmania del Pino-Sedeño, Yadira González Hernández, Raúl Quirós, Beatriz León-Salas, Vicente Ribrag, María M. Trujillo Martín, Grupo de trabajo de EuroBlood de la ERN

ABSTRACT

Introduction

Burkitt lymphoma (BL) is a rare and aggressive subtype of non-Hodgkin’s lymphoma. Several studies have identified prognostic factors (PFs) for disease progression and mortality among adults with BL. However, there is no consensus on risk stratification based on PFs. This study aims to identify, critically assess, and synthesize the available evidence on PFs for survival in adults with BL.

Methods

A systematic review was conducted. Medline, EMBASE, and CENTRAL were searched from inception to February 22, 2022. Randomized or non-randomized clinical trials and longitudinal observational studies were eligible for inclusion. Reference screening, data extraction, and risk-of-bias assessment were conducted independently and in duplicate. Publication bias was examined by visual inspection of funnel plots. Meta-analyses were conducted when appropriate using Review Manager 5. The certainty of evidence was assessed using GRADE.

Results

The search identified 1119 references. Of these, 76 papers were selected for full-text assessment and 36 studies (N = 10,882) reported in 39 articles were eligible for inclusion. Older age, higher performance status, and central nervous system involvement were associated with poorer overall survival (OS) and progression-free survival (PFS). Black patients exhibited significantly lower OS and relative survival. Bone marrow involvement and higher albumin levels were associated with poorer OS. Treatment with rituximab, and with methotrexate were associated with better OS and PFS.

Conclusion

This study provides a comprehensive and methodologically rigorous evidence review on PFs in adults with BL. Several significant associations of PFs and survival estimates were observed, therefore, providing data to inform treatment decisions and to improve patient care.

 

You can read the full article here.

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NOW AVAILABLE: Recording of the RedETS 2025 Open Day

If you missed the RedETS 2025 Open Day, held on November 19 at the TEA Tenerife Espacio de las Artes, you can now watch the full recording (in spanish) on our YouTube channel:

PART 1

PART 2

All information about the event, including contents and materials, is also available on the website: https://sescs.es/redets2025/

We invite you to visit the site and continue checking for new content and information that we will be adding in the coming weeks.

Predictores sociodemográficos y clínicos de la adherencia a los antidepresivos en los trastornos depresivos: una revisión sistemática con un metanálisis
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SESCS PUBLICATION: Conduction system pacing using electro-anatomical mapping-guided system vs. fluoroscopy: a systematic review, meta-analysis and economic evaluation

Beatriz León-Salas, Diego Infante-Ventura, Aránzazu Hernández-Yumar, Renata Linertová, Estefanía Herrera-Ramos, Alezandra Torres-Castaño, Himar González-Pacheco, Analía Abt-Sacks, Javier García-García, Raúl Quirós-López, María M. Trujillo-Martín

Introduction:

Electro-anatomical mapping (EAM) system has been shown as an alternative procedure to fluoroscopy for conduction system pacing (CSP) in patients with severe bradyarrhythmia, however its beneficial and harmful effects has not been assessed in a systematic review (SR). We sought to assess their safety, effectiveness and cost-effectiveness.

Methods:

A SR of the available scientific literature was conducted on the safety, effectiveness, and cost-effectiveness of CSP using EAM system versus fluoroscopy in patients with severe bradyarrhythmia. A partial economic evaluation was carried out to compare the costs of both strategies from the perspective of the Spanish National Health System. A budget impact analysis was also conducted with a five-year horizon.

Results:

Seven comparative observational studies (N = 231), analyzing the use of EAM versus fluoroscopy were selected. Statistically significant differences were observed in total fluoroscopy time: −9.87 minutes (95%CI:−14.20, −5.53, p < 0.01; I2 = 95%; k = 7; n = 231); His-lead fluoroscopic time: −8.08 minutes (95%CI:−10.36, −5.81, p < 0.01; I2 = 0%; k = 2; n = 50); and His-lead radiation dose: −17.21 mGy (95%CI:−24.08, −10.34, p < 0.01; k = 1; n = 20). No differences in total fluoroscopy dose, successful procedure or safety were found. The use of EAM represents an increase of EUR 1397.81 per patient and a net budget impact of EUR 1.63 million.

Discussion:

EAM is a valuable alternative for patients who should not be exposed to ionizing radiation with similar effectiveness and safety than fluoroscopy. However, the inclusion of EAM systems, for the indication under study, in routine clinical practice would mean an increase in costs for the Spanish National Health System.

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
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SESCS PUBLICATION: Can Quality of Life Tests Be Useful in Patients Affected by Alpha-1 Antitrypsin Deficiency?

José María Hernández-Pérez, Hassan Khadour-Khadour, Gema Romero-Romero, Miguel Ángel García-Bello

ABSTRACT

Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that predisposes a person to certain diseases over their lifetime, mainly including lung disease (in the form of emphysema) and liver disease (liver cirrhosis). Quality of life questionnaires are instruments designed to quantify the deterioration of a patient’s health.

Background/Objectives:

This study aimed to assess whether certain quality of life tests that are routinely used in clinical practice can be useful for patients with AATD.

Methods:

A sample of AATD patients, with various genotypes, but with the common characteristic that they must have both altered alleles (Pi* ≠ M), participated in the study. Different quality of life tests were used, including the COPD Assessment Test (CAT), COPD and Asthma Sleep Impact Scale, the short form of the Short Form Health Survey, and EuroQol 5 dimensions, and were related to differing clinical and functional characteristics.

Results:

The sample was composed of 54 patients, and slightly more than half of the participants were women (57.4%), with a mean age of 51.5 ± 13.7. The main genotypes were Pi*SZ (43.4%) and Pi*ZZ (34%). In patients under 65 years of age (n = 47), those who were actively working could walk a greater distance in the walking test, namely, 573 m (511–629), compared to those who were not actively working, namely, 415.5 m (392–469; p < 0.001). Active non-workers had a worse CAT (13.6 ± 7.8 vs. 4.6 ± 4.3; p < 0.001). In total, 80% of non-working patients had exacerbations, but only 46. 9% of those who were active, although the association did not reach statistical significance (p = 0.068). Having a lower score in the physical component of SF-12 was related to suffering from lung disease (46.0 ± 11.4 vs. 38.4 ± 11.1 (p = 0.026)).

Conclusions:

Quality of life tests were able to detect differences and relate them to functional factors such as the distance covered in the walking test, being sensitive and specific in this regard.

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
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SESCS PUBLICATION: Family physicians’ attitudes and practice on screening and prevention of fragility fractures, and shared decision-making with postmenopausal women: a qualitative study in Spain

Montserrat León-García, Esther Cánovas Martínez, Yolanda Álvarez Pérez, María Antonia Pou, Alberto López García-Franco, Ana Sanz Bas, Sara Rodriguez-Moreno, Claudia Erika Delgado Espinoza, Pablo Roca, Aránzazu González Osuna, Diana Fernández Valverde, Betzabeth Marín Nanco, Melixa Medina-Aedo, Lilisbeth Perestelo-Pérez, Pablo Alonso-Coello

ABSTRACT

Background
Osteoporosis is a prevalent condition among postmenopausal women, significantly increasing the risk of fragility fractures. Despite the availability of clinical guidelines, their implementation in primary care, remains highly variable, particularly regarding fracture prevention and shared decision-making (SDM).

Methods
We conducted a qualitative study to explore the attitudes and practices of Spanish family physicians in preventing fractures among postmenopausal women. Sixteen semi-structured interviews were conducted with physicians from diverse socioeconomic backgrounds and levels of clinical experience. Data were analysed using an iterative, theory-driven approach to identify key themes and barriers.

Results
Physicians showed substantial variability in fracture risk assessment approaches, frequently combining tools such as FRAX with clinical judgment. Most were cautious about prescribing bisphosphonates for primary prevention, citing concerns about the strength of the evidence and potential adverse effects. While non-pharmacological strategies, such as lifestyle modifications and fall prevention, were emphasized, their implementation was often constrained by workload pressures. Patient involvement in decision-making was hindered by widespread misconceptions about osteoporosis and its treatment, as well as the lack of appropriate decision-support tools. Participants highlighted the need for clearer guidelines, enhanced educational resources, and accessible decision aids to facilitate patient engagement in care.

Conclusions
This study highlights the complex challenges family physicians face in fracture prevention among postmenopausal women, including heterogeneity of recommendations in guidelines, limited SDM implementation, and systemic barriers within primary care. Addressing these issues will require multifaceted interventions targeting both healthcare system constraints and patient education. Future efforts should focus on developing and implementing strategies that support evidence-based, patient-centred decision-making while accounting for the realities of primary care practice.

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
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SESCS PUBLICATION: Long-Term Effects of Ozone Treatment in Patients with Persistent Numbness and Tingling Secondary to Chemotherapy-Induced Peripheral Neuropathy. A Retrospective Study

Bernardino Clavo, Delvys Rodríguez-Abreu, Saray Galván-Ruiz, Mario Federico, Angeles Cánovas-Molina, Yolanda Ramallo-Fariña, Carla Antonilli, Gretel Benítez, Himar Fabelo, Carla García-Lourve, Damián González-Beltrán, Ignacio J Jorge, Francisco Rodríguez-Esparragón, Gustavo M Callico

ABSTRACT

Background:
Numbness and tingling secondary to chemotherapy-induced peripheral neuropathy (CIPN) are frequent side effects that limit chemotherapy treatment and quality of life. Successful treatments for CIPN are limited. This preliminary report shows the potential long-term effects of ozone treatment in the management of persistent numbness and tingling secondary to CIPN.

Methods:
Ozone treatment was administered by rectal insufflation in 15 patients (female/male: 8/7, age: 66 years old) suffering from persistent numbness and tingling secondary to grade-2 or grade-3 CIPN. Planned ozone treatment consisted of 40 sessions over 4 months. The initial concentration of 10 μg/mL was progressively increased to 30 μg/mL. The initial gas volume of 180 mL/session was progressively increased to 300 mL/session if tolerated. Before and after ozone treatment, and at 3- and 6- months after the end of treatment, they were assessed (i) the grade of CIPN-toxicity, and (ii) the self-reported decrease in numbness and tingling.

Results:
After ozone treatment, 47% of patients experienced a decrease in the grade of CIPN-toxicity (P = .016), and 67% of patients reported a decrease in numbness and tingling ≥50% (P = .002). These effects were maintained at 3- and 6- months after the end of O3T.

Conclusions:
In this retrospective report, patients with persistent numbness and tingling secondary to CIPN showed clinically relevant and long-term improvements after ozone treatment. The magnitude and duration of the observed effects merit further research and support our ongoing clinical trials.

Keywords: numbness and tingling, paresthesias, chemotherapy-induced peripheral neuropathy, grade of toxicity, side effects, cancer survivors, ozone treatment, oxidative stress modulation, Nrf2

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
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SESCS PUBLICATION: Acceptance and commitment therapy for couples: A systematic review and meta-analysis

Jorge Barraca, Thomas Polanski, Andrea Duarte-Díaz, Lilisbeth Perestelo-Pérez

ABSTRACT

Couple interventions have a long tradition, yet their effectiveness is generally less well-known than that of individual therapies, particularly within contextual therapies. Although Acceptance and Commitment Therapy (ACT) has already gathered significant evidence of effectiveness in various psychological health problems and disorders, its application in the context of couple therapy has not been thoroughly analyzed. A systematic review and meta-analysis were conducted, involving a total of 17 randomized controlled trials (RCTs), examining effectiveness in various areas of couple functioning. The analyses revealed that ACT was more effective than passive control groups for alexithymia, anxiety, communication skills, fertility quality of life, marital intimacy, marital satisfaction, psychological well-being, physical health, and relational social functioning. It did not, however, have any significant effect on marital burnout, marital conflict, or conflict resolution. ACT was also effective in post-traumatic stress disorder, but in a joint intervention with Mindfulness-Based Cognitive Therapy (MBCT). When compared with active controls, ACT was sometimes similar and sometimes inferior in results. For instance, ACT, Integrative Behavioral Couple Therapy (IBCT), and CBCT all increased marital intimacy, but with no significant difference between them (g = −0.26, 95% CI: −0.98, 0.46; I2 = 0%). ACT, IBCT and Emotionally Focused Couples Therapy (EFCT) also all helped social functioning, and EFCT and ACT both fostered forgiveness. However, CBCT was clearly superior to ACT in improving marital satisfaction (g = −1.23, 95% CI: −1.86, −0.59; I2 = 0%) and ACT was also beaten out by Schema Therapy for fostering forgiveness. Imago therapy seems to help anxiety more than ACT while ACT helped more with physical health. The RCTs included in the review exhibit a significant series of biases and limitations, which were analyzed in detail. Taking these limitations into account, although ACT can be a promising therapy for some couple difficulties, it still needs to gather more evidence of effectiveness with new, better-controlled studies, carried out in a wider variety of countries and cultures, with well-defined protocols and comparisons with active controls like EFCT, IBCT, and CBCT, all of which have more empirical support.

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
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SESCS PUBLICATION: Validation of the PECUNIA reference unit costs templates in Spain: a useful tool for multi-national economic evaluations of health technologies

Lidia García-Pérez, Renata Linertová, Aránzazu Hernández-Yumar, Cristina Valcárcel-Nazco, Jhoner Perdomo Vielma, Pedro Serrano Aguilar, Mencia R Gutiérrez-Colosia, Luis Salvador Carulla, Enrique Fernández-Vega, Susanne Mayer, Judit Simón, Grupo PECUNIA

ABSTRACT

Background:

The PECUNIA Project was funded by the H2020 programme in which 10 partners from six countries participated. The aim was to develop standardized, harmonized and validated methods and tools to calculate costs in different sectors (such as health and social care, education among others), with the purpose of facilitating comparability of economic evaluations of health technologies across European countries. In this paper we report the first validation of the developed reference unit cost templates in Spain.

Methods:

The evaluation of the PECUNIA Reference Unit Cost (RUC) Templates involved usability, transferability and feasibility assessment. Applicability tests were performed to estimate the cost of a selection of 15 resource items by means of the RUC templates in Spain and in four Spanish regions. External validation involved comparison with existing unit costs.

Results:

It was possible to estimate the cost of five services (dental care and general practitioner in the Canary Islands, general practitioner in Spain [tariffs], health-related day care centre and education services provided in a special education school in the Basque Country), car vandalism as an example of potential health-related consequences, and informal care in Spain. The templates were feasible although data completeness depended on the type of data needed to estimate the costs. The templates are transferable across countries although comparability depends on the services available in each jurisdiction.

Conclusions:

The PECUNIA RUC Templates are free and feasible tools to estimate comparable reference unit costs across countries. Although more validation exercises are needed, they seem useful tools to perform robust multi-national economic evaluations and increase the transferability of cost-effectiveness studies of health technologies in Europe. However, they cannot compensate for the lack of data across jurisdictions.

Keywords: Costing; Economic evaluation; Europe; Services; Societal perspective; Spain; Unit costs; Validation.

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
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SESCS PUBLICATION: A virtual community of practice to empower patients with recent ischemic heart disease: A randomized controlled trial

Helena Vall-Roqué, Vanesa Ramos-García, Amado Rivero-Santana, Alezandra Torres-Castaño, Patricia Cifuentes, Débora Koatz, Javier García-García, Valeria Pacheco-Huergo, Pau Rello, Anthea Santos-Álvarez, Alba Campillejo García, Sofía Garrido Elustondo, Marcelo Sanmartín, Lilisbeth Perestelo-Pérez, Ana Isabel González-González, Carola Orrego

ABSRACT

Objective

To evaluate the effectiveness of a virtual community of practice (vCoP) in improving the activation of individuals with ischemic heart disease (IHD).

Method

We conducted a randomized controlled trial. A total of 282 patients with IHD from Madrid, Catalonia, and the Canary Islands were randomly allocated to an intervention or a control group. Patients were anonymized and the statistician was blinded to group allocation. The intervention was a multicomponent-tailored vCoP built on the Web 2.0 concept and focused on skills toward patient empowerment. The primary outcome was the Patient Activation Measure score. Secondary outcomes were self-efficacy to manage the disease, adherence to the Mediterranean diet, level of physical activity, depression, anxiety, medication adherence, and health-related quality of life. A linear regression model of mixed effects was carried out to estimate the effect of participating in the vCoP.

Results

Significant differences in adherence to the Mediterranean diet were found favoring the intervention at 6, 12, and 18 months, B = 0.86, 95% confidence interval (CI) [0.36, 1.35]. No significant changes among data collection points were found for the other variables.

Conclusion

Our results suggest that vCoPs can be helpful for improving adherence to the Mediterranean diet in individuals with IHD, but not for improving their activation or quality of life. However, considerable uncertainty remains due to participants’ high dropout rate. Further research is needed to identify the behavioral change mechanisms of such an intervention. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Trial registration: ClinicalTrials.gov NCT03959631

You can read the full article here.