Person-Centered Coordinated Care Experience of People With Long-Term Conditions in the Balearic Islands Measured by the P3CEQ.

Objective: This study aimed to use the Person-Centered Coordinated Care Experience Questionnaire (P3CEQ) to assess the experience of person-centered coordinated care among people with long-term conditions in the Balearic Islands, Spain. Methods: Over 1300 participants receiving treatment for chronic conditions or HIV pre-exposure prophylaxis were invited to complete the P3CEQ and a socio-demographic questionnaire, both administered electronically via the Naveta app. The P3CEQ assesses the key domains of the P3C through an 11-item questionnaire. Items 1, 2, 3, 4, 5, 8, 9 and 10 assess specifically person-centredness (PC subscale), while items 5, 6, 7, 8 and 9 measure care coordination (CC subscale; question 7 includes 4 sub-questions to specifically assess care plans). Descriptive statistics were used to summarize patient characteristics and P3CEQ items scores. Data analysis included chi-squared test of independence, Student's t-test and analysis of variance test. Pairwise comparisons were adjusted by Bonferroni correction. Results: The P3CEQ and a socio-demographic questionnaire were sent to 1313 individuals (651 men, 657 women, 5 'other gender'). A response rate of 35.34% was achieved, with 464 P3CEQ responders (223 men and 241 women). Significant differences in response rates were observed by age, smoking status, alcohol consumption, membership of patient organizations, and use of alternative medicine. Care planning was rated significantly lower than other measured domains. Women experienced less person-centered care than men (16.64 vs 17.91) and rated care coordination worse than their male counterparts (9.18 vs 10.23). There were also differences in scores between medical condition types, with cancer and inflammatory bowel disease patients rating highest for both person-centered care (21.20 and 19.13, respectively) and care coordination (10.70 vs 10.88, respectively). Patients with skin and rheumatic diseases rated lowest their experience of person-centered care. People with higher education and those employed or studying experienced better person-centeredness. Conclusion: Using the P3CEQ, we detected significant differences in the care experiences of people with chronic conditions, suggesting the need to address potential gender biases, social inequalities, and the poorer ratings observed for certain conditions in the study population.

Implementing Systematic Patient-Reported Measures for Chronic Conditions Through the Naveta Value-Based Telemedicine Initiative: Observational Retrospective Multicenter Study.

BACKGROUND: Patient-reported outcome and experience measures can play a critical role in providing patient-centered and value-based health care to a growing population of patients who are chronically ill. Value-based telemedicine platforms such as the Naveta initiative may facilitate the effective integration of these tools into health care systems. OBJECTIVE: This study aims to evaluate the response rate to electronic patient-reported outcome measures (ePROMs) and electronic patient-reported experience measures (ePREMs) among patients participating in the Naveta telemedicine initiative and its correlations with sociodemographic and clinical characteristics, as well as the evolution of the response rates over time. METHODS: Between January 1, 2021, and June 30, 2023, a total of 53,364 ePREMs and ePROMs for 20 chronic conditions were administered through the Naveta-Phemium platform. Descriptive statistics were used to summarize continuous and categorical variables. Differences in response rates within each sociodemographic variable were analyzed using logistic regression models, with significance assessed via chi-square and post hoc Tukey tests. Two-way ANOVA was used to examine the interaction between time interval and disease type on response rate evolution. RESULTS: A total of 3372 patients with severe chronic diseases from 64 public hospitals in Spain participated in the Naveta health questionnaire project. The overall response rate to ePROMs and ePREMs during the first 2.5 years of the Naveta initiative was 46.12% (24,704/53,364), with a baseline rate of 53.33% (7198/13,496). Several sociodemographic factors correlated with lower response rates, including male gender, older age, lower education level, frequent alcohol use, being a student, and not being physically active. There were also significant variations in response rates among different types of chronic conditions (P<.001), with the highest rates being for respiratory (433/606, 71.5%), oncologic (200/319, 62.7%), digestive (2247/3601, 62.4%), and rheumatic diseases (7506/12,982, 57.82%) and the lowest being for HIV infection (7473/22,695, 32.93%). During the first 6 months of follow-up, the response rates decreased in all disease types, except in the case of the group of patients with oncologic disease, among whom the response rate increased up to 100% (6/6). Subsequently, the overall response rate approached baseline levels. CONCLUSIONS: Recognizing the influence of sociodemographic factors on response rates is critical to identifying barriers to participation in telemonitoring programs and ensuring inclusiveness in patient-centered health care practices. The observed decline in response rates at follow-up may be due to survey fatigue, highlighting the need for strategies to mitigate this effect. In addition, the variation in response rates across chronic conditions emphasizes the importance of tailoring telemonitoring approaches to specific patient populations.

[Development of integrated support software for clinical nutrition]. / Desarrollo de una aplicación informática de ayuda al soporte nutricional especializado integrado en la historia clínica electrónica.

OBJECTIVES: to develop an integrated computer software application for specialized nutritional support, integrated in the electronic clinical record, which detects automatically and early those undernourished patients or at risk of developing undernourishment, determining points of opportunity for improvement and evaluation of the results. METHODS: the quality standards published by the Nutrition Work Group of the Spanish Society of Hospital Pharmacy (SEFH) and the recommendations by the Pharmacy Group of the Spanish Society of Parenteral and Enteral Nutrition (SENPE) have been taken into account. According to these quality standards, the nutritional support has to include the following healthcare stages or sub-processes: nutritional screening, nutritional assessment, plan for nutritional care, prescription, preparation and administration. RESULTS: this software allows to conduct, in an automated way, a specific nutritional assessment for those patients with nutritional risk, implementing, if necessary, a nutritional treatment plan, conducting follow-up and traceability of outcomes derived from the implementation of improvement actions, and quantifying to what extent our practice is close to the established standard. CONCLUSIONS: this software allows to standardize the specialized nutritional support from a multidisciplinary point of view, introducing the concept of quality control per processes, and including patient as the main customer.

Objetivos: desarrollar una aplicacion informatica integral en el soporte nutricional especializado, e integrado en la historia clinica electronica, que detecte de forma automatizada y precoz a los pacientes desnutridos o en riesgo de desarrollar desnutricion, determinando puntos de oportunidad de mejora y evaluacion de resultados. Métodos: se han tenido en cuenta los estandares de calidad publicados por el grupo de trabajo de nutricion de la Sociedad Espanola de Farmacia Hospitalaria (SEFH) y las recomendaciones del grupo de farmacia de la Sociedad Espanola de Nutricion Parenteral y Enteral (SENPE). De acuerdo con dichos estandares de calidad, las etapas o subprocesos asistenciales que debe contemplar el soporte nutricional son: cribado nutricional, valoracion nutricional, plan de cuidados nutricionales, formulacion, elaboracion y administracion. Resultados: la aplicacion permite, de forma automatizada, realizar una valoracion nutricional especifica a los pacientes con riesgo nutricional, instaurando, si fuese preciso, un plan de tratamiento nutricional y realizando el seguimiento y trazabilidad de los resultados derivados de la implantacion de acciones de mejora y, cuantificando en que medida nuestra practica se aproxima a la establecida como estandar. Conclusiones: la aplicacion permite estandarizar el soporte nutricional especializado desde un punto multidisciplinar, introduciendo el concepto de control de calidad por procesos y al paciente como cliente principal.

Development of integrated support software for clinical nutrition / Desarrollo de una aplicación informática de ayuda al soporte nutricional especializado integrado en la historia clínica electrónica

Objectives: to develop an integrated computer software application for specialized nutritional support, integrated in the electronic clinical record, which detects automatically and early those undernourished patients or at risk of developing undernourishment, determining points of opportunity for improvement and evaluation of the results. Methods: the quality standards published by the Nutrition Work Group of the Spanish Society of Hospital Pharmacy (SEFH) and the recommendations by the Pharmacy Group of the Spanish Society of Parenteral and Enteral Nutrition (SENPE) have been taken into account. According to these quality standards, the nutritional support has to include the following healthcare stages or sub-processes: nutritional screening, nutritional assessment, plan for nutritional care, prescription, preparation and administration. Results: this software allows to conduct, in an automated way, a specific nutritional assessment for those patients with nutritional risk, implementing, if necessary, a nutritional treatment plan, conducting follow-up and traceability of outcomes derived from the implementation of improvement actions, and quantifying to what extent our practice is close to the established standard. Conclusions: this software allows to standardize the specialized nutritional support from a multidisciplinary point of view, introducing the concept of quality control per processes, and including patient as the main customer (AU)

Objetivos: desarrollar una aplicación informática integral en el soporte nutricional especializado, e integrado en la historia clínica electrónica, que detecte de forma automatizada y precoz a los pacientes desnutridos o en riesgo de desarrollar desnutrición, determinando puntos de oportunidad de mejora y evaluación de resultados. Métodos: se han tenido en cuenta los estándares de calidad publicados por el grupo de trabajo de nutrición de la Sociedad Española de Farmacia Hospitalaria (SEFH) y las recomendaciones del grupo de farmacia de la Sociedad Española de Nutrición Parenteral y Enteral (SENPE). De acuerdo con dichos estándares de calidad, las etapas o subprocesos asistenciales que debe contemplar el soporte nutricional son: cribado nutricional, valoración nutricional, plan de cuidados nutricionales, formulación, elaboración y administración. Resultados: la aplicación permite, de forma automatizada, realizar una valoración nutricional específica a los pacientes con riesgo nutricional, instaurando, si fuese preciso, un plan de tratamiento nutricional y realizando el seguimiento y trazabilidad de los resultados derivados de la implantación de acciones de mejora y, cuantificando en qué medida nuestra práctica se aproxima a la establecida como estándar. Conclusiones: la aplicación permite estandarizar el soporte nutricional especializado desde un punto multidisciplinar, introduciendo el concepto de control de calidad por procesos y al paciente como cliente principal (AU)

Errores de conciliación en el ingreso y en el alta hospitalaria en pacientes ancianos polimedicados. Estudio prospectivo aleatorizado multicéntrico / Reconciliation errors at admission and departure in old and polymedicated patients. Prospective, multicenter randomized study

Fundamento y objetivo: El objetivo del estudio es conocer la incidencia de los errores de conciliación en el ingreso y en el alta hospitalaria en pacientes ancianos polimedicados así como los factores de riesgo asociados. Pacientes y método: Estudio prospectivo aleatorizado y multicéntrico en el ingreso o en el alta hospitalaria. Cualquier discrepancia no justificada entre el tratamiento crónico y el prescrito en el hospital se consideró un error de conciliación. Resultados: Se incluyeron 603 pacientes, de los cuales 318 (52,7%) presentaron al menos un error de conciliación. De las 3.991 prescripciones, 2.340 prescripciones (59%) no mostraron discrepancias, mientras que 970 prescripciones (24%) fueron discrepancias justificadas y 644 prescripciones (16%) fueron discrepancias no justificadas; en 37 prescripciones (1%) no fue posible determinarlo. De las 644 discrepancias no justificadas, en 555 discrepancias, el médico las aceptó como error de conciliación (tasa de errores de conciliación del 13,9%). Discusión: El 52,7% de los pacientes ancianos polimedicados presentaron errores de conciliación durante su estancia hospitalaria, lo que implica el 13,9% de los medicamentos. La conciliación de la medicación debe ser un objetivo estratégico para mejorar la seguridad de los pacientes (AU)

Background and objective: The objective of this study was to know of the incidence rate of reconciliation errors in elderly poly-medicated patients. Patients and method: A prospective randomized multicenter study in a cohort of patients at admission or at discharge. Any unjustified discrepancy in medication between chronic treatment and the treatment prescribed in the hospital was considered as a Reconciliation Error. Results: From January 2006 to April 2008 603 patients were analyzed: 318 (52.7%) showed at least one Reconciliation Error. The patients had a total of 3.991 medications registered, 2.340 (59%) showed no discrepancies, 970 (24%) HAD justified discrepancies and 644 (16%) not justified; in 37 (1%) it was not possible to determine whether this was an error or not. Of the 644 unjustified discrepancies, 555 were accepted by the doctor as Reconciliation Errors. Reconciliation Error rate of 13.9%. Conclusion: According to this study, 52.7% of elderly poly-medicated patients have reconciliation errors during hospitalization. Medication reconciliation should be a strategic objective to increase the safety of patients (AU)

[Reconciliation errors at admission and departure in old and polymedicated patients. Prospective, multicenter randomized study]. / Errores de conciliación en el ingreso y en el alta hospitalaria en pacientes ancianos polimedicados. Estudio prospectivo aleatorizado multicéntrico.

BACKGROUND AND OBJECTIVE: The objective of this study was to know of the incidence rate of reconciliation errors in elderly poly-medicated patients. PATIENTS AND METHOD: A prospective randomized multicenter study in a cohort of patients at admission or at discharge. Any unjustified discrepancy in medication between chronic treatment and the treatment prescribed in the hospital was considered as a Reconciliation Error. RESULTS: From January 2006 to April 2008 603 patients were analyzed: 318 (52.7%) showed at least one Reconciliation Error. The patients had a total of 3.991 medications registered, 2.340 (59%) showed no discrepancies, 970 (24%) HAD justified discrepancies and 644 (16%) not justified; in 37 (1%) it was not possible to determine whether this was an error or not. Of the 644 unjustified discrepancies, 555 were accepted by the doctor as Reconciliation Errors. Reconciliation Error rate of 13.9%. CONCLUSION: According to this study, 52.7% of elderly poly-medicated patients have reconciliation errors during hospitalization. Medication reconciliation should be a strategic objective to increase the safety of patients.