
Ana Isabel González González- MD, PhD
- Wissenschaftlichen Mitarbeiterin at Bielefeld University
Ana Isabel González González
- MD, PhD
- Wissenschaftlichen Mitarbeiterin at Bielefeld University
About
121
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Introduction
Current institution
Publications
Publications (121)
Introduction: Virtual Communities of Practices (vCoP) offer patients the possibility to interact and share tools and knowledge necessary for their empowerment. This paper describes the co-design process of a vCoP for the empowerment of people with ischemic heart disease (IHD).
Methods: We used a modified experience-based design approach to co-desig...
Objetivos Explorar las vivencias y experiencias de los pacientes de mediana edad con multimorbilidad en el sistema sanitario. Pacientes y métodos Diseño: estudio cualitativo exploratorio. Población: 11 profesionales sanitarios y 14 pacientes de las Islas Canarias y Madrid (España). Se realizaron entrevistas semiestructuradas a través de reuniones v...
Introduction
This study systematically reviews and synthesizes recommendations from national and international clinical practice guidelines (CPGs) regarding the primary prevention of atherosclerotic cardiovascular disease (ASCVD) in adults in primary care settings.
Methods
CPGs were retrieved from MEDLINE, Trip, guideline repositories, and website...
Objetivo: Evaluar la efectividad de una comunidad de práctica virtual (vCoP, por sus siglas en inglés) para mejorar la activación de personas con cardiopatía isquémica (IHD, por sus siglas en inglés). Métodos: Realizamos un estudio controlado aleatorio. Un total de 282 pacientes con IHD de Madrid, Cataluña y Canarias fueron asignados aleatoriamente...
Introduction
Virtual Communities of Practice (vCoP) may play a key role connecting like- minded individuals and fostering knowledge sharing and growth. vCoPs offer valuable information, peer support, and resource sharing. The aim of this study was to evaluate the effectiveness and cost-effectiveness of a vCoP in the improvement of the activation of...
Introduction
Incorporating shared decision-making (SDM) is a central part of patient empowerment, as it facilitates greater activation, gaining control over their care and developing skills to solve their health problems. Despite these benefits, there are still difficulties in implementing SDM among healthcare professionals due to internal and exte...
Introduction
This study assesses a Patient Decision Aid (PtDA) based on a Spanish Clinical Practice Guideline (CPG) for treating Generalized Anxiety Disorder (GAD) in primary care (PC).
Methods
The study involved: (1) developing a web-based PtDA for GAD patients from an evidence-based CPG, and (2) assessing PtDA effectiveness in a randomized contr...
Introduction
Virtual Communities of Practice (VCoP) offer information and exchange possibilities for people with chronic diseases. This could be especially valuable for self-management in patients with multimorbidity. The first phase of this project is based on building a Patient Journey Map through a co-creation process with professionals and pati...
Introduction
Empowering people living with multimorbidity (multiple chronic conditions) to gain greater confidence in managing their health can enhance their quality of life. Education focused on self-management is a key tool for fostering patient empowerment and is mostly provided on an individual basis. Virtual communities of practice (VCoP) pres...
Background
The incorporation of shared decision making (SDM) is a central part of empowerment processes, as it facilitates greater activation on the part of patients, increasing the likelihood of them gaining control over their healthcare and developing skills to solve their health problems. Despite these benefits, there are still difficulties in t...
Introduction
Medical deserts are a growing phenomenon across many European countries. They are usually defined as (i) rural areas, (ii) underserved areas or (iii) by applying a measure of distance/time to a facility or a combination of the three characteristics. The objective was to define medical deserts in Spain as well as map their driving facto...
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 kno...
Self-management interventions (SMIs) may enhance heart failure (HF) outcomes and address challenges associated with disease management. This study aims to review randomized evidence and identify knowledge gaps in SMIs for adult HF patients. Within the COMPAR-EU project, from 2010 to 2018, we conducted searches in the databases MEDLINE, CINAHL, Emba...
Background: Medical deserts are increasingly considered a problematic issue for many countries, which try to employ a multitude of policies, actions, and initiatives to achieve a better distribution of the health workforce (HWF). Aims and Objectives: Participants will be able to discuss different reasons for shortages of HWF in medical deserts and...
Background:
Chronic diseases are a leading cause of global morbidity and mortality. In response to this challenge, self-management interventions (SMIs) have emerged as an essential tool in improving patient outcomes. However, the diverse and complex nature of SMIs pose significant challenges in measuring their effectiveness. This work aims to inve...
Self-management interventions (SMIs) may be promising in the treatment of Diabetes Mellitus Type 2 (T2DM). However, accurate comparisons of their relative effectiveness are challenging, partly due to a lack of clarity and detail regarding the intervention content being evaluated. This study summarizes intervention components and characteristics in...
Introduction
Atherosclerotic cardiovascular disease (ASCVD) was the main cause of death in Germany in 2021, with major risk factors (ie, hypertension, diabetes, dyslipidaemia, obesity and certain lifestyle factors) being highly prevalent. Preventing ASCVD by assessment and modification of these risk factors is an important challenge for general pra...
Although exercise guidelines now recommend exercise for patients with MCI, the long-term effects of exercise in patients with MCI has not been reviewed systematically. The aim was to assess (1) the effectiveness of exercise and physical activity (EXPA) interventions in improving long-term patient-relevant cognitive and non-cognitive outcomes in peo...
Introduction
Identifying stakeholders’ needs is crucial to informing decisions and policy development. This study aims to identify healthcare and social-related needs and effective strategies associated with COVID-19 from the first-person perspectives of patients and healthcare providers.
Methods
Cross-sectional online survey design including qual...
Background
It is particularly difficult for healthcare providers to deliver optimal medical care to multimorbid middle-aged persons because patients’ professional activities, family lives, and other everyday responsibilities hinder them from making necessary lifestyle changes. Our aim was to find out how patients and healthcare providers view and m...
BACKGROUND
Shared decision making (SDM) is a crucial aspect of patient-centered care in the field of healthcare. While several SDM training programs for health care professional have been developed, only a few have been evaluated. In Spain, Evaluation of SDM training programs in for healthcare professionals, in field generalized anxiety disorder (G...
Background
Shared decision-making (SDM) is a crucial aspect of patient-centered care. While several SDM training programs for health care professionals have been developed, evaluation of their effectiveness is scarce, especially in mental health disorders such as generalized anxiety disorder.
Objective
This study aims to assess the feasibility and...
“Medical deserts,” areas characterized by limited access to healthcare services, are a growing global concern. These areas often face a shortage of healthcare professionals, which significantly contributes to poor healthcare access, reduced health outcomes, and health inequalities [1]. As future healthcare providers, medical students have the poten...
Background: Medical deserts are considered a problematic issue for many Western countries
which try to employ multitude of policies and initiatives to achieve a better distribution of their
health workforce (HWF). The aim of this study was to systematically map research and provide an
overview of definitions, characteristics, contributing factor...
Objectives:
To conduct an evidence map on self-management interventions and patient-relevant outcomes for adults living with overweight/obesity.
Methods:
Following Arksey and O'Malley methodology, we searched in five electronical databases including randomized controlled trials (RCTs) on SMIs for overweight/obesity. We used the terms "self-manag...
Background
Half the US population uses drugs with anticholinergic properties. Their potential harms may outweigh their benefits. Amitriptyline is among the most frequently prescribed anticholinergic medicinal products, is used for multiple indications, and rated as strongly anticholinergic. Our objective was to explore and quantify (anticholinergic...
Introduction:
Despite policies aiming at universal health coverage by ensuring availability and accessibility of general practitioners (GPs), medically underserved areas are still present in Europe. This systematic review aims to summarize and compare literature on interventions and their potential effectiveness of GP recruitment and retention in...
Background
Anticholinergic burden has been associated with adverse outcomes such as falls. To date, no gold standard measure has been identified to assess anticholinergic burden, and no conclusion has been drawn on which of the different measure algorithms best predicts falls in older patients from general practice. This study compared the ability...
Introduction:
Medical deserts are increasingly considered problematic and many countries employ a multitude of actions and initiatives to achieve a better distribution of the health workforce (HWF). This study systematically maps research and provides an overview of the definitions/characteristics of medical deserts. It also identifies contributin...
Background
The Implementation Leadership Scale (ILS) was developed to assess leadership behavior with regard to being proactive, knowledgeable, supportive, or perseverant in implementing evidence-based practices (EBPs). As part of a study on the implementation of a digitally supported polypharmacy management application in primary care, the origina...
Citation: Aparicio Betancourt, M.; Duarte-Díaz, A.; Vall-Roqué, H.; Seils, L.; Orrego, C.; Perestelo-Pérez, L.; Barrio-Cortes, J.; Beca-Martínez, M.T.; Molina Serrano, A.; Bermejo-Caja, C.J.; et al. Global Healthcare Needs Abstract: The COVID-19 pandemic has exposed gaps and areas of need in health systems worldwide. This work aims to map the evide...
Introduction
Mild cognitive impairment (MCI) is a clinical syndrome characterised by persistent cognitive deficits that do not yet fulfil the criteria of dementia. Delaying the onset of dementia using secondary preventive measures such as physical activity and exercise can be a safe way of reducing the risk of further cognitive decline and maintain...
Structured management programs have been developed for single diseases but rarely for patients with multiple medications. We conducted a qualitative study to investigate the views of stakeholders on the development and implementation of a polypharmacy management program in Germany. Overall, we interviewed ten experts in the fields of health policy...
Middle-aged persons with multimorbidity have to take their illnesses into account in their daily work, family and leisure activities. The MuMiA project aims to identify early preventive measures that make it easier for those between 30 and 60 years of age with multiple chronic diseases to manage their illnesses in their everyday lives. An interdisc...
Purpose:
We aimed to evaluate the effectiveness of a virtual community of practice (vCoP) in improving primary health care professionals' (HCPs') attitudes toward empowering patients with chronic disease.
Methods:
We conducted a cluster randomized controlled trial. Practices were units of randomization, and primary HCPs and patients were units o...
Introduction
In past years, the urgency of putting people in the centre of health care research has clearly been established in the public discourse. However, the depth of patient inclusion is still limited.
In our COMPAR-EU project (Horizon 2020) we aim to move forward by investigating effectiveness of self-management interventions (SMIs) through...
Introduction:
Older patients with multimorbidity, polypharmacy and related complex care needs represent a growing proportion of the population and a challenge for healthcare systems. Particularly in transitional care (hospital admission and hospital discharge), medical errors, inappropriate treatment, patient concerns and lack of confidence in hea...
Evidence-based clinical guidelines generally consider single conditions, and rarely multimorbidity. We developed an evidence-based guideline for a structured care program to manage polypharmacy in multimorbidity by using a realist synthesis to update the German polypharmacy guideline including the following five methods: formal prioritization in fo...
The healthcare burden of patients with multimorbidity may negatively affect their family lives, leisure time and professional activities. This mixed methods systematic review synthesizes studies to assess how multimorbidity affects the everyday lives of middle-aged persons, and identifies skills and resources that may help them overcome that burden...
Introduction
Multimorbidity is the simultaneous occurrence of several (chronic) diseases. Persons living with multimorbidity not only have complex care needs, but the burden of care often has a negative impact on their family lives, leisure time and professional activities. The aim of this project is to systematically review the literature to asses...
Introduction : Self-management (SM) interventions are complex interventions and one of the main components of high-quality chronic disease care for which the incorporation of the perspectives of patients and their informal caregivers is crucial. We aim to identify, appraise and synthesise the evidence exploring patients’ and caregivers’ perspective...
Introduction
Clinically complex patients often require multiple medications. Polypharmacy is associated with inappropriate prescriptions, which may lead to negative outcomes. Few effective tools are available to help physicians optimise patient medication. This study assesses whether an electronic medication management support system (eMMa) reduces...
Background
To investigate patients’ perspectives on polypharmacy and the use of a digital decision support system to assist general practitioners (GPs) in performing medication reviews.
Methods
Qualitative interviews with patients or informal caregivers recruited from participants in a cluster-randomized controlled clinical trial (cRCT). The inter...
Objective
To explore factors that potentially impact external validation performance while developing and validating a prognostic model for hospital admissions (HAs) in complex older general practice patients.
Study design and setting
Using individual participant data from four cluster-randomised trials conducted in the Netherlands and Germany, we...
Shared decision making (SDM) aims to involve patients in the decisions about their care, considering their preferences, values and concerns about the different treatment options. However, research shows that people with mental health problems have considerable unmet information needs about their condition. This community-based cross-sectional study...
Background
A large body of evidence suggests that self-management interventions (SMIs) may improve outcomes in chronic obstructive pulmonary disease (COPD). However, accurate comparisons of the relative effectiveness of SMIs are challenging, partly due to heterogeneity of outcomes across trials and uncertainty about the importance of these outcomes...
The prevalence of multimorbidity and polypharmacy increases significantly with age and are associated with negative health consequences. However, most current interventions to optimize medication have failed to show significant effects on patient-relevant outcomes. This may be due to ineffectiveness of interventions themselves but may also reflect...
Background: Cumulative anticholinergic exposure, also known as anticholinergic burden, is associated with a variety of adverse outcomes. However, studies show that anticholinergic effects tend to be underestimated by prescribers, and anticholinergics are the most frequently prescribed potentially inappropriate medication in older patients. The grad...
Unpredictable disease trajectories make early clarification of end-of-life (EoL) care preferences in older patients with multimorbidity advisable. This mixed methods systematic review synthesizes studies and assesses such preferences. Two independent reviewers screened title/abstracts/full texts in seven databases, extracted data and used the Mixed...
Introduction
Patients with generalised anxiety disorder (GAD) have concerns and needs about their health and the healthcare they receive. Patient decision aids (PtDAs) are tools that assist patients in making health decisions, when there is uncertainty about treatment choice, incorporating their personal preferences and values about the available t...
Background
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 Scal...
Objectives
To develop and validate a prognostic model to predict deterioration in health-related quality of life (dHRQoL) in older general practice patients with at least one chronic condition and one chronic prescription.
Study Design and Setting
We used individual participant data from five cluster-randomized trials conducted in the Netherlands...
Introduction
Virtual Communities of Practice (VCoP) or knowledge-sharing virtual communities offer ubiquitous access to information and exchange possibilities for people in similar situations, which might be especially valuable for the self-management of patients with chronic diseases. In view of the scarce evidence on the clinical and economic imp...
Background Patients with chronic heart failure (CHF) are generally treated by family physicians. Since the majority of those patients are multimorbid, it is particularly important to consider the potential harms of interventions. Objective To systematically review harms reporting in randomized controlled trials (RCTs) of interventions involving pat...
Introduction
End-of-life care is an essential task performed by most healthcare providers and often involves decision-making about how and where patients want to receive care. To provide decision support to healthcare professionals and patients in this difficult situation, we will systematically review a knowledge cluster of the end-of-life care pr...
Abstract Background Unwanted anticholinergic effects are both underestimated and frequently overlooked. Failure to identify adverse drug reactions (ADRs) can lead to prescribing cascades and the unnecessary use of over-the-counter products. The objective of this systematic review and meta-analysis is to explore and quantify the frequency and severi...
Objective:
The aim of the study was to support the development of future critical incident reporting systems (CIRS) in primary care by collecting information on existing systems. Our focus was on processes used to report and analyze incidents, as well as strategies used to overcome difficulties.
Methods:
Based on literature from throughout the w...
Introduction : Self-management (SM) interventions are complex interventions and one of the main components of high-quality chronic disease care for which the incorporation of the perspectives of patients and their informal caregivers is crucial. We aim to identify, appraise and synthesise the evidence exploring patients’ and caregivers’ perspective...
Objectives
To systematically identify knowledge clusters and research gaps in the health-related preferences of older patients with multimorbidity by mapping current evidence.
Design
Evidence map (systematic review variant).
Data sources
MEDLINE, EMBASE, PsycINFO, PSYNDEX, CINAHL and Science Citation Index/Social Science Citation Index/-Expanded...
Introduction
Interaction of conditions and treatments, complicated care needs and substantial treatment burden make patient–physician encounters involving multimorbid older patients highly complex. To optimally integrate patients’ preferences, define and prioritise realistic treatment goals and individualise care, a patient-centred approach is reco...
Background: Communities of practice are based on the idea that learning involves a group of people exchanging experiences and knowledge. The e-MPODERA project aims to assess the effectiveness of a virtual community of practice aimed at improving primary healthcare professional attitudes to the empowerment of patients with chronic diseases.
Methods...
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 t...
Introduction
Interaction of conditions and treatments, complicated care needs and substantial treatment burden make patient–physician encounters involving multimorbid older patients highly complex. To optimally integrate patients’ preferences, define and prioritise realistic treatment goals and individualise care, a patient-centred approach is rec...
The complexity and heterogeneity of patients with multimorbidity and polypharmacy renders traditional disease‐oriented guidelines often inadequate and complicates clinical decision making. To address this challenge, guidelines have been developed on multimorbidity or polypharmacy. To systematically analyze their recommendations, we conducted a syst...
Background:
Communities of practice are based on the idea that learning involves a group of people exchanging experiences and knowledge. The e-MPODERA project aims to assess the effectiveness of a virtual community of practice aimed at improving primary healthcare professional attitudes to the empowerment of patients with chronic diseases.
Method...
Background: Person-centred care can have a big impact on the quality of care. Reviews of research about this topic found that offering care in a more person-centred way usually improves outcomes. Some of the most common ways that have shown to improve person-centred care include helping people learn more about their conditions, prompting people to...
Virtual Communities of Practice (vCoP) are based on the idea of learning through the participation of a group of interested people via the exchange of experiences and knowledge. The e-MPODERA project aims to assess the effectiveness of a vCoP in improving attitudes of primary care health professionals on the empowerment of patients with chronic dis...
Hintergrund: Klinische Entscheidungsfindung sollte auf qualitativ hochwertiger Evidenz basieren, um einzuschätzen, ob der zu erwartende Nutzen den möglichen Schaden überwiegt. Im systematischen Review von Blom et al. [1] wurden alle Herzinsuffizienz-RCTs, publiziert 01.01.2011-01.06.2012, auf nutzenbezogene Endpunkte untersucht. Da Herzinsuffizienz...
Objetivos: 1) Analizar la concordancia entre la clasificación por niveles de riesgo del agrupador grupos de morbilidad ajustados (GMA) y el nivel de intervención asignado por los médicos de familia (MF). 2) Estudiar la utilidad del agrupador como herramienta de ayuda en historia clínica electrónica (HCE) para la toma de decisiones clínicas.
Diseño:...
Abstract
Background: Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinic...
Introduction: In order to achieve a successful integrated model, organizations must work in the development of six key elements that have been extensively described in the literature: coordination between policy makers and managers at regional and local levels; single entry to social and health care services; case management; individual care plan;...
Importance
Delayed antibiotic prescription helps to reduce antibiotic use with reasonable symptom control. There are different strategies of delayed prescription, but it is not yet clear which one is the most effective.Objective
To determine the efficacy and safety of 2 delayed strategies in acute, uncomplicated respiratory infections.Design, Set...
Introduction: In order to achieve a successful integrated model, organizations must work in the development of six key elements that have been extensively described in the literature: coordination between policy makers and managers at regional and local levels; single entry to social and health care services; case management; individual care plan;...
Background
Respiratory tract infections are an important burden in primary care and it’s known that they are usually self-limited and that antibiotics only alter its course slightly. This together with the alarming increase of bacterial resistance due to increased use of antimicrobials calls for a need to consider strategies to reduce their use. On...
Evidence based medicine (EBM) has made a substantial impact on primary care in Spain over the last few years. However, little research has been done into family physicians (FPs)' attitudes related to EBM. The present study investigates FPs' perceptions of EBM in the primary care context.
This study used qualitative methodology. Information was obta...
The aim of this study was to determine the accuracy of BNP test for early diagnosis of left ventricular dysfunction in patients at high-risk for heart failure.
Cross-sectional descriptive study.
7 Primary Care Centres in Madrid (Spain).
A consecutive sample of 204 consecutive asymptomatic patients with high risk for heart failure (Stages A-B, AHA/A...
Vaginitis is a common complaint in primary care. In uncomplicated candidal vaginitis, there are no differences in effectiveness between oral or vaginal treatment. Some studies describe that the preferred treatment is the oral one, but a Cochrane's review points out inconsistencies associated with the report of the preferred way that limit the use o...
The philosophy of evidence-based medicine (EBM) was introduced in the early 90s as a new approach to the practice of medicine, using the best available evidence to make decisions about health care. Despite ongoing controversy, EBM has developed enormously and physicians' attitude towards it is generally positive. Nevertheless, in Spain little is kn...
The aim of this study was to determine the information needs of primary care physicians in Spain and to describe their information-seeking patterns.
This observational study took place in primary care practices located in Madrid, Spain. Participants were a random stratified sample of 112 primary care physicians. Physicians' consultations were video...