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de Toro J, Cea-Calvo L, García-Vivar ML, Pantoja L, Lerín-Lozano C, García-Díaz S, Galindo MJ, Marín-Jiménez I, Fernández S, Mestre Y, Orozco-Beltrán D. The Experience With Health Care of Patients With Inflammatory Arthritis: A Cross-sectional Survey Using the Instrument to Evaluate the Experience of Patients With Chronic Diseases. J Clin Rheumatol 2021; 27:25-30. [PMID: 31356399 PMCID: PMC7748048 DOI: 10.1097/rhu.0000000000001155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients' experience with health care is becoming a key component for the provision of a patient-centered health care model. The aim of this study was to assess the experience with health care of patients with inflammatory arthritis and patient- and health care-related factors. METHODS Patients responded to an anonymous survey provided by their treating clinical teams. The survey comprised the validated 12-item IEXPAC (Instrument to Evaluate the EXperience of PAtients with Chronic diseases) tool and demographic variables and health care-related characteristics that may affect patients' experience. RESULTS A total of 359 of 625 surveys were returned (response rate, 57.4%). Overall, patient responses were positive (>60% gave "always/mostly" answers) for statements assessing the interaction between patients and health care professionals or patient self-management following health care professional guidance. However, positive patient responses for items regarding patient interaction with the health care system via the internet or with other patients were less than 13%. Only 25.6% of patients who had been hospitalized reported receiving a follow-up call or visit following discharge. In the bivariate analysis, experience scores were higher (better experience) in men, those seen by fewer specialists or by the same physician, and in patients treated with a fewer number of drugs or with subcutaneous/intravenous drugs. Multivariate analyses identified regular follow-up by the same physician and treatment with subcutaneous/intravenous drugs as variables associated with a better patient experience. CONCLUSIONS This study identifies areas of care for patients with inflammatory arthritis with the potential to improve patients' experience and highlights the importance of patient-physician relationships and comprehensive patient care.
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Affiliation(s)
- Javier de Toro
- From the Rheumatology Department, Hospital Universitario A Coruña, Universidade da Coruña, INIBIC, A Coruña
| | | | | | | | | | - Silvia García-Díaz
- Rheumatology Department, Hospital Transversal Sant Joan Despí Moisès Broggi-General, Consorci Sanitari Integral, Barcelona
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de Toro J, González CM, Cea-Calvo L, Arteaga MJ, Fernández S, Carmona L, Otón T. Patients' perceptions on shared decision making during prescription of subcutaneous biological drug treatments for inflammatory arthritis: The RHEU-LIFE survey. Musculoskeletal Care 2020; 18:568-574. [PMID: 32840050 DOI: 10.1002/msc.1499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/07/2020] [Accepted: 08/08/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The aim of this study was to explore the preferences of patients with rheumatic diseases and their perceived experience regarding participation in shared decision making (SDM) when they were prescribed a subcutaneous (SC) biological drug. METHODS A printed survey was handed to 1,000 patients with inflammatory rheumatic diseases treated with SC biological drug. The survey included closed questions about preferences regarding decision making and about patients' experience when they were prescribed an SC biological drug. Descriptive statistics were performed with stratification by patient profiles, using chi-square for comparisons between groups. RESULTS A total of 592 surveys were received (response rate 59.2%, mean age 51.7 years, 57.6% women). Some 28.2% of patients reported preferring to take part in treatment selection, a percentage that was higher in younger patients, in those with higher academic degree and in those who search information in sources different to that of health care professionals. Over half of patients (56.3%) perceived that the rheumatologist considered their opinion when prescribing an SC biological drug, a percentage higher in younger people. Only in 40.8% of cases did the patients' preference match their perception of their participation in the process. No differences were observed by sex, disease or number of biologics. CONCLUSIONS Patients with inflammatory rheumatic diseases want information about their treatments but mostly leave the prescription decision to the rheumatologist. Younger people, or those with higher academic degree, more often want to participate in the SDM. There are discrepancies between patient preferences and perceptions of this process.
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Affiliation(s)
- Javier de Toro
- Department of Rheumatology, Hospital Universitario A Coruña, A Coruña, Spain
| | - Carlos M González
- Department of Rheumatology, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | - Loreto Carmona
- Instituto de Salud Musculoesquelética (InMusc), Madrid, Spain
| | - Teresa Otón
- Instituto de Salud Musculoesquelética (InMusc), Madrid, Spain
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Orozco-Beltrán D, de Toro J, Galindo MJ, Marín-Jiménez I, Casellas F, Fuster-RuizdeApodaca MJ, García-Vivar ML, Hormigo-Pozo A, Guilabert M, Sánchez-Vega N, Fernández G, Cea-Calvo L. Healthcare Experience and their Relationship with Demographic, Disease and Healthcare-Related Variables: A Cross-Sectional Survey of Patients with Chronic Diseases Using the IEXPAC Scale. Patient 2020; 12:307-317. [PMID: 30430456 PMCID: PMC6525115 DOI: 10.1007/s40271-018-0345-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background Patient experience is acknowledged as a principal aspect of quality healthcare delivery, and it has implications with regard to outcomes. Objectives Our objective was to evaluate the healthcare experience of patients with chronic diseases to identify patient-perceived healthcare gaps and to assess the influence of demographic and healthcare-related variables on patient experiences. Methods A cross-sectional survey was delivered to adult patients with chronic diseases: diabetes mellitus (DM), human immunodeficiency virus (HIV) infection, inflammatory bowel disease (IBD) or rheumatic diseases. Patient experiences were assessed with the Instrument for Evaluation of the Experience of Chronic Patients (IEXPAC) questionnaire, with possible scores ranging from 0 (worst) to 10 (best experience). Results Of the 2474 patients handed the survey, 1618 returned it (response rate 65.4%). Patients identified gaps in healthcare related mainly to access to reliable information and services, interaction with other patients and continuity of healthcare after hospital discharge. The mean ± standard deviation (SD) IEXPAC score was 6.0 ± 1.9 and was higher for patients with HIV (6.6 ± 1.7) than for those with rheumatic disease (5.5 ± 2.0), IBD (5.9 ± 2.0) or DM (5.9 ± 1.9) (p < 0.001). In multivariate models, better overall IEXPAC experience was associated with follow-up by the same physician, follow-up by a nurse, receiving healthcare support from others and treatment with subcutaneous or intravenous drugs. The multivariate model that confirmed patients with HIV or DM had better experience than did those with rheumatic diseases. Conclusions Through IEXPAC, patients identified aspects for healthcare quality improvements and circumstances associated with better experience, which may permit greater redirection of healthcare toward patient-centered goals while facilitating improvements in social care and long-term healthcare quality. Electronic supplementary material The online version of this article (10.1007/s40271-018-0345-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Javier de Toro
- Rheumatology Department, A Coruña University Hospital, A Coruña, Spain
| | | | - Ignacio Marín-Jiménez
- IBD Unit, Gastroenterology Department, Clinical Research Institute Gregorio Marañón (IiSGM), Gregorio Marañón University, Madrid, Spain
| | - Francesc Casellas
- Crohn-Colitis Care Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | | | - Mercedes Guilabert
- Department of Health Psychology, Miguel Hernández University, Elche, Alicante, Spain
| | | | - Gonzalo Fernández
- Medical Affairs Department, Merck Sharp and Dohme Spain, Madrid, Spain
| | - Luis Cea-Calvo
- Medical Affairs Department, Merck Sharp and Dohme Spain, Madrid, Spain.
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Cea-Calvo L, Marín-Jiménez I, de Toro J, Fuster-RuizdeApodaca MJ, Fernández G, Sánchez-Vega N, Orozco-Beltrán D. Association between non-adherence behaviors, patients' experience with healthcare and beliefs in medications: a survey of patients with different chronic conditions. Curr Med Res Opin 2020; 36:293-300. [PMID: 31580168 DOI: 10.1080/03007995.2019.1676539] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective: The objective of the current work was to assess the frequency of non-adherence behaviors and potential association with patients' experience with healthcare and beliefs in medicines self-reported by patients with four different chronic conditions.Methods: Patients responded anonymously to a survey comprising five non-adherence behaviors (based on physician and patient input), an assessment of patients' experience with healthcare using the validated Instrument to Evaluate the EXperience of PAtients with Chronic diseases (IEXPAC), and a validated Spanish version of the Beliefs about Medicines Questionnaire (BMQ). Associations of non-adherence behavior were analyzed using logistic regression models.Results: Of 1530 respondents, 53.1% reported ≥1 non-adherence behavior. Non-adherence rates were 59.8% in diabetes mellitus (DM), 56.0% in rheumatic disease, 55.6% in inflammatory bowel disease, and 42.8% in human immunodeficiency virus (HIV) infection patients (p < .001). IEXPAC and BMQ scores were higher in adherent vs. non-adherent patients. In multivariate analysis, non-adherence behavior was strongly associated with lower overall BMQ, lower BMQ Necessity scores and higher BMQ Concerns scores (p < .001 for all), and with a lower IEXPAC self-management score (p = .007), but not with the overall IEXPAC score. Non-adherence was more frequent in DM patients compared with HIV infection patients (p < .001).Conclusions: Patients' beliefs in medicines-a lower perception for the necessity of medication, and higher concerns in taking medication-and low patient self-management experience score were associated with non-adherence behavior. These are modifiable aspects that need to be addressed to increase medication adherence in chronic disease.
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Affiliation(s)
- Luis Cea-Calvo
- Medical Affairs Department, Merck Sharp & Dohme Spain, Madrid, Spain
| | - Ignacio Marín-Jiménez
- IBD Unit, Gastroenterology Department, Clinical Research Institute Gregorio Marañón (IiSGM), Gregorio Marañón University Hospital, Madrid, Spain
| | - Javier de Toro
- Rheumatology Department, A Coruña University Hospital, A Coruña, Spain
| | | | - Gonzalo Fernández
- Medical Affairs Department, Merck Sharp & Dohme Spain, Madrid, Spain
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Cea-Calvo L, Marín-Jiménez I, de Toro J, Fuster-RuizdeApodaca MJ, Fernández G, Sánchez-Vega N, Orozco-Beltrán D. Different Associations of Intentional and Non-Intentional Non-Adherence Behaviors with Patient Experience with Healthcare and Patient Beliefs in Medications: A Survey of Patients with Chronic Conditions. Patient Prefer Adherence 2020; 14:2439-2450. [PMID: 33363360 PMCID: PMC7754618 DOI: 10.2147/ppa.s281985] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/26/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To investigate relationships between intentional and non-intentional non-adherence behaviors and patient experience with healthcare and beliefs in medications. PATIENTS AND METHODS This is a post hoc analysis of a cross-sectional anonymous survey distributed between May and September 2017 to patients with rheumatic disease, inflammatory bowel disease, HIV infection or diabetes mellitus from outpatient and primary care clinics in Spain. Patients answered five questions about non-adherence behaviors and completed questionnaires on their experience with healthcare (IEXPAC: Instrument to Evaluate the EXperience of PAtients with Chronic diseases) and beliefs about medicines (BMQ: Beliefs About Medicines Questionnaire). RESULTS Among 1530 respondents, 53% showed ≥1 non-adherence behavior; 35% had ≥1 non-intentional non-adherence behavior, and 33% had ≥1 intentional non-adherence behavior. Patients with HIV infection had the lowest frequency of intentional non-adherence behaviors. Non-intentional non-adherence was associated with patient beliefs (inversely with BMQ overall score) and patient experiences (inversely with IEXPAC Factor 3 sub-score, self-management). Intentional non-adherence was strongly associated with beliefs scores (directly with BMQ concerns and inversely with BMQ necessity sub-score) and inversely associated with HIV infection. CONCLUSION The different associations of intentional and non-intentional non-adherence behaviors found in this study help to understand how patient experiences and beliefs influence medical non-adherence, and in the development of strategies for reducing non-adherence.
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Affiliation(s)
- Luis Cea-Calvo
- Medical Affairs Department, MSD Spain, Madrid, Spain
- Correspondence: Luis Cea-Calvo Medical Affairs Department, MSD Spain, Josefa Valcárcel 38, Madrid28027, SpainTel +34 913210740 Email
| | - Ignacio Marín-Jiménez
- IBD Unit, Gastroenterology Department, Clinical Research Institute Gregorio Marañón (IiSGM), Gregorio Marañón University Hospital, Madrid, Spain
| | - Javier de Toro
- Rheumatology Department, A Coruña University Hospital, A Coruña, Spain
| | - María J Fuster-RuizdeApodaca
- SEISIDA (Spanish AIDS Multidisciplinary Society), Madrid, Spain
- Department of Social and Organizational Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
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de Toro J, Cea-Calvo L, Battle E, Carmona L, Arteaga MJ, Fernández S, González CM. Perceptions of patients with rheumatic diseases treated with subcutaneous biologicals on their level of information: RHEU-LIFE Survey. Reumatol Clin (Engl Ed) 2019; 15:343-349. [PMID: 29277578 DOI: 10.1016/j.reuma.2017.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate, in Spanish patients with rheumatic diseases treated with subcutaneous biological drugs, their sources of information, which sources they consider most relevant, and their satisfaction with the information received in the hospital. METHODS Rheumatologists from 50 hospitals handed out an anonymous survey to 20 consecutive patients with rheumatoid arthritis, axial spondyloarthritis or psoriatic arthritis treated with subcutaneous biologicals. The survey was developed ad hoc by 4 rheumatologists and 3 patients, and included questions with closed-ended responses on sources of information and satisfaction. RESULTS The survey was handed-out to 1,000 patients, 592 of whom completed it (response rate: 59.2%). The rheumatologist was mentioned as the most important source of information (75%), followed by the primary care physician, nurses, and electronic resources; 45.2% received oral and written information about the biological, 46.1% oral only, and 6.0% written only; 8.7% stated that they had not been taught to inject the biological. The percentage of patients satisfied with the information received was high (87.2%), although the satisfaction was lower in relation to safety. If the information came from the rheumatologist, the satisfaction was higher (89.6%) than when coming from other sources (59.6%; P<.001). Satisfaction was also higher if the information was provided orally and written (92.8%) than if provided only orally (86.1%; P=.013); 45.2% reported having sought information from sources outside the hospital. CONCLUSIONS The rheumatologist is key in transmitting satisfactory information on biological treatment to patients. He or she must also act as a guide, since a high percentage of patients seeks information in other different sources.
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Affiliation(s)
- Javier de Toro
- Departamento de Reumatología, Hospital Universitario A Coruña, A Coruña, España
| | - Luis Cea-Calvo
- Departamento de Medical Affairs, Merck Sharp & Dohme de España
| | - Enrique Battle
- Departamento de Reumatología, Hospital Universitario de Sant Joan d'Alacant, Alicante, España
| | - Loreto Carmona
- Instituto de Salud Musculoesquelética (InMusc), Madrid, España.
| | - María J Arteaga
- Departamento de Medical Affairs, Merck Sharp & Dohme de España
| | | | - Carlos M González
- Departamento de Reumatología, Hospital Universitario Gregorio Marañón, Madrid, España
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Fuster-RuizdeApodaca MJ, Sánchez-Vega N, Galindo MJ, Marín-Jimenez I, de Toro J, Orozco-Beltrán D, Cotarelo M, López JC. The Influence of Patient Experience with Healthcare on the Health-Related Quality of Life of People Living with HIV: An Observational Cross-Sectional Survey. Infect Dis Ther 2019; 8:369-382. [PMID: 31290081 PMCID: PMC6702509 DOI: 10.1007/s40121-019-0252-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Indexed: 01/06/2023] Open
Abstract
Introduction Patient experience is central to the quality of healthcare delivery, showing positive associations with several outcome measures. The main objectives of this study are to analyze the influence of patient experience on the health-related quality of life in people living with HIV and the role played by treatment complexity and clinical care. Methods We conducted a cross-sectional survey with 467 patients with HIV. We used the Instrument for Evaluation of the Experience of Chronic Patients and the Health-related Quality of Life Questionnaire (EQ-5D-5L). We analyzed a predictive model through the partial least squares (PLS) method. Results The patient self-management scores showed the highest positive relationship with the patient’s health-related quality of life (β = 0.24, β = 0.32, p < 0.0001). Patients’ treatment complexity had a negative influence on health-related quality of life (β = − 0.21, β = − 0.28, p < 0.0001). The complexity of clinical care had negative effects on health-related quality of life, both directly (β = − 0.37, β = − 0.19, p < 0.0001) and through its negative influence on the productive interactions with healthcare professionals (β = − 0.21, p < 0.0001) and patient self-management factors (β = − 0.21, p < 0.0001). The effects of patient experience dimensions on their health-related quality of life were higher in people living with HIV > 50 years old (p < 0.05). Conclusions Patient experience mainly influenced the health-related quality of life of older people living with HIV. The treatment and clinical care complexity played an important role in degrading the patients' experience and their quality of life. More integrated care would benefit the health-related quality of life of people living with HIV. Funding This project was funded by Merck Sharp & Dohme, Spain. Electronic supplementary material The online version of this article (10.1007/s40121-019-0252-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - María J Galindo
- Research Department, SEISIDA (Spanish AIDS Multidisciplinary Society), Madrid, Spain.,Internal Medicine Department, Clinic University Hospital, Valencia, Spain
| | - Ignacio Marín-Jimenez
- IBD Unit, Gastroenterology Department Clinical Research Institute Gregorio Marañón (IiSGM), Gregorio Marañón Hospital, Madrid, Spain
| | - Javier de Toro
- Rheumatology Department, A Coruña University Hospital, A Coruña, Spain
| | | | - Manuel Cotarelo
- Medical Affairs Department, Merck Sharp and Dohme Spain, Madrid, Spain
| | - Juan Carlos López
- Research Department, SEISIDA (Spanish AIDS Multidisciplinary Society), Madrid, Spain.,HIV Unit, Clinical Microbiology and Infectious Diseases Department, Clinical Research Institute Gregorio Marañón (IiSGM), Gregorio Marañón Hospital, Madrid, Spain
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Marín-Jiménez I, Casellas F, Cortés X, García-Sepulcre MF, Juliá B, Cea-Calvo L, Soto N, Navarro-Correal E, Saldaña R, de Toro J, Galindo MJ, Orozco-Beltrán D. The experience of inflammatory bowel disease patients with healthcare: A survey with the IEXPAC instrument. Medicine (Baltimore) 2019; 98:e15044. [PMID: 30946348 PMCID: PMC6456160 DOI: 10.1097/md.0000000000015044] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
To assess inflammatory bowel disease (IBD) patients' experience of chronic illness care and the relationship with demographic and healthcare-related characteristics.This cross-sectional survey used the Instrument to Evaluate the EXperience of PAtients with Chronic diseases (IEXPAC) questionnaire to identify parameters associated with a better healthcare experience for IBD patients. IEXPAC questionnaire responses are grouped into 3 factors - productive interactions, new relational model, and patient self-management, scoring from 0 (worst) to 10 (best experience). Scores were analyzed by bivariate comparisons and multiple linear regression models.Surveys were returned by 341 of 575 patients (59.3%, mean age 46.8 (12.9) years, 48.2% women). Mean (SD) IEXPAC score was 5.9 (2.0); scores were higher for the productive interactions (7.7) and patient self-management factors (6.7) and much lower for the new relational model factor (2.2). Follow-up by a nurse, being seen by the same physician, and being treated with a lower number of medicines were associated with higher (better) overall patient experience score, and higher productive interactions and self-management factor scores. A higher productive interactions score was also associated with patients receiving medication subcutaneously or intravenously. Higher new relational model scores were associated with follow-up by a nurse, affiliation to a patients' association, receiving help from others for healthcare, a lower number of medicines and a higher educational level.In patients with IBD, a better overall patient experience was associated with follow-up by a nurse, being seen by the same physician, and being treated with a lower number of medicines.
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Affiliation(s)
- Ignacio Marín-Jiménez
- IBD Unit, Gastroenterology Department; Clinical Research Institute Gregorio Marañón (IiSGM); Gregorio Marañón University Hospital, Madrid
| | - Francesc Casellas
- Crohn-Colitis Care Unit, Hospital Universitari Vall d’Hebron, Barcelona
| | | | | | - Berta Juliá
- Medical Affairs Department, Merck Sharp & Dohme Spain, Madrid
| | - Luis Cea-Calvo
- Medical Affairs Department, Merck Sharp & Dohme Spain, Madrid
| | - Nadia Soto
- Medical Affairs Department, Merck Sharp & Dohme Spain, Madrid
| | | | - Roberto Saldaña
- Confederation of Patients with Inflammatory Bowel Disease of Spain (ACCU)
| | - Javier de Toro
- Rheumatology Department, A Coruña University Hospital, A Coruña
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Mateos J, Fafián-Labora J, Morente-López M, Lesende-Rodriguez I, Monserrat L, Ódena MA, de Oliveira E, de Toro J, Arufe MC. Next-Generation Sequencing and Quantitative Proteomics of Hutchinson-Gilford progeria syndrome-derived cells point to a role of nucleotide metabolism in premature aging. PLoS One 2018; 13:e0205878. [PMID: 30379953 PMCID: PMC6209416 DOI: 10.1371/journal.pone.0205878] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/03/2018] [Indexed: 02/05/2023] Open
Abstract
Hutchinson-Gilford progeria syndrome (HGPS) is a very rare fatal disease characterized for accelerated aging. Although the causal agent, a point mutation in LMNA gene, was identified more than a decade ago, the molecular mechanisms underlying HGPS are still not fully understood and, currently, there is no cure for the patients, which die at a mean age of thirteen. With the aim of unraveling non-previously altered molecular pathways in the premature aging process, human cell lines from HGPS patients and from healthy parental controls were studied in parallel using Next-Generation Sequencing (RNAseq) and High-Resolution Quantitative Proteomics (iTRAQ) techniques. After selection of significant proteins and transcripts and crosschecking of the results a small set of protein/transcript pairs were chosen for validation. One of those proteins, ribose-phosphate pyrophosphokinase 1 (PRPS1), is essential for nucleotide synthesis. PRPS1 loss-of-function mutants present lower levels of purine. PRPS1 protein and transcript levels are detected as significantly decreased in HGPS cell lines vs. healthy parental controls. This modulation was orthogonally confirmed by targeted techniques in cell lines and also in an animal model of Progeria, the ZMPSTE24 knock-out mouse. In addition, functional experiments through supplementation with S-adenosyl-methionine (SAMe), a metabolite that is an alternative source of purine, were done. Results indicate that SAMe has a positive effect in the proliferative capacity and reduces senescence-associated Beta-galactosidase staining of the HPGS cell lines. Altogether, our data suggests that nucleotide and, specifically, purine-metabolism, are altered in premature aging, opening a new window for the therapeutic treatment of the disease.
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Affiliation(s)
- Jesús Mateos
- Grupo de Terapia Celular y Medicina Regenerativa, Dpto. Ciencias Biomédicas, Medicina y Fisioterapia, Facultad de Ciencias de la Salud, Universidade da Coruña, INIBIC-CHUAC
| | - Juan Fafián-Labora
- Grupo de Terapia Celular y Medicina Regenerativa, Dpto. Ciencias Biomédicas, Medicina y Fisioterapia, Facultad de Ciencias de la Salud, Universidade da Coruña, INIBIC-CHUAC
| | - Miriam Morente-López
- Grupo de Terapia Celular y Medicina Regenerativa, Dpto. Ciencias Biomédicas, Medicina y Fisioterapia, Facultad de Ciencias de la Salud, Universidade da Coruña, INIBIC-CHUAC
| | | | | | - María A. Ódena
- Proteomics Platform–Barcelona Science Park, Barcelona, Spain
| | | | - Javier de Toro
- Grupo de Terapia Celular y Medicina Regenerativa, Dpto. Ciencias Biomédicas, Medicina y Fisioterapia, Facultad de Ciencias de la Salud, Universidade da Coruña, INIBIC-CHUAC
| | - María C. Arufe
- Grupo de Terapia Celular y Medicina Regenerativa, Dpto. Ciencias Biomédicas, Medicina y Fisioterapia, Facultad de Ciencias de la Salud, Universidade da Coruña, INIBIC-CHUAC
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González CM, Carmona L, de Toro J, Batlle-Gualda E, Torralba AI, Arteaga MJ, Cea-Calvo L. Perceptions of patients with rheumatic diseases on the impact on daily life and satisfaction with their medications: RHEU-LIFE, a survey to patients treated with subcutaneous biological products. Patient Prefer Adherence 2017; 11:1243-1252. [PMID: 28790806 PMCID: PMC5530861 DOI: 10.2147/ppa.s137052] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE The aim of this study was to explore perceptions of patients with rheumatic diseases treated with subcutaneous (SC) biological drugs on the impact on daily life and satisfaction with current therapy, including preferred attributes. METHODS A survey was developed ad hoc by four rheumatologists and three patients, including Likert questions on the impact of disease and treatment on daily life and preferred attributes of treatment. Rheumatologists from 50 participating centers were instructed to handout the survey to 20 consecutive patients with rheumatoid arthritis (RA), axial spondyloarthritis (ax-SpA), or psoriatic arthritis (PsA) receiving SC biological drugs. Patients responded to the survey at home and sent it to a central facility by prepaid mail. RESULTS A total of 592 patients returned the survey (response rate: 59.2%), 51.4% of whom had RA, 23.8% had ax-SpA, and 19.6% had PsA. Patients reported moderate-to-severe impact of their disease on their quality of life (QoL) (51.9%), work/daily activities (49.2%), emotional well-being (41.0%), personal relationships (26.0%), and close relatives' life (32.3%); 30%-50% patients reported seldom/never being inquired about these aspects by their rheumatologists. Treatment attributes ranked as most important were the normalization of QoL (43.6%) and the relief from symptoms (35.2%). The satisfaction with their current antirheumatic therapy was high (>80% were "satisfied" or "very satisfied"), despite moderate/severe impact of disease. CONCLUSION Patients with rheumatic diseases on SC biological therapy perceive a high disease impact on different aspects of daily life, despite being highly satisfied with their treatment; the perception is that physicians do not frequently address personal problems. Normalization of QoL is the most important attribute of therapies to patients.
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Affiliation(s)
| | - Loreto Carmona
- Instituto de Salud Musculoesquelética, Madrid
- Correspondence: Loreto Carmona, Instituto de Salud Musculoesquelética, Calle Conde de la Cimera, 6, 28040 Madrid, Spain, Tel +34 91 756 88 71, Mob +34 628 578 576, Email
| | - Javier de Toro
- Department of Rheumatology, Hospital Universitario A Coruña, A Coruña
| | | | | | - María J Arteaga
- Medical Affairs Department, Merck Sharp & Dohme, Madrid, Spain
| | - Luis Cea-Calvo
- Medical Affairs Department, Merck Sharp & Dohme, Madrid, Spain
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Naranjo A, de Toro J, Nolla JM. La enseñanza de la reumatología en la universidad. La travesía desde el aprendizaje basado en el profesor al centrado en el alumno. ACTA ACUST UNITED AC 2015; 11:196-203. [DOI: 10.1016/j.reuma.2014.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 12/10/2014] [Accepted: 12/15/2014] [Indexed: 11/26/2022]
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Olivé A, Ángel Jover J, Cáliz R, Díaz F, García-Castro M, Guanyabens N, Talaverano S, de Toro J, Trujillo E, Usón J, Andreu JL. [Formation of specialists in rheumatology: Accreditation criteria]. Reumatol Clin 2011; 6:311-5. [PMID: 21794740 DOI: 10.1016/j.reuma.2010.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 05/18/2010] [Indexed: 11/24/2022]
Abstract
The National Rheumatology Board is responsible for postgraduate formation in rheumatology. Herein we present the new criteria for accreditation of teaching units. These criterion contemplate four domains, namely: structure, clinical work, teaching and research. Each domain is divided in subdomains and items. Some of them are of an obligatory nature. This document serves as reference for future applications. The document may be reviewed in the future.
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Affiliation(s)
- Alejandro Olivé
- Comisión Nacional de Reumatología, Ministerio de Sanidad y Política Social, Madrid, España
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