A Method to Compare the Delivery of Psychiatric Care for People with Treatment-Resistant Schizophrenia

Esquizofrènia resistent al tractament; Tecnologies de la informació i la comunicació (TIC); Serveis de salut mentalEsquizofrenia resistente al tratamiento; Tecnologías de la información y la comunicación (TIC); Servicios de salud mentalTreatment-resistant schizophrenia; Information and communication technologies (ICT); Mental health servicesIntroduction: Community services are gaining ground when it comes to attention to patients with psychiatric diseases. Regarding patients with treatment-resistant schizophrenia (TRS), the use of information and communication technology (ICT) could help to shift the focus from hospital-centered attention to community services. This study compares the differences in mental health services provided for patients with TRS in Budapest (Hungary), Tel-Aviv (Israel) and Catalonia (Spain) by means of a method for the quick appraisal of gaps among the three places, for a potential implementation of the same ICT tool in these regions. Methods: An adapted version of the Description and Standardised Evaluation of Services and Directories in Europe for Long Term Care (DESDE-LTC) instrument was made by researchers in Semmelweis University (Budapest, Hungary), Gertner Institute (Tel-Aviv, Israel) and Hospital de la Santa Creu I Sant Pau and Parc Sanitari Sant Joan de Déu (Catalonia, Spain). Results: Two types of outpatient care services were available in the three regions. Only one type of day-care facility was common in the whole study area. Two residential care services, one for acute and the other for non-acute patients were available in every region. Finally, two self-care and volunteer-care facilities were available in the three places. Conclusion: Although the availability of services was different in each region, most of the services provided were sufficiently similar to allow the implementation of the same ICT solution in the three places.This work has been supported by the Horizon 2020 Framework Programme of the European Union (grant number 643552). This research was also funded by ONA CORPORATION

Mobile Phone and Wearable Sensor-Based mHealth Approach for Psychiatric Disorders and Symptoms : Systematic Review and Link to the m-RESIST Project

Background: Mobile Therapeutic Attention for Patients with Treatment-Resistant Schizophrenia (m-RESIST) is an EU Horizon 2020-funded project aimed at designing and validating an innovative therapeutic program for treatment-resistant schizophrenia. The program exploits information from mobile phones and wearable sensors for behavioral tracking to support intervention administration. Objective: To systematically review original studies on sensor-based mHealth apps aimed at uncovering associations between sensor data and symptoms of psychiatric disorders in order to support the m-RESIST approach to assess effectiveness of behavioral monitoring in therapy. Methods: A systematic review of the English-language literature, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed through Scopus, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials databases. Studies published between September 1, 2009, and September 30, 2018, were selected. Boolean search operators with an iterative combination of search terms were applied. Results: Studies reporting quantitative information on data collected from mobile use and/or wearable sensors, and where that information was associated with clinical outcomes, were included. A total of 35 studies were identified; most of them investigated bipolar disorders, depression, depression symptoms, stress, and symptoms of stress, while only a few studies addressed persons with schizophrenia. The data from sensors were associated with symptoms of schizophrenia, bipolar disorders, and depression. Conclusions: Although the data from sensors demonstrated an association with the symptoms of schizophrenia, bipolar disorders, and depression, their usability in clinical settings to support therapeutic intervention is not yet fully assessed and needs to be scrutinized more thoroughly.Peer reviewe

Evaluación de la seguridad, eficacia/efectividad y eficiencia de la teleconsulta en atención primaria, y de los aspectos organizativos, éticos, sociales y legales ligados a su uso

Atenció primària; Teleconsulta; AvaluacióAtención primaria; Teleconsulta; EvaluaciónPrimary care; Teleconsultation; EvaluationL'atenció primària de salut actualment s’enfronta a una limitació en recursos, sobretot econòmics i de força de treball. A més, la pandèmia pel coronavirus SARS-CoV-2 (COVID-19) ha posat de manifest més que mai la importància de poder atendre pacients de manera remota (a distància). La teleconsulta (entesa com la comunicació a distància entre professional de la salut i pacient, bé de forma síncrona a través de videotrucada, trucada telefònica o missatgeria instantània, o bé de forma asíncrona a través de correu electrònic en plataformes segures, eConsulta o similar) es planteja com una possible eina que podria ajudar a estalviar recursos econòmics i de disponibilitat de temps a tots els actors que formen part de la cadena de valor, mantenir o millorar la qualitat de l’atenció (resultats en salut) i l’experiència de l’usuari, i garantir la futura viabilitat dels serveis d’atenció primària.La atención primaria de salud se enfrenta actualmente a una limitación en recursos, sobre todo económicos y de fuerza de trabajo. Además, la pandemia por el coronavirus SARS-CoV-2 (COVID19) ha puesto de manifiesto más que nunca la importancia de poder atender a pacientes de forma remota (a distancia). La teleconsulta (entendida como la comunicación a distancia entre profesional de la salud y paciente, bien de forma síncrona a través de videollamada, llamada telefónica o mensajería instantánea, bien de forma asíncrona a través de correo electrónico en plataformas seguras, eConsulta o similar) se plantea como una posible herramienta que podría ayudar a ahorrar recursos económicos y de disponibilidad de tiempo a todos los actores que forman parte de la cadena de valor, manteniendo o mejorando la calidad de la atención (resultados en salud) y la experiencia del usuario, y garantizando la viabilidad futura de los servicios de atención primaria.Primary healthcare is currently facing a restriction of available resources, especially in terms of finances and workforce. In addition, the SARS-CoV-2 coronavirus pandemic (COVID-19) has highlighted more than ever the importance of being able to care for patients remotely. Teleconsultation (understood as remote communication between health professional and patient, either synchronously via video call, telephone call or instant messaging, or asynchronously via email on secure platforms, eConsultation or similar) is seen as a possible tool that could help save financial resources and time availability for all the actors involved in the value chain, maintaining or improving the quality of care (health outcomes) and the user experience, and guaranteeing the future viability of primary care services

Mobile Phone and Wearable Sensor-Based mHealth Approach for Psychiatric Disorders and Symptoms : Systematic Review and Link to the m-RESIST Project

Background: Mobile Therapeutic Attention for Patients with Treatment-Resistant Schizophrenia (m-RESIST) is an EU Horizon 2020-funded project aimed at designing and validating an innovative therapeutic program for treatment-resistant schizophrenia. The program exploits information from mobile phones and wearable sensors for behavioral tracking to support intervention administration. Objective: To systematically review original studies on sensor-based mHealth apps aimed at uncovering associations between sensor data and symptoms of psychiatric disorders in order to support the m-RESIST approach to assess effectiveness of behavioral monitoring in therapy. Methods: A systematic review of the English-language literature, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed through Scopus, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials databases. Studies published between September 1, 2009, and September 30, 2018, were selected. Boolean search operators with an iterative combination of search terms were applied. Results: Studies reporting quantitative information on data collected from mobile use and/or wearable sensors, and where that information was associated with clinical outcomes, were included. A total of 35 studies were identified; most of them investigated bipolar disorders, depression, depression symptoms, stress, and symptoms of stress, while only a few studies addressed persons with schizophrenia. The data from sensors were associated with symptoms of schizophrenia, bipolar disorders, and depression. Conclusions: Although the data from sensors demonstrated an association with the symptoms of schizophrenia, bipolar disorders, and depression, their usability in clinical settings to support therapeutic intervention is not yet fully assessed and needs to be scrutinized more thoroughly.Peer reviewe

Health policies for the reduction of obstetric interventions in singleton full-term births in Catalonia

To explore the effect of hospital's characteristics in the proportion of obstetric interventions (OI) performed in singleton fullterm births (SFTB) in Catalonia (2010-2014), while incentives were employed to reduce C-sections. Data about SFTB assisted at 42 public hospitals were extracted from the dataset of hospital discharges. Hospitals were classified according to the level of complexity, the volume of births attended, and the adoption of a non-medicalized delivery (NMD) strategy. The annual average change in the percentage for OI was calculated based on Poisson regression models. The rate of OI (35% of all SFTB) including C-sections (20.6%) remained stable through the period. Hospitals attending less complex cases had a lower average of OI, while hospitals attending lower volumes had the highest average. Higher levels of complexity increased the use of C-sections (+4% yearly) and forceps (+16%). The adoption of the NMD strategy decreased the rate of C-sections. The proportion of OI, including C-sections, remained stable in spite of public incentives to reduce them. The adoption of the NMD strategy could help in decreasing the rate of OI. To reduce the OI rate, new strategies should be launched as the development of low-risk pregnancies units, alignment of incentives and hospital payment, increased value of incentives and encouragement of a cultural shift towards non-medicalized births. [Abstract copyright: Copyright © 2018 Elsevier B.V. All rights reserved.

Mobile Phone and Wearable Sensor-Based mHealth Approaches for Psychiatric Disorders and Symptoms : Systematic Review

Altres ajuts: This work was supported by the Horizon 2020 Framework Programme of the European Union (grant number 643552) and was partly funded by Fonds Européen de Développement Économique et Régional (FEDER) and Centres de Recerca de Catalunya (CERCA) Programme, Generalitat de Catalunya. We are grateful to all members of the m-RESIST project, who are also collaborative authors of this review under the name of m-RESIST Group.Mobile Therapeutic Attention for Patients with Treatment-Resistant Schizophrenia (m-RESIST) is an EU Horizon 2020-funded project aimed at designing and validating an innovative therapeutic program for treatment-resistant schizophrenia. The program exploits information from mobile phones and wearable sensors for behavioral tracking to support intervention administration. To systematically review original studies on sensor-based mHealth apps aimed at uncovering associations between sensor data and symptoms of psychiatric disorders in order to support the m-RESIST approach to assess effectiveness of behavioral monitoring in therapy. A systematic review of the English-language literature, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed through Scopus, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials databases. Studies published between September 1, 2009, and September 30, 2018, were selected. Boolean search operators with an iterative combination of search terms were applied. Studies reporting quantitative information on data collected from mobile use and/or wearable sensors, and where that information was associated with clinical outcomes, were included. A total of 35 studies were identified; most of them investigated bipolar disorders, depression, depression symptoms, stress, and symptoms of stress, while only a few studies addressed persons with schizophrenia. The data from sensors were associated with symptoms of schizophrenia, bipolar disorders, and depression. Although the data from sensors demonstrated an association with the symptoms of schizophrenia, bipolar disorders, and depression, their usability in clinical settings to support therapeutic intervention is not yet fully assessed and needs to be scrutinized more thoroughly

Measuring Users’ Receptivity Toward an Integral Intervention Model Based on mHealth Solutions for Patients With Treatment-Resistant Schizophrenia (m-RESIST): A Qualitative Study

BACKGROUND: Despite the theoretical potential of mHealth solutions in the treatment of patients with schizophrenia, there remains a lack of technological tools in clinical practice. OBJECTIVE: The aim of this study was to measure the receptivity of patients, informal carers, and clinicians to a European integral intervention model focused on patients with persistent positive symptoms: Mobile Therapeutic Attention for Patients with Treatment-Resistant Schizophrenia (m-RESIST). METHODS: Before defining the system requirements, a qualitative study of the needs of outpatients with treatment-resistant schizophrenia was carried out in Spain, Israel, and Hungary. We analyzed the opinions of patients, informal carers, and clinicians concerning the services originally intended to be part of the solution. A total of 9 focus groups (72 people) and 35 individual interviews were carried out in the 3 countries, using discourse analysis as the framework. RESULTS: A webpage and an online forum were perceived as suitable to get both reliable information on the disease and support. Data transmission by a smart watch (monitoring), Web-based visits, and instant messages (clinical treatment) were valued as ways to improve contact with clinicians. Alerts were appreciated as reminders of daily tasks and appointments. Avoiding stressful situations for outpatients, promoting an active role in the management of the disease, and maintaining human contact with clinicians were the main suggestions provided for improving the effectiveness of the solution. CONCLUSIONS: Positive receptivity toward m-RESIST services is related to its usefulness in meeting user needs, its capacity to empower them, and the possibility of maintaining human contact

Dataset used to perform Focus Groups in Spain, Israel and Hungary (related to m-RESIST project)

<p>Dataset used to perform the following manuscripts: </p> <p>- Huerta-Ramos, E., Escobar-Villegas, M. S., Rubinstein, K., Unoka, Z. S., Grasa, E., Hospedales, M., … Usall, J. (2016). Measuring Users’ Receptivity Toward an Integral Intervention Model Based on mHealth Solutions for Patients With Treatment-Resistant Schizophrenia (m-RESIST): A Qualitative Study. <em>JMIR mHealth and uHealth</em>, <em>4</em>(3), e112. http://doi.org/10.2196/mhealth.5716</p> <p>rom March to June (2015), it was included opinions of patients, informal carers, and clinicians from the three countries concerning the services originally intended to be part of the solution. The activities related to the publication were the following: 9 focus groups (72 people) and 35 individual interviews were carried out in the 3 countries. All recorded data was analysed using discourse analysis as the framework. </p