Drug cost avoidance analysis of cancer clinical trials in Spain: a study on cost contributors and their impact.

OBJECTIVE: Analyze the cost contributors and their impact on the drug cost avoidance (DCA) resulting from cancer clinical trials over the period of 2015-2020 in a tertiary-level hospital in Spain (HCUVA). METHODS: We performed a cross-sectional, observational, retrospective study of a total of 53 clinical trials with 363 patients enrolled. We calculated the DCA from the price of the best standard of care (i.e.: drugs that the institution would otherwise fund). A linear regression model was used to determine cost contributors and estimate their impact. RESULTS: The total DCA was ~ 4.9 million euros (31 clinical trials; 177 enrollees), representing ~ 30% and ~ 0,05% approximately of the annual pharmaceutical expenditures at the HCUVA and for the Spanish Health System, respectively. Cancer type analysis showed that lung cancer had the highest average DCA by trial, indicating that treatments in these trials were the most expensive. Linear regression analysis showed that the number of patients in a trial did not significantly affect that trial's DCA. Instead, cancer type, phase trials, and intention of treatment were significant cost contributors to DCA. Compared to digestive cancer trials, breast and lung trials were significantly more expensive, (p < 0.05 and p < 0.1, respectively). Phase III trials were more expensive than Phase II (p < 0.01) and adjuvant trials were less expensive than palliative (p < 0.05). CONCLUSION: We studied cost contributors that significantly impacted the estimated DCA from cancer clinical trials. Our work provides the groundwork to explore DCA contributors with potential to enhance public relations material and serve as a negotiating tool for budgeting, thus playing an important role to inform decisions about resource allocation.

La musicoterapia como asignatura en los estudios de grado en enfermería / Music therapy as a subject in grade studies in nursing

Introducción: la musicoterapia se entiende por el uso de la música o sus elementos con fines terapéuticos. Su empleo en la enfermería es escaso más allá del uso de la intervención NIC 4400. Objetivo: conocer y analizar el grado de aceptación por parte de los estudiantes de enfermería ante la posible inclusión de la musicoterapia como asignatura en los programas educativos de los estudios de Grado en Enfermería. Método: se ha realizado un estudio observacional descriptivo de corte transversal con una muestra n=346 participantes. Resultados: los resultados muestran que el 93,93% de los alumnos sí incluirían la musicoterapia como una asignatura Optativa en los estudios de Grado en Enfermería, haciendo uso de ella en su futuro profesional

Introduction: music therapy is understood by the use of music or its elements for therapeutic purposes. Its use in nursing is scarce beyond the use of the NIC 4400 intervention. Objective: the research aims to know and analyze the degree of acceptance by nursing students regarding the possible inclusion of music therapy as a subject in the educational programs of the Nursing Degree studies. Method: a cross-sectional, observational, descriptive study was carried out with a sample of n=346 participants. Conclusion: the results show that 93.93% of the students did include music therapy as an optional subject in Nursing Degree studies, making use of it in their professional future

Percepción del paciente acerca de su bienestar durante la hospitalización / Patient's perception on their well-being during hospitalization

Objetivo: Conocer la opinión de los pacientes acerca de los aspectos de la atención que reciben durante la hospitalización, que son importantes para lograr su bienestar. Metodología: Estudio cualitativo exploratorio. Los participantes fueron 30 informantes claves que estuvieron hospitalizados en cirugía general y fueron entrevistados en sus domicilios, posterior a su egreso, mediante una guía de entrevista semi-estructurada. Resultados: La atención técnica e interpersonal son esenciales para lograr el bienestar durante la hospitalización. Además es relevante la infraestructura, servicios otorgados por otros departamentos y cumplimiento de expectativas de los pacientes. Conclusión: Los pacientes hospitalizados perciben bienestar cuando reciben buen trato y son atendidos por personal competente. Es relevante la consideración de los otros aspectos que modulan la percepción del bienestar y dependen directamente del entorno hospitalario (AU)

Objective: The objective was to know the patient's opinion regarding the elements of the care they receive during hospitalization that are important to attain their well-being. Methodology: Exploratory qualitative study. The participants included 30 key informants who had been hospitalized in general surgery and were interviewed in their homes after they were discharged, using a semi-structured interview guide. Results: Technical and interpersonal care are essential factors to attain well-being during hospitalization. The infrastructures, services provided by other departments and meeting the patient's expectations are also important elements. Conclusion: Hospitalized patients perceive wellness when they are treated properly and attended by trained personnel. It is important to consider the other issues that modulate the perception on well-being, which depend directly on the hospital environment (AU)