Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Universidad y sociedad: comunicación e integración en empresas e instituciones públicas y organizaciones no lucrativas. Nuevas orientaciones

Proyecto de Innovación docente 2021Depto. de Teorías y Análisis de la ComunicaciónFac. de Ciencias de la InformaciónFALSEsubmitte

Universidad y sociedad: comunicación e integración en empresas e instituciones públicas y organizaciones no lucrativas. Renovación y vanguardia

Depto. de Teorías y Análisis de la ComunicaciónFac. de Ciencias de la InformaciónFALSEsubmitte

Marketing de influencia: educación sanitaria online

Internet and social networks represent a turning point in healthcare information exchange. This process has generated consequences such as the loss of control over the information available, or the risk of health education in a wrong way. The state of the question addresses the marketing of influence on health-related products and services. Consequently, this article aims to offer a present-day perspective about the communication processes between citizens and influential characters from the online scene. Thanks to an online survey, plenty of influencers that shared any recommendation of health products have been identified. Thanks to this sign, different publications have been analysed and several conclusions have been obtained. Some of the obtained resultsin the analysis of these profiles is that influencers gain more recognition and repercussion rather than proffesional profiles and sanitary experts. In addition, the posts that are related to sanitary products achieve an enormous quantity of engagement datum despite being comercial content, which means a good public acceptation. The key to success in marketing campaigns of influence in the health sector is the gigantic trust that the followers have on influencers, which means a big risk because, most of the times, it is not a good source of trustful information.Internet y las redes sociales han supuesto un antes y un después en el intercambio de información sanitaria. Este proceso ha generado consecuencias como la pérdida de control sobre la información disponible, así como el riesgo de educar en salud de una manera errónea. En el presente estado de la cuestión se aborda, entre otros temas, el marketing de influencia en la promoción de productos y servicios relacionados con el ámbito de la salud para, a continuación, ofrecer una perspectiva actual de los procesos comunicativos entre la ciudadanía y las figuras influyentes del panorama online. Gracias a una encuesta online, se han podido identificar varios influencers que compartían en Instagram alguna recomendación sobre productos de salud. Con esta muestra, se han analizado diferentes publicaciones y se han obtenido diversas conclusiones. Algunos de los resultados obtenidos en el análisis de estos perfiles es que los influencers obtienen más reconocimiento y repercusión que los perfiles de profesionales y expertos sanitarios. Además, los posts que versan sobre productos relacionados con la salud obtienen grandes datos de engagement a pesar de ser contenido comercial, lo que significa una buena aceptación por parte del público. La clave del éxito de las campañas de marketing de influencia en el sector de la salud reside en la enorme confianza que depositan los seguidores sobre los influencers, lo que supone un verdadero riesgo, pues en la mayoría de los casos no se trata de información veraz y de calidad