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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: Making “inclusion” more than a buzzword: A critical interpretive synthesis of literature about recruiting seldom-heard groups in health research

Meghan Bradway, Lilisbeth Perestelo-Pérez, Alezandra Torres-Castaño, Ana María Claudia Wagner, María Luisa Álvarez-Malé, Garlene Beatriz Zamora Zamorano, Kari Dyb

ABSTRACT

Introducción

Seldom-heard’ groups do not experience equitable access, engagement, or benefits from health services and are often underrepresented in research.

Métodos

This paper presents a critical interpretive synthesis (CIS) of the literature. The included articles were those published between 2000 and 2024 in PubMed and Web of Science that focused on the recruitment and engagement of ‘seldom-heard’, ‘hard-to-reach’, or ‘disadvantaged’ groups in Europe. Purposive samples of articles followed a flexible and iterative review. Analysis and synthesis focused on identifying “synthetic constructs” or overarching themes, which informed the development of a “synthesizing argument” regarding recruitment and engagement strategies for seldom-heard groups. The presented paper focuses on the “synthetic constructs”, whereas the “synthetic argument” will be described in a subsequent paper.

Resultados

Of the 7601 articles identified, 23 were included. The analysis revealed four synthetic constructs: 1) the complexity of labels and identity, 2) the impact of labels on recruitment, 3) strategies to address recruitment challenges, and 4) the broader effects of these strategies on research and researchers.

Conclusión

Effective recruitment of seldom heard groups requires lengthy, careful planning, relationship-building, and an understanding of their unique perspectives. In doing so, researchers can contribute to reducing health inequalities and amplifying the voices of underrepresented populations.

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 : Psychometric properties of the EQ-5D-5L in diabetes mellitus patients in Spain

Amaia Bilbao-González, Marta González-Sáenz de Tejada, Montse Ferrer, Yolanda Ramallo-Fariña, Miguel Paja-Fano, Carlos García-Forero, Daniela Mestre, Iñigo Gorostiza-Hormaetxe

ABSTRACT

Background

The EQ-5D-5L five-dimensional instrument, is one of the most widely used generic preference-based questionnaires to measure health-related quality of life and to estimate utility indices for use in economic evaluation. This study aimed to assess the psychometric properties of the Spanish EQ-5D-5L questionnaire in patients with Diabetes Mellitus (DM) assessing reliability, validity, and item-level properties such as item functioning.

Methodology

We included 133 patients with DM who completed the EQ-5D-5L, the Audit on Diabetes-Dependent Quality of Life (ADDQoL), the Hospital Anxiety and Depression Scale (HADS), one question about general health and sociodemographic, and clinical data. The reliability was assessed by Cronbach’s alpha, and the item functioning by the item response theory (IRT). Convergent validity was tested using the Spearman correlation coefficient between EQ-5D-5L, ADDQoL, HADS and the general health question. We examined known-groups validity by comparing the EQ-5D-5L scores between subgroups defined by age, gender, BMI, regular physical activity, disease duration, glycemic control by glycosylated blood hemoglobin (HbA1c) (%), type of DM, general health and anxiety and depression level using t-test, ANOVA, Wilcoxon or Kruskal-Wallis tests.

Results

The reliability was supported with a Cronbach’s alpha of 0.78. The IRT results supported the unidimensionality and showed adequate item functioning, except for the anxiety/depression dimension. The item with highest discriminatory power was usual activities dimension, followed by self-care and mobility dimensions. The EQ-5D-5L showed adequate convergent validity, with high correlation with the ADDQoL, HADS and general health. Older age, women, obese, no regular physical activity, ≥ 10 years of disease duration, poor glycemic control, poorer general health and higher anxiety and depression level linked with lower EQ-5D-5L scores.

Conclusions

These findings support the adequate psychometric properties of the EQ-5D-5L in patients with DM, supporting its use for clinicians and researchers as an outcome measure and for use in economic evaluation studies.

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: Analysis of therapeutic adherence to antidepressants and associated factors in patients with depressive disorder: A population-based cohort study

Diego Infante-Ventura, Benjamín Rodríguez-Díaz, Miguel Ángel García Bello, Cristina Valcárcel-Nazco, Francisco Estupiñán-Romero, Francisco Javier Acosta Artiles, Beatriz González de León, Isabel Hurtado-Navarro, Tasmania del Pino-Sedeño

ABSTRACT

Background

Non-adherence to antidepressants is a common problem that can significantly impact health outcomes in patients with depressive disorders. The aim of this study was to assess antidepressant adherence rates and identify factors associated with non-adherence in a population-based cohort of patients with depressive disorders, using real-world data.

Methods

This retrospective, population-based cohort study used real-world data from patients diagnosed with depression in the Canary Islands, Spain, between 2013 and 2021. Adherence to antidepressants was assessed using the Medication Possession Ratio (MPR) over a 12-month follow-up period. Patients were classified as adherent if they had an MPR ≥ 0.8. To assess the association with sociodemographic, clinical, and lifestyle variables, multivariate logistic regression models were performed.

Results

Among the 39,800 patients included, the overall adherence rate to antidepressants was 31.02 %. Older age, female sex, and the presence of multiple comorbidities were significantly associated with higher adherence rates. In contrast, alcohol, and tobacco use, as well as inadequate nutrition, were significantly linked with lower adherence.

Conclusion

Non-adherence to antidepressants is a highly prevalent problem in patients with depressive disorders. The findings of this study highlight the importance of identifying factors that influence adherence and developing specific interventions to improve treatment outcomes in this population.

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: STRATUM project: AI-based point of care computing for neurosurgical 3D decision support tools

Himar Fabelo, Raquel Leon, Emanuele Torti, Santiago Marco, Asaf Badouh, Max Verbers, Carlos Vega, Javier Santana-Nunez, Yann Falevoz, Yolanda Ramallo-Farina, Christian Weis, Ana M Wagner, Eduardo Juarez, Claudio Rial, Alfonso Lagares, Gustav Burstrom, Francesco Leporati, Luis Jimenez-Roldan, Elisa Marenzi, Teresa Cervero, Miquel Moreto, Giovanni Danese, Svitlana Zinger, Francesca Manni, Maria Luisa Alvarez-Male, Miguel A. García-Bello, Lidia García, Jesus Morera, Juan F. Pineiro, Chrysanthi Bairaktari, Beatriz Noriega-Ortega, Bernardino Clavo, Gustavo M. Callico, STRATUM Consortium

ABSTRACT

Integrated digital diagnostics are transforming complex surgical procedures, with brain tumour surgery being among the most challenging. STRATUM, a five-year Horizon Europe-funded project, aims to develop an advanced 3D decision support system leveraging real-time multimodal data processing powered by artificial intelligence. A key innovation of STRATUM is its design as an energy-efficient Point-of-Care computing system, seamlessly integrated into neurosurgical workflows. This system will provide surgeons with real-time, AI-driven insights, enhancing decision-making accuracy and efficiency. By optimizing surgical precision and reducing procedure duration, STRATUM is expected to improve patient outcomes while streamlining resource utilization within European healthcare systems.

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: Exploring digital health tools for depression management in primary health care: Systematic review and meta-analysis

Aïna Fuster-Casanovas, Sonia Moretó Melero, Daniela Cabutto, Carme Carrion, Josep Vidal-Alaball, Estefania Herrera-Ramos, Carles Barcons, Andrea Duarte-Díaz

ABSTRACT

Background

Digital health tools are transforming mental health care, particularly in treating depression, which affects 5 % of the global population and is projected to be the top disease burden by 2030. In primary care, these tools improve accessibility and efficacy, addressing rising mental health demands, especially post-COVID-19.

Objective

The aim of this study is to assess the efficacy of digital health tools for the management of depression within primary care.

Methods

A systematic review followed PRISMA guidelines, focusing on digital health tools for reducing depressive symptoms. Controlled trials were included, with RCTs assessed via the Cochrane risk-of-bias tool and non-RCTs evaluated using the JBI checklist for quasi-experimental studies. Depressive symptom reduction was the primary outcome.

Results

A total of 29 controlled trials met the inclusion criteria, identifying were web-based platforms, mobile apps, phone calls, text messages, and decision algorithms. The meta-analysis revealed that digital health tools had a significant effect on depressive symptoms (g = −0.22, 95 % CI: −0.37; −0.06, I2 = 79.64 %). At 6 to 12-month follow-up, the random effects meta-analysis showed that digital health tools had a significant effect on depressive symptoms (g = −0.19, 95%CI: −0.29; −0.09, I2 = 53.42 %).

Conclusions

Digital health tools are effective in reducing the symptoms of repression. Symptom severity does not predict suitability for digital treatment, emphasizing the need for gender-sensitive approaches and strategies for older adults. Integrating digital interventions into clinical guidelines requires studies like this to support their adoption in real-world 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: Guideline for the economic evaluation of medicines: a proposal by the Spanish National Health System’s Advisory Committee for Pharmaceutical Financing

Marta Trapero-Bertran, Juan Oliva, Ferrán Catalá-López, Lidia García-Pérez, Lluís Segú, Emilio Jesús Alegre-del-Rey, Ana Clopés, Félix Lobo, Ana Ortega, Jaume Puig-Junoy

ABSTRACT

In 2023, the General Directorate of Pharmacy of the Ministry of Health commissioned the Advisory Committee on the Financing of Pharmaceuticals for the National Health System (CAPF, Comité Asesor para la Financiación de la Prestación Farmacéutica del Sistema Nacional de Salud) to produce a guideline for the evaluation of the efficiency of medicines. The aim of this methodological note is to present their main points. The guideline includes 17 dimensions that an economic evaluation of medicines must encompass, the design of a reference case, and a checklist for evaluating the methodological quality and reporting. This guideline should serve as a foundational document for reforming the health technologies evaluation processes of the Ministry of Health. The guideline can also assist researchers, public health professionals, health technology companies and decision makers in assessing the validity of findings and conclusions from health economic evaluations.

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: 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.

 News

Improving Type 1 Diabetes Care: Update of the Clinical Practice Guideline

The Evaluation Service of the Canary Islands Health Service (SESCS) has methodologically coordinated the update of the Clinical Practice Guideline on Type 1 Diabetes Mellitus.

The guideline is part of the SNS Clinical Practice Guideline Program, coordinated by Guíasalud, and is published in 2026 after addressing a 14-year gap in scientific and technological advances in the management of Type 1 Diabetes.

Funded by the Ministry of Health through RedETS, this update contributes to improving equity, healthcare quality, and patient safety across the Spanish National Health System.

🔗 Read the full guideline

 

 News

World Day of the Fight Against Depression: SESCS’ Key Publications and Projects

💛 Yesterday was the World Day of the Fight Against Depression, and we want to highlight the importance of supporting and caring for mental health. At SESCS, we share some of our work aimed at improving the treatment and follow-up of people with depression:

1️⃣ Validation and selection of criteria for evaluating apps for managing depression: a Delphi study (2025)

2️⃣ Analysis of therapeutic adherence to antidepressants and associated factors in patients with depressive disorder: A population-based cohort study (2025)

3️⃣ Exploring digital health tools for depression management in primary health care: Systematic review and meta-analysis (2025)

4️⃣ Effectiveness of interventions to improve adherence to antidepressant medication in patients with depressive disorders: a cluster randomized controlled trial (2024)

5️⃣ Sociodemographic and clinical predictors of adherence to antidepressants in depressive disorders: a systematic review with a meta-analysis (2024)

Finally, our MENTAL-COST project, where we evaluate the efficiency of treatment and follow-up of patients with mental disorders using real-world data: adherence, variability, and costs.

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.