Featured

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

SESCS PUBLICATION: Recommendations on self-management interventions for adults living with obesity: COMPAR-EU project

Melixa Medina Aedo, Jessica Beltrán, Claudia Valli, Carlos Canelo Aybar, Canción Yang, Marta Ballester, Jacqueline Bowman-Busato, Cristo Cristogiannis, María G. Grammatikopoulou, Oliver Groene, Monique Heijmans, Martine Hoogendorn, Sarah Louise Killeen, Katerina-Maria Kontouli, Dimitris Mavridis, Miñambres Inka, Beate Sigrid Mueller, Ena Niño de Guzmán, Janneke Noordman, Carola Orrego, Lilisbeth Perestelo-Pérez, Zuleika Saz-Parkinson, Georgios Seitidis, Rosa Suñol, Sofía Tsokani, Pablo Alonso Coello

ABSTRACT

Self-management interventions (SMIs) may improve disease management in adults living with obesity. We formulated evidence-based recommendations for SMIs within the context of the COMPAR-EU project. The multidisciplinary panel selected critical outcomes based on the COMPAR-EU core outcome set and established decision thresholds for each outcome. Recommendations were informed by systematic reviews of effects, cost-effectiveness, and a contextual assessment. To assess the certainty of the evidence and formulate the recommendations, we used the GRADE approach guidance. Overall, SMIs were deemed to have a small impact, but the absence of harmful effects and potential cumulative benefits indicated a favourable balance of effects, despite low certainty. SMIs showed variations in structure, intensity, and resource utilisation, but overall are likely to be cost-effective. Adapting SMIs to local contexts would enhance equity, acceptability, and feasibility, considering patients’ values, and availability of resources and teamwork. Consequently, the panel made conditional recommendations favouring SMIs over usual care. The rigorous and explicit recommendations demonstrated the effectiveness of SMIs for adults living with obesity. However, the gaps in the literature influenced the panel to make only conditional recommendations in favour of SMIs. Further research is needed to strengthen the evidence base and improve recommendations’ certainty and applicability.

Keywords: guideline; obesity; recommendations; self‐management interventions.

You can read the full article here.

Or, if you prefer, you can access it via PUBMED.

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

SESCS PUBLICATION: Effectiveness of interventions to improve adherence to antidepressant medication in patients with depressive disorders: a cluster-randomized controlled trial

Tasmania del Pino-Sedeño, Himar González-Pacheco, Beatriz González de León, Pedro Serrano Pérez, Francisco Javier Acosta Artiles, Cristina Valcárcel-Nazco, Isabel Hurtado Navarro, Cristobalina Rodríguez Álvarez, María M. Trujillo-Martín.

ABSTRACT

Aim: To assess the effectiveness of two interventions of knowledge transfer and behavior modification to improve medication adherence in patients with depressive disorders.

Methods: An open, multicenter, three-arm clinical trial with random allocation by cluster to usual care or to one of the two interventions. The intervention for psychiatrists (PsI) included an educational program based on a patient-centered care model. The intervention for patients and relatives (PtI) included a collaborative care program plus a reminder system that works using an already available medication reminder application. The primary outcome was patient adherence to antidepressant treatment assessed through the Sidorkiewicz Adherence Instrument. Secondary measures were depression severity, comorbid anxiety and health-related quality of life. Mixed regression models with repeated measures were used for data analysis.

Results: Ten psychiatrists and 150 patients diagnosed with depressive disorder from eight Community Mental Health Units in the Canary Islands (Spain) were included. Compared with usual care, no differences in long-term adherence were observed in either group PsI or PtI. The PsI group had significantly improved depression symptoms (B = −0.39; 95%CI: −0.65, −0.12; p = 0.004) during the follow-up period. The PtI group presented improved depression symptoms (B = −0.63; 95%CI: −0.96, −0.30; p < 0.001) and mental quality of life (B = 0.08; 95%CI: 0.004, 0.15; p = 0.039) during the follow-up period.

Conclusion: The assessed interventions to improve adherence in patients with depressive disorder were effective for depression symptoms and mental quality of life, even over the long term. However, no effect on antidepressant adherence was observed.

You can read the full text here.

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

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
 Featured, News

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