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Evaluating the implementation of PROMs and PREMs in routine clinical care: co‑design of tools from the perspective of patients and healthcare professionals
(2025-02-17) Amat Fernandez, Clara; Pardo Cladellas, Yolanda; Ferrer, Montse; Bosch, Guillermo; Lizano Barrantes, Catalina; Briseño Diaz, Renata; Vernet Tomas, Maria; Fumadó, Lluís; Beisani, Marc; Redondo Pachón, Dolores; Bach Pascual, Anna; Garin, Olatz; Hospital de Mar Patient-Reported Measures Group
Background Implementation of patient-reported measures (PRMs) is an integral element for patient-centered models; however, there is still hardly any quantitative evidence regarding its impact in routine care settings. The objective of this study was to codesign two concise tools that allow for a standardized and longitudinal assessment of the implementation of PRMs in routine care in terms of acceptability and perceived value from the perspective of both patients and healthcare professionals. Methods A list of constructs and items to be presented, separately, to patients and healthcare professionals was cre‑ ated from evidence gathered through a narrative literature review. Focus groups, composed of either patients or healthcare professionals from different chronic conditions, were conducted for the co-design of independent assessments. Once agreement was reached, the content validity was examined in separate consensus meetings. Results A total of 10 patients and 10 healthcare professionals participated in the focus groups. After 7 focus groups, the PRMs Implementation Assessment Tool for patients (PRMIAT-P) was developed with 33 items in 9 constructs, and the tool for healthcare professionals (PRMIAT-HP) had 33 items in 16 constructs. Content validity was confirmed for both tools. Conclusions The perspective of patients and healthcare professionals regarding the implementation of PRMs in routine care can be evaluated quantitively with the PRMIAT tools. These tools are understandable, concise and com‑ prehensive, and can be used in multiple settings and for different chronic conditions. They have been codesigned as a standard set to facilitate both longitudinal assessments and performing benchmarking among different initiatives.
Montelukast in paediatric asthma and allergic rhinitis: a systematic review and meta-analysis
(2023-10-18) Mayoral Oritz, Karina; Lizano Barrantes, Catalina; Zamora, Víctor; Pont, Angels; Miret Lopez, Carme; Barrufet, Cristina; Caballero Rabasco, María Araceli; Praena Crespo, Manuel; Bercedo Sanz, Alberto; Valdesoiro Navarrete, Laura; Guerra, Maria Teresa; Pardo Cladellas, Yolanda; Martínez Zapata, María José; Garin, Olatz; Ferrer, Montserrat
Background: We aim to assess the impact of montelukast on paediatric patients with asthma/allergic rhinitis, measured using patient-reported outcome measures, compared with other treatments or placebo.
Methods: Protocol registration CRD42020216098 (www.crd.york.ac.uk/PROSPERO). MEDLINE and Embase databases were used to conduct the search. Two authors independently selected studies and extracted data, and a third reviewer resolved discrepancies. Meta-analyses were constructed to estimate the standardised mean difference (SMD) using a random-effects model.
Results: Out of 3937 articles identified, 49 studies met the inclusion criteria, mostly randomised clinical trials (sample sizes: 21–689 patients). The SMD of change pooled estimators for the global, mental and physical domains of health-related quality of life were not statistically significant. For daytime and nighttime symptoms scores, the SMD (95% CI) was in favour of inhaled corticosteroids (−0.12, −0.20– −0.05 and −0.23, −0.41– −0.06, respectively). The pooled estimator for global asthma symptoms was better for montelukast when compared with placebo (0.90, 0.44–1.36).
Conclusions: The synthesis of the available evidence suggests that, in children and adolescents, montelukast was effective in controlling asthma symptoms when compared with placebo, but inhaled corticosteroids were superior in controlling symptoms, especially at night-time. These findings of our systematic review concur with current guidelines for asthma treatment.
The piper at the gates of brain: A systematic review of surface modification strategies on lipid nanoparticles to overcome the Blood-Brain-Barrier
(2024-11-15) González Vargas, Ronny; Lizano Barrantes, Catalina; Romero Obon, Miquel; Valencia Clua, Kevin; Narváez Narváez, David A.; Suñé Negre, Josep Ma; Pérez Lozano, Pilar; García Montoya, Encarna; Martinez Martinez, Noelia; Hernández Munain, Cristina; Suñé, Carlos; Suñé Pou, Marc
The Blood-Brain Barrier (BBB) significantly impedes drug delivery to the central nervous system. Nanotechnology, especially surface-functionalized lipid nanoparticles, offers innovative approaches to overcome this barrier. However, choosing an effective functionalization strategy is challenging due to the lack of detailed comparative analysis in current literature. Our systematic review examined various functionalization strategies and their impact on BBB permeability from 2041 identified articles, of which 80 were included for data extraction. Peptides were the most common modification (18) followed by mixed strategies (12) proteins (9), antibodies (7), and other strategies (8). Interestingly, 26 studies showed BBB penetration with unmodified or modified nanoparticles using commonly applied strategies such as PEGylation or surfactant addition. Statistical analysis across 42 studies showed correlation between higher in vivo permeation improvements and nanoparticle type, size, and functionalization category. The highest ratios were found for nanostructured lipid carriers or biomimetic systems, in studies with particle sizes under 150 nm, and in those applying mixed functionalization strategies. The interstudy heterogeneity we observed highlights the importance of adopting standardized evaluation protocols to enhance comparability. Our systematic review aims to provide a comparative insight and identify future research directions in the development of more effective lipid nanoparticle systems for drug delivery to the brain to help improve the treatment of neurological and psychiatric disorders and brain tumours.
Smartphone App for monitoring Asthma in children and adolescents
(2021-01-02) Mayoral, Karina; Garin, Olatz; Caballero Rabasco, María Araceli; Praena Crespo, Manuel; Bercedo Sanz, Alberto; Hernández, Gimena; Castillo Laita, José Antonio; Lizano Barrantes, Catalina; Pardo Cladellas, Yolanda; Ferrer, Montse; ARCA group
Purpose The asthma stepwise treatment approach recommended is based on monitoring patients' symptoms. The Asthma Research in Children and Adolescents (ARCA) cohort was created to provide evidence about the evolution of persistent asthma. This manuscript describes the development of an electronic health tool, comprising a mobile health application for patients with asthma and its associated online platform for pediatricians to monitor them. Methods The development process followed 7 phases: the first 5 (Conceptualization, Preparation, Assessment scheduling, Image and user interface, and Technical development) defined and designed the tool, followed by a testing phase (functionality assessment and pilot test with ARCA patients), anda last phase which evaluated usability. Since the target population was aged 6-16 years, three versions were designed within the same smartphone application: parents/proxy, children, and adolescents. The online platform for pediatricians provides real-time information from the application: patients' responses over time with color-coded charts (red/amber/green, as in traffic lights). Results The pilot test through semi-structured phone interviews of the first 50 participants included in the ARCA study (n =53) detected their misunderstandings. Pediatricians were trained to emphasize that the application is free of charge and requires monthly answers. Median ofthe System Usability Scale scores (n=85), ranging O (negative)-100 (positive), was > 93 in the three age versions of the application. Conclusions Technology has the capability of transforming the use of patient-reported outcomes. Describing all the development phases of a mobile health application for monitoring children and adolescents with asthma may increase the knowledge on how to design applications for young patients.
Uso de aplicaciones móviles y fomento de confianza en los profesionales de la salud como herramientas en el Seguimiento Farmacoterapéutico de un paciente joven.
(2020-06-14) Vásquez Navarro, Luis Gerardo; Lizano Barrantes, Catalina
En la Universidad de Costa Rica, los estudiantes del curso Atención Farmacéutica II de la carrera Licenciatura en Farmacia, bajo tutoría docente, ofrecen el servicio de Seguimiento Farmacoterapéutico (SFT) a pacientes que lo requieran. Se presenta el caso de un paciente varón de 19 años con migraña y rinitis alérgica no controladas; dolores ocasionales de cadera y rodilla; y desconfianza en el médico. Se implementaron intervenciones farmacéuticas basadas en la utilización de aplicaciones móviles y fomento de confianza en los profesionales de la salud para abordar los problemas y riesgos detectados en las fases de estudio y evaluación del SFT. Se logró el control de la migraña, con 87 días sin sufrir ataques, y de la rinitis alérgica; asimismo, los dolores de cadera y rodilla no se volvieron a presentar; y se generó confianza en los profesionales de la salud.