Medida de percepción en enfermedades crónicas : adaptación cultural de los cuestionarios Illness Perception Questionnaire Revised (IPQ-R) y Brief Illness Perception Questionnaire (BIPQ) para la población española /

Descripció del recurs: el 01 setembre 2012Actualmente uno de los grandes retos de los sistemas de salud es responder a la creciente prevalencia de enfermedades crónicas. A pesar de los importantes avances en su diagnóstico y tratamiento, su control no se corresponde con el esperado. Explorar la percepción que las personas tienen de su enfermedad permite identificar sus creencias y desarrollar intervenciones más efectivas que tengan en cuenta sus perspectivas y preferencias. Existen diferentes modelos para explicar la percepción de la enfermedad, entre los que destaca el de Autorregulación de Sentido Común que ha generado un creciente interés dando lugar a diversos instrumentos, como el Illness Perception Questionnaire Revised (IPQ-R), el más utilizado internacionalmente, y el Brief Illness Perception Questionnaire (BIPQ), una versión breve del mismo. Ambos han demostrado tener buenas propiedades psicométricas. El objetivo de este trabajo fue adaptar culturalmente ambos cuestionarios a la población española para disponer de nuevas herramientas en el abordaje de las EC, evaluar su aplicabilidad y profundizar en el conocimiento de la representación de la enfermedad en nuestra cultura. Siguiendo la cronología del proyecto, el texto se estructura en tres estudios: Estudio I. Validación lingüística: Se siguió un método estandarizado utilizando técnicas cualitativas, obteniéndose versiones conceptual y lingüísticamente equivalentes a los cuestionarios originales. Estudio II. Validación psicométrica: Se utilizaron diversas técnicas cuantitativas. Ambos cuestionarios requirieron un alto porcentaje de hetero-administración. Respecto a la validez, la versión adaptada del IPQ-R mostró una estructura similar al cuestionario original, excepto por la unificación de las dimensiones representaciones emocionales-consecuencias. Se destaca relación entre esta dimensión, la identidad y la duración cíclica, y también entre el control de tratamiento, control personal y coherencia, y además, la dificultad de reproducir la estructura del apartado Causas. Los resultados del BIPQ mostraron un agrupamiento de los ítems en dos factores que reforzaron la evidencia de la relación existente entre las dimensiones mencionadas. Las dimensiones del primer grupo mostraron una mayor relación con el estado de salud percibido, en menor grado, con algunas de las medidas de utilización de servicios estudiadas y una escasa asociación con la adherencia a la medicación. Por otra parte, las puntuaciones de ambos grupos permitieron distinguir a las enfermedades estudiadas en dos grupos con un patrón de respuesta similar. Respecto a la fiabilidad, la versión adaptada del IPQ-R mostró valores de consistencia interna y reproducibilidad menores que el cuestionario original en algunas dimensiones, que podrían deberse a su menor cantidad de ítems, el alto porcentaje de heteroadministración y dificultades en la comprensión de algún ítem. El BIPQ también evidenció una reproducibilidad ligeramente menor en algunos ítems, probablemente relacionada con los aspectos mencionados. Estudio III. Aportación de un grupo focal de entrevistadores al proceso de adaptación cultural: Los entrevistadores proporcionaron nuevas evidencias de validez e identificaron áreas de mejora en el procedimiento de administración y en el contenido de los cuestionarios. Asimismo se comprobó la utilidad de dos estrategias de análisis de los datos textuales, una cualitativa y otra cuantitativa. Los resultados de estos estudios tienen interés tanto para la práctica clínica como para la investigación. A partir de los mismos se dispone de dos instrumentos con puntuaciones válidas y una consistencia aceptable, aplicables en nuestro contexto, para medir la percepción de la enfermedad y tener en cuenta su representación en las personas con EC. A nivel metodológico se han llevado a cabo diversas triangulaciones de métodos y técnicas que han contribuido a enriquecer y garantizar la calidad del proceso. Asimismo, se aportan datos que coinciden con los resultados de otros autores y que plantean interrogantes e hipótesis para avanzar en el conocimiento del modelo teórico de la representación de la enfermedad en nuestra cultura.One of the major challenges currently confronting health systems is how to cope with the growing prevalence of chronic diseases. Despite the important advances made in their diagnosis and treatment, the degree of control achieved has failed to meet the expectations. Exploring patients' perceptions of their illnesses would enable to identify their beliefs and to develop interventions that take their points of view and preferences into account Among the different models developed to explain illness perception, the Common Sense Model of Self- Regulation has generated growing interest and has led to a number of instruments, such as the Illness Perception Questionnaire Revised (IPQ-R), the most internationally widely use, and the Brief Illness Perception Questionnaire (BIPQ), an abbreviated version of it. Both instruments have proved to have good psychometric properties. The aim of this study was to culturally adapt both questionnaires to the Spanish population, to have new tools for the management of chronic illnesses, to evaluate their applicability and to achieve a deeper understanding of illness representation in our culture. Following the chronology of the project, the text is structured in three studies: Study I. Linguistic validation: A standardized method was followed predominantly using qualitative techniques. Versions conceptually and lingüistically equivalent to original instruments were obtained. Study II. Psychometric validation: Various quantitative techniques were developed. Both questionnaires required a high percentage of interviewer-based administration. Regarding validity, the adapted version of IPQ-R displayed a similar structure to that of the original questionnaire, except for the grouping of emotional representation and consequences dimensions. We highlight the relation between this dimension and the identity and cyclical timeline, and also between treatment control, personal control and coherence and, otherwise, the difficulty of reproducing the structure of the Causes section. The BIPQ results provide further evidence of the relationship between the mentioned dimensions Scores of dimensions in first group showed a greater relation with external variables, especially with quality of life and, to a lesser extent, with some measures of health services use, and poor relation with treatment adherence. Otherwise, scores of dimensiones in both groups allowed to distinguish studied illnesses in two groups with a similar response pattern. Regarding reliability, the adapted version of the IPQ-R showed smaller scores of internal consistency and reproducibility than the original questionnaire in some dimensions, which could be due to some aspects of administration and comprehension. The BIPQ also showed a slightly lower reproducibility in some of its items, probably also related with the mentioned aspects. Study III. Analysis of a focus group of interviewers to the cultural adaptation process: The interviewers provided new evidence of validity and identified potential areas for improvement in the administration procedure and in the content of the questionnaires. Moreover, it showed the usefulness of two strategies for textual data analysis, with qualitative and quantitative approaches respectively, which converged substantially in their key findings. The findings/results of this study have implications for clinical practice and research alike. As a consequence of the presented studies, two instruments are available with valid test scores and acceptable consistency, applicable in our context, to measure the illness perception and consider its representation in people with chronic illnesses. At the methodological level, a number of triangulations of methods and techniques were carried out, that contributed to enrich and ensure the quality of the process. On the other hand, the findings of this work are in line with other authors' results and raise questions and hypothesis that enable further knowledge of the theoretical model of illness representation in our culture

Cross-cultural validation of the patient-practitioner orientation scale among primary care professionals in Spain

In recent decades, many self-report instruments have been developed to assess the extent to which patients want to be informed and involved in decisions about their health as part of the concept of person-centred care (PCC). The main objective of this research was to translate, adapt and validate the Patient-Practitioner Orientation Scale (PPOS) using a sample of primary care health-care professionals in Spain. Baseline analysis of PPOS scores for 321 primary care professionals (general practitioners and nurses) from 63 centres and 3 Spanish regions participating in a randomized controlled trial. We analysed missing values, distributions and descriptive statistics, item-to-scale correlations and internal consistency. Performed were confirmatory factor analysis (CFA) of the 2-factor model (sharing and caring dimensions), scale depuration and principal component analysis (PCA). Low inter-item correlations were observed, and the CFA 2-factor model only obtained a good fit to the data after excluding 8 items. Internal consistency of the 10-item PPOS was acceptable (0.77), but low for individual subscales (0.70 and 0.55). PCA results suggest a possible 3-factor structure. Participants showed a patient-oriented style (mean = 4.46, SD = 0.73), with higher scores for caring than sharing. Although the 2-factor model obtained empirical support, measurement indicators of the PPOS (caring dimension) could be improved. Spanish primary care health-care professionals overall show a patient-oriented attitude, although less marked in issues such as patients' need for and management of medical information

Acceptability and feasibility of a virtual community of practice to primary care professionals regarding patient empowerment: A qualitative pilot study

Background: Virtual communities of practice (vCoPs) facilitate online learning via the exchange of experiences and knowledge between interested participants. Compared to other communities, vCoPs need to overcome technological structures and specific barriers. Our objective was to pilot the acceptability and feasibility of a vCoP aimed at improving the attitudes of primary care professionals to the empowerment of patients with chronic conditions. Methods: We used a qualitative approach based on 2 focus groups: one composed of 6 general practitioners and the other of 6 practice nurses. Discussion guidelines on the topics to be investigated were provided to the moderator. Sessions were audio-recorded and transcribed verbatim. Thematic analysis was performed using the ATLAS-ti software. Results: The available operating systems and browsers and the lack of suitable spaces and time were reported as the main difficulties with the vCoP. The vCoP was perceived to be a flexible learning mode that provided up-to-date resources applicable to routine practice and offered a space for the exchange of experiences and approaches. Conclusions: The results from this pilot study show that the vCoP was considered useful for learning how to empower patients. However, while vCoPs have the potential to facilitate learning and as shown create professional awareness regarding patient empowerment, attention needs to be paid to technological and access issues and the time demands on professionals. We collected relevant inputs to improve the features, content and educational methods to be included in further vCoP implementation. Trial registration: ClinicalTrials.gov, NCT02757781. Registered on 25 April 2016.This study was financed by Instituto de Salud Carlos III and Cofinanced by Fondo Europeo de Desarrollo Regional (FEDER). Ministerio de Economía y Competitividad. Gobierno de España. (PI15/00164, PI15/00586, PI15/00566

Medida de Percepción en Enfermedades Crónicas: Adaptación Cultural de los cuestionarios Illness Perception Questionnaire Revised (IPQ-R) y Brief Illness Perception Questionnaire (BIPQ) para la población española

Actualmente uno de los grandes retos de los sistemas de salud es responder a la creciente prevalencia de enfermedades crónicas. A pesar de los importantes avances en su diagnóstico y tratamiento, su control no se corresponde con el esperado. Explorar la percepción que las personas tienen de su enfermedad permite identificar sus creencias y desarrollar intervenciones más efectivas que tengan en cuenta sus perspectivas y preferencias. Existen diferentes modelos para explicar la percepción de la enfermedad, entre los que destaca el de Autorregulación de Sentido Común que ha generado un creciente interés dando lugar a diversos instrumentos, como el Illness Perception Questionnaire Revised (IPQ‐R), el más utilizado internacionalmente, y el Brief Illness Perception Questionnaire (BIPQ), una versión breve del mismo. Ambos han demostrado tener buenas propiedades psicométricas. El objetivo de este trabajo fue adaptar culturalmente ambos cuestionarios a la población española para disponer de nuevas herramientas en el abordaje de las EC, evaluar su aplicabilidad y profundizar en el conocimiento de la representación de la enfermedad en nuestra cultura. Siguiendo la cronología del proyecto, el texto se estructura en tres estudios: Estudio I. Validación lingüística: Se siguió un método estandarizado utilizando técnicas cualitativas, obteniéndose versiones conceptual y lingüísticamente equivalentes a los cuestionarios originales. Estudio II. Validación psicométrica: Se utilizaron diversas técnicas cuantitativas. Ambos cuestionarios requirieron un alto porcentaje de hetero‐administración. Respecto a la validez, la versión adaptada del IPQ‐R mostró una estructura similar al cuestionario original, excepto por la unificación de las dimensiones representaciones emocionales‐consecuencias. Se destaca relación entre esta dimensión, la identidad y la duración cíclica, y también entre el control de tratamiento, control personal y coherencia, y además, la dificultad de reproducir la estructura del apartado Causas. Los resultados del BIPQ mostraron un agrupamiento de los ítems en dos factores que reforzaron la evidencia de la relación existente entre las dimensiones mencionadas. Las dimensiones del primer grupo mostraron una mayor relación con el estado de salud percibido, en menor grado, con algunas de las medidas de utilización de servicios estudiadas y una escasa asociación con la adherencia a la medicación. Por otra parte, las puntuaciones de ambos grupos permitieron distinguir a las enfermedades estudiadas en dos grupos con un patrón de respuesta similar. Respecto a la fiabilidad, la versión adaptada del IPQ‐R mostró valores de consistencia interna y reproducibilidad menores que el cuestionario original en algunas dimensiones, que podrían deberse a su menor cantidad de ítems, el alto porcentaje de heteroadministración y dificultades en la comprensión de algún ítem. El BIPQ también evidenció una reproducibilidad ligeramente menor en algunos ítems, probablemente relacionada con los aspectos mencionados. Estudio III. Aportación de un grupo focal de entrevistadores al proceso de adaptación cultural: Los entrevistadores proporcionaron nuevas evidencias de validez e identificaron áreas de mejora en el procedimiento de administración y en el contenido de los cuestionarios. Asimismo se comprobó la utilidad de dos estrategias de análisis de los datos textuales, una cualitativa y otra cuantitativa. Los resultados de estos estudios tienen interés tanto para la práctica clínica como para la investigación. A partir de los mismos se dispone de dos instrumentos con puntuaciones válidas y una consistencia aceptable, aplicables en nuestro contexto, para medir la percepción de la enfermedad y tener en cuenta su representación en las personas con EC. A nivel metodológico se han llevado a cabo diversas triangulaciones de métodos y técnicas que han contribuido a enriquecer y garantizar la calidad del proceso. Asimismo, se aportan datos que coinciden con los resultados de otros autores y que plantean interrogantes e hipótesis para avanzar en el conocimiento del modelo teórico de la representación de la enfermedad en nuestra cultura.One of the major challenges currently confronting health systems is how to cope with the growing prevalence of chronic diseases. Despite the important advances made in their diagnosis and treatment, the degree of control achieved has failed to meet the expectations. Exploring patients' perceptions of their illnesses would enable to identify their beliefs and to develop interventions that take their points of view and preferences into account Among the different models developed to explain illness perception, the Common Sense Model of Self‐ Regulation has generated growing interest and has led to a number of instruments, such as the Illness Perception Questionnaire Revised (IPQ‐R), the most internationally widely use, and the Brief Illness Perception Questionnaire (BIPQ), an abbreviated version of it. Both instruments have proved to have good psychometric properties. The aim of this study was to culturally adapt both questionnaires to the Spanish population, to have new tools for the management of chronic illnesses, to evaluate their applicability and to achieve a deeper understanding of illness representation in our culture. Following the chronology of the project, the text is structured in three studies: Study I. Linguistic validation: A standardized method was followed predominantly using qualitative techniques. Versions conceptually and lingüistically equivalent to original instruments were obtained. Study II. Psychometric validation: Various quantitative techniques were developed. Both questionnaires required a high percentage of interviewer‐based administration. Regarding validity, the adapted version of IPQ‐R displayed a similar structure to that of the original questionnaire, except for the grouping of emotional representation and consequences dimensions. We highlight the relation between this dimension and the identity and cyclical timeline, and also between treatment control, personal control and coherence and, otherwise, the difficulty of reproducing the structure of the Causes section. The BIPQ results provide further evidence of the relationship between the mentioned dimensions Scores of dimensions in first group showed a greater relation with external variables, especially with quality of life and, to a lesser extent, with some measures of health services use, and poor relation with treatment adherence. Otherwise, scores of dimensiones in both groups allowed to distinguish studied illnesses in two groups with a similar response pattern. Regarding reliability, the adapted version of the IPQ‐R showed smaller scores of internal consistency and reproducibility than the original questionnaire in some dimensions, which could be due to some aspects of administration and comprehension. The BIPQ also showed a slightly lower reproducibility in some of its items, probably also related with the mentioned aspects. Study III. Analysis of a focus group of interviewers to the cultural adaptation process: The interviewers provided new evidence of validity and identified potential areas for improvement in the administration procedure and in the content of the questionnaires. Moreover, it showed the usefulness of two strategies for textual data analysis, with qualitative and quantitative approaches respectively, which converged substantially in their key findings. The findings/results of this study have implications for clinical practice and research alike. As a consequence of the presented studies, two instruments are available with valid test scores and acceptable consistency, applicable in our context, to measure the illness perception and consider its representation in people with chronic illnesses. At the methodological level, a number of triangulations of methods and techniques were carried out, that contributed to enrich and ensure the quality of the process. On the other hand, the findings of this work are in line with other authors’ results and raise questions and hypothesis that enable further knowledge of the theoretical model of illness representation in our culture

Knowledge and adherence to antihypertensive therapy in primary care: results of a randomized trial Conocimiento y adherencia a la terapia antihipertensiva en atención primaria: resultados de un ensayo clínico

Objectives: To evaluate the efficacy of a healthcare education program for patients with hypertension. Methods: A multicenter, prospective, cluster-randomized trial was conducted. Randomization was by primary care center; 18 of 36 urban primary care centers in Barcelona and its metropolitan area were randomized to the intervention group (IG) and 18 to the control group (CG). The study sample consisted of patients with hypertension (n=996; 515 in the IG and 481 in the CG) receiving outpatient treatment with antihypertensive drugs. The intervention consisted of personalized information by a trained nurse and written leaflets. Questionnaires on knowledge and awareness of hypertension and its medication, treatment adherence, healthy lifestyle habits, systolic and diastolic blood pressure, and body mass index were assessed at each visit, with a 12-month follow-up. An intention-to-treat analysis was applied. Results: Knowledge of hypertension increased by 27.8% in the IG and by 18.5% in the CG, while that of medication increased by 10.1% in the IG and 5.5% in the CG. Treatment adherence measured by the Morisky-Green test increased by 9.6% (95% CI: 5.5-13.6) in the IG and 8.8% (95% CI: 4.9-12.6) in the CG. There were no differences in adherence on the other tests used. No differences were observed between the IG and CG in clinical variables such as blood pressure or BMI at the end of the trial. Conclusions: The educational intervention had no significant impact on patients´ adherence to the medication.<br>Objetivos: Evaluar la eficacia de un programa de educación sanitaria en pacientes con hipertensión. Métodos: Se diseñó un estudio multicéntrico prospectivo y aleatorizado de conglomerados. La unidad de aleatorización fueron los centros de atención primaria (CAP) situados en Barcelona y su área metropolitana, con 18 CAPs urbanos asignados al grupo intervención (GI) y 18 al grupo control (GC). La muestra de pacientes hipertensos que recibían tratamiento con antihipertensivos ambulatoriamente fue de 996 (GC=481 y GI=515). La intervención consistió en información personalizada mediante enfermera entrenada y material educativo escrito. Se midió en cada visita la presión arterial, el índice de masa corporal, el conocimiento de la enfermedad y de la medicación, la adherencia al tratamiento y los hábitos saludables; el seguimiento fue de 12 meses. Para el análisis de los datos se aplicó el criterio de intención del tratar. Resultados: El conocimiento de la enfermedad aumentó un 27,8% en el GI y un 18,5% en el GC, así como el de la medicación un 10,1% en el GI y un 5,5% en el GC. La adherencia al tratamiento mediante la prueba de Morisky-Green aumentó un 9,6% en el GI y un 8,8% en el GC. No se observaron diferencias entre GI y GC en las otras medidas de adherencia, ni en las variables clínicas relativas a la presión arterial o el índice de masa corporal al final del ensayo. Conclusiones: La intervención educativa no mostró un impacto significativo en el la adherencia a la medicación de la hipertensión

Knowledge and adherence to antihypertensive therapy in primary care: results of a randomized trial.

OBJECTIVES: To evaluate the efficacy of a healthcare education program for patients with hypertension. METHODS: A multicenter, prospective, cluster-randomized trial was conducted. Randomization was by primary care center; 18 of 36 urban primary care centers in Barcelona and its metropolitan area were randomized to the intervention group (IG) and 18 to the control group (CG). The study sample consisted of patients with hypertension (n=996; 515 in the IG and 481 in the CG) receiving outpatient treatment with antihypertensive drugs. The intervention consisted of personalized information by a trained nurse and written leaflets. Questionnaires on knowledge and awareness of hypertension and its medication, treatment adherence, healthy lifestyle habits, systolic and diastolic blood pressure, and body mass index were assessed at each visit, with a 12-month follow-up. An intention-to-treat analysis was applied. RESULTS: Knowledge of hypertension increased by 27.8% in the IG and by 18.5% in the CG, while that of medication increased by 10.1% in the IG and 5.5% in the CG. Treatment adherence measured by the Morisky-Green test increased by 9.6% (95% CI: 5.5-13.6) in the IG and 8.8% (95% CI: 4.9-12.6) in the CG. There were no differences in adherence on the other tests used. No differences were observed between the IG and CG in clinical variables such as blood pressure or BMI at the end of the trial. CONCLUSIONS: The educational intervention had no significant impact on patients' adherence to the medication

Knowledge and adherence to antihypertensive therapy in primary care: results of a randomized trial.

OBJECTIVES: To evaluate the efficacy of a healthcare education program for patients with hypertension. METHODS: A multicenter, prospective, cluster-randomized trial was conducted. Randomization was by primary care center; 18 of 36 urban primary care centers in Barcelona and its metropolitan area were randomized to the intervention group (IG) and 18 to the control group (CG). The study sample consisted of patients with hypertension (n=996; 515 in the IG and 481 in the CG) receiving outpatient treatment with antihypertensive drugs. The intervention consisted of personalized information by a trained nurse and written leaflets. Questionnaires on knowledge and awareness of hypertension and its medication, treatment adherence, healthy lifestyle habits, systolic and diastolic blood pressure, and body mass index were assessed at each visit, with a 12-month follow-up. An intention-to-treat analysis was applied. RESULTS: Knowledge of hypertension increased by 27.8% in the IG and by 18.5% in the CG, while that of medication increased by 10.1% in the IG and 5.5% in the CG. Treatment adherence measured by the Morisky-Green test increased by 9.6% (95% CI: 5.5-13.6) in the IG and 8.8% (95% CI: 4.9-12.6) in the CG. There were no differences in adherence on the other tests used. No differences were observed between the IG and CG in clinical variables such as blood pressure or BMI at the end of the trial. CONCLUSIONS: The educational intervention had no significant impact on patients' adherence to the medication

Knowledge and adherence to antihypertensive therapy in primary care: results of a randomized trial.

OBJECTIVES: To evaluate the efficacy of a healthcare education program for patients with hypertension. METHODS: A multicenter, prospective, cluster-randomized trial was conducted. Randomization was by primary care center; 18 of 36 urban primary care centers in Barcelona and its metropolitan area were randomized to the intervention group (IG) and 18 to the control group (CG). The study sample consisted of patients with hypertension (n=996; 515 in the IG and 481 in the CG) receiving outpatient treatment with antihypertensive drugs. The intervention consisted of personalized information by a trained nurse and written leaflets. Questionnaires on knowledge and awareness of hypertension and its medication, treatment adherence, healthy lifestyle habits, systolic and diastolic blood pressure, and body mass index were assessed at each visit, with a 12-month follow-up. An intention-to-treat analysis was applied. RESULTS: Knowledge of hypertension increased by 27.8% in the IG and by 18.5% in the CG, while that of medication increased by 10.1% in the IG and 5.5% in the CG. Treatment adherence measured by the Morisky-Green test increased by 9.6% (95% CI: 5.5-13.6) in the IG and 8.8% (95% CI: 4.9-12.6) in the CG. There were no differences in adherence on the other tests used. No differences were observed between the IG and CG in clinical variables such as blood pressure or BMI at the end of the trial. CONCLUSIONS: The educational intervention had no significant impact on patients' adherence to the medication

Interprofessional education about shared decision making for patients in primary care settings

With an increasingly complex array of interventions facing healthcare professionals and patients, coupled with a potentially diverse number of professionals operating within the primary care team, the adoption of shared decision making (SDM) - with or without patients' decision aids - in an interprofessional manner is essential to ensure the highest quality of care for patients. In this article, we propose a framework for interprofessional education about SDM targeted to primary care settings. Five areas of knowledge and skills were agreed to be essential for all relevant stakeholders for interprofessional education in SDM to be successful: understanding the concept of SDM; acquiring relevant communication skills to facilitate SDM; understanding interprofessional sensitivities; understanding the roles of different professions within the relevant primary care group; and acquiring relevant skills to implement SDM. We suggest a series of teaching methods for the aforementioned areas, using principles from adult learning

Exploring value creation in a virtual community of practice: a framework analysis for knowledge and skills development among primary care professionals

Abstract Background Healthcare professionals traditional education reflects constraints to face the complex needs of people with chronic diseases in primary care settings. Since more innovative and practical solutions are required, Virtual Community of Practices (vCoP) seem to better respond to learning updates, improving professional and organizational knowledge. However, little is known about the value created in vCoPs as social learning environments. The objective of this project was to explore the value creation process of a gamified vCoP (“e-mpodera vCoP”) aimed at improving the knowledge and attitudes of primary healthcare professionals (PCPs) (nurses and general practitioners) to the empowerment of people with chronic conditions. Methods A framework analysis assessed the value creation process using a mixed methods approach. The framework provided awareness about knowledge and usefulness in a learning community through five cycles: (1) immediate value, (2) potential value, (3) applied value, (4) realized value, and (5) reframing value. Quantitative data included vCoP analytics such as logins, contributions, points, badges, and performance metrics. Qualitative data consisted of PCPs’ forum contributions from Madrid, Catalonia, and Canary Islands over 14 months. Results A total of 185 PCPs had access to the e-mpodera vCoPs. The vCoP showed the dynamic participation of 146 PCPs, along 63 content activities posted, including a total of 3,571 contributions (including text, images, links to webpages, and other files). Regarding the value creation process, the e-mpodera vCoP seems to encompass a broad spectrum of value cycles, with indicators mostly related to cycle 1 (immediate value – activities and interactions) and cycle 2 (potential value – knowledge capital); and to a lesser extent for cycle 3 (applied value – changes in practice) and for cycle 4 (realized value – performance improvement). The presence of indicators related to cycle 5 (reframing value), was minimal, due to few individual redefinitions of success. Conclusion To reach a wider range of value possibilities, a combination of learning objectives, competence framework, challenged-based gamified platform, and pathway model of skill development seems crucial. However, additional research is required to gain clearer insights into organizational values, professionals’ lifelong educational needs in healthcare, and the long-term sustainability of performance improvement. Trial registration ClinicalTrials.gov, NCT02757781. Registered on 02/05/2016