Josep Roca

Josep Roca
Hospital Clínic de Barcelona · Servicio de Neumología

Doctor of Medicine

About

552
Publications
71,776
Reads
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26,828
Citations
Introduction
Prof. Dr. Josep Roca is is Professor of Medicine at the University of Barcelona, senior consultant at Hospital Clínic of Barcelona and senior researcher at IDIBAPS, as well as Adjunct Professor at the University of Sourthern Denmark (Odense). Author of more than 300 original articles in peer-reviewed journals and several book chapters, review articles and books. His two main fields of interest are: Chronic patients management (integrated care and systems medicine); and, Gas exchange and skeletal muscle bioenergetics in chronic respiratory diseases. Dr.Roca has been coordinator of several EU projects.
Additional affiliations
January 1997 - present
Hospital Clínic de Barcelona
Position
  • Consultant
February 1989 - present
University of Barcelona
Position
  • Professor
Education
January 1999 - December 1999
University of Barcelona
Field of study
  • Medicine - Hospital Management
January 1981 - January 1983
University of Barcelona
Field of study
  • Medicine

Publications

Publications (552)
Article
Full-text available
Objective The main objective was to assess repeatability and learning effect of the 6-min walk test (6MWT) in a cohort of preoperative cancer patients referred to a prehabilitation program. As a secondary objective, we aimed to identify determinants of improvement in the second test. Materials and methods Secondary analysis from a large prospectiv...
Preprint
Full-text available
Objective the main objective was to assess repeatability and learning effect of the six-minute walk test (6MWT) in a cohort of preoperative cancer patients referred to a prehabilitation program. As a secondary objective we aimed to identify determinants of improvement in the second test. Materials and Methods secondary analysis from a large prospe...
Article
Full-text available
The European Union (EU) initiative on the Digital Transformation of Health and Care (Digicare) aims to provide the conditions necessary for building a secure, flexible, and decentralized digital health infrastructure. Creating a European Health Research and Innovation Cloud (HRIC) within this environment should enable data sharing and analysis for...
Article
Full-text available
Background As the prevalence of multi-morbidity increases in ageing societies, health and social care systems face the challenge of providing adequate care to persons with complex needs. Approaches that integrate care across sectors and disciplines have been increasingly developed and implemented in European countries in order to tackle this challe...
Article
Full-text available
Background: Home hospitalization is widely accepted as a cost-effective alternative to conventional hospitalization for selected patients. A recent analysis of the home hospitalization and early discharge (HH/ED) program at Hospital Clínic de Barcelona over a 10-year period demonstrated high levels of acceptance by patients and professionals, as w...
Article
Background : Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) belongs to a subgroup of coronaviruses rampant in bats for centuries. It caused the coronavirus disease 2019 (COVID-19) pandemic. Most patients recover, but a minority of severe cases experience acute respiratory distress or an inflammatory storm devastating many organs that...
Article
Introduction The impact of pulmonary hypertension (PH) on exercise tolerance in chronic obstructive pulmonary disease (COPD) has not been fully elucidated. It is necessary to characterize pulmonary hemodynamics in patients with moderate to severe COPD in order to improve their management. The aim of the study was to determine whether in COPD the pr...
Book
Full-text available
Libro de Texto de Medicina Interna en dos volumenes
Preprint
BACKGROUND Home hospitalization is widely accepted as a cost-effective alternative to conventional hospitalization for selected patients. A recent analysis of the home hospitalization and early discharge (HH/ED) program at Hospital Clínic de Barcelona over a 10-year period demonstrated high levels of acceptance by patients and professionals, as wel...
Article
Abstract—Forced spirometry testing is gradually becoming available across different healthcare tiers including primary care. It has been demonstrated in earlier work that commercially available spirometers are not fully able to assure the quality of individual spirometry manoeuvres. Thus a need to expand the availability of high quality spirometry...
Article
Background: Multimodal prehabilitation is a preoperative intervention with the objective to enhance cancer patients’ functional status which has been showed to reduce both postoperative morbidity and hospital length of stay in digestive oncologic surgery. However, in lung cancer surgery patients further studies with higher methodological quality ar...
Article
Full-text available
Background: Multimodal prehabilitation is a preoperative intervention with the objective to enhance cancer patients' functional status which has been showed to reduce both postoperative morbidity and hospital length of stay in digestive oncologic surgery. However, in lung cancer surgery patients further studies with higher methodological quality a...
Article
Full-text available
Background: Multimorbidity is highly relevant for both service commissioning and clinical decision-making. Optimization of variables assessing multimorbidity in order to enhance chronic care management is an unmet need. To this end, we have explored the contribution of multimorbidity to predict use of healthcare resources at community level by com...
Chapter
Full-text available
The current study analyzes the information collected and the lessons learned during the first six months of the CONNECARE project in Israel, in order to assess the use of the mobile technology by patients, their motivations and obstacles; as well as their satisfaction. As of the middle of February 2019, 59 patients were recruited and 18 discharged...
Chapter
Full-text available
Patients with chronic obstructive pulmonary disease (COPD) generate a high, and growing, burden on Health Systems worldwide due to COPD prevalence, population aging and co-morbidites. The chapter analyses COPD as a representative use case of non-communicable disorders and analyses the main challenges faced by clinicians and health scientists in ord...
Article
Introduction: The impact of pulmonary hypertension (PH) on exercise tolerance in chronic obstructive pulmonary disease (COPD) has not been fully elucidated. It is necessary to characterize pulmonary hemodynamics in patients with moderate to severe COPD in order to improve their management. The aim of the study was to determine whether in COPD the...
Preprint
BACKGROUND Home-based noninvasive ventilation has proven cost-effective. But, adherence to therapy still constitutes a common clinical problem. We hypothesized that a behavioral intervention supported by mHealth can enhance patients’ self-efficacy. It is widely accepted that mHealth-supported services might enhance productive interactions among the...
Article
Full-text available
Background: Home-based noninvasive ventilation has proven cost-effective. But, adherence to therapy still constitutes a common clinical problem. We hypothesized that a behavioral intervention supported by a mobile health (mHealth) app could enhance patient self-efficacy. It is widely accepted that mHealth-supported services can enhance productive...
Article
Full-text available
Background: Digital health tools comprise a wide range of technologies to support health processes. The potential of these technologies to effectively support health care transformation is widely accepted. However, wide scale implementation is uneven among countries and regions. Identification of common factors facilitating and hampering the imple...
Conference Paper
Full-text available
Introduction: The efficacy of prehabilitation (PreHab) to reduce surgical complications, and facilitate postoperative recovery, has been demonstrated (Ann Surg. 2018; 267(1):50-56). Deployment of PreHab as mainstream service at Hospital Clínic de Barcelona (HCB) has been undertaken. However, there is a need for consolidation of modular digital heal...
Article
Full-text available
As the average age of the population increases, so will the prevalence of chronic respiratory diseases and associated multimorbidity. This will result in a more complex clinical environment. Part of the solution will be to allow patients to be co-creators in the design of their care. It will also require clinicians to shift in their current approac...
Conference Paper
Home hospitalization (HH) is presented as a healthcare alternative capable of providing high standards of care when patients no longer need hospital facilities. Although HH seems to lower healthcare costs by shortening hospital stays and improving patient's quality of life, the lack of continuous observation at home may lead to complications in som...
Article
Full-text available
Background Comprehensive assessment of integrated care deployment constitutes a major challenge to ensure quality, sustainability and transferability of both healthcare policies and services in the transition toward a coordinated service delivery scenario. To this end, the manuscript articulates four different protocols aiming at assessing large-sc...
Preprint
Full-text available
BACKGROUND Digital health tools comprise a wide arrange of technologies to support health processes. The potential of these technologies to effectively support healthcare transformation is widely accepted. However, wide scale implantation is uneven among countries/regions. Identification of common factors facilitation and hampering the implementati...
Article
Full-text available
Background: Prehabilitation showed efficacy to reduce postoperative complications. However, sustainability of its health benefits and impact on costs needs further assessment. Objective: To assess the mid-term clinical impact and costs from a hospital perspective of an endurance exercise training-based prehabilitation program in high-risk patients...
Article
Full-text available
Aim We hypothesize that training‐induced changes in muscle oxygen saturation (StO2) assessed by near‐infrared spectroscopy (NIRS) during constant work‐rate cycling exercise (CWRE) may be a useful marker of the effects of training at “vastus medialis” of the quadriceps in patients with chronic obstructive pulmonary disease (COPD). Methods Increment...
Book
La medición de la función pulmonar es una parte fundamental del diagnóstico de los pacientes con sospecha de enfermedades respiratorias, pues permite definir la gravedad de la enfermedad y facilita el seguimiento evolutivo de los pacientes. Asimismo, desempeña un importante papel en la evaluación de la capacidad para tolerar intervenciones que pued...
Article
Full-text available
Due to profound changes occurring in biomedical knowledge and in health systems worldwide, an entirely new health and social care scenario is emerging. Moreover, the enormous technological potential developed over the last years is increasingly influencing life sciences and driving changes toward personalized medicine and value-based healthcare. Ho...
Conference Paper
Full-text available
Background: Technology-supported integrated care services can enhance clinical management of chronic patients. But, the role of an electronic Personal Health Folder (ePHF) and mobile technology (mHealth) to facilitate behavioral change is not clear. Objective: To assess the impact of an intervention supported by mHealth on behavioral aspects and he...
Article
Full-text available
Introduction Chronic obstructive pulmonary disease (COPD) is a highly prevalent chronic disease characterised by persistent respiratory symptoms. A focus of COPD interventional studies is directed towards prevention of exacerbations leading to hospital readmissions. Telehealth as a method of remote patient monitoring and care delivery may be implem...
Article
Full-text available
Background: Chronic diseases are generating a major health and societal burden worldwide. Healthy lifestyles, including physical activity (PA), have proven efficacy in the prevention and treatment of many chronic conditions. But, so far, national PA surveillance systems, as well as strategies for promotion of PA, have shown low impact. We hypothes...
Article
Full-text available
Introduction Comorbidities in patients with chronic obstructive pulmonary disease (COPD) generate a major burden on healthcare. Identification of costeffective strategies aiming at preventing and enhancing management of comorbid conditions in patients with COPD requires deeper knowledge on epidemiological patterns and on shared biological pathways...
Article
Full-text available
Home Hospitalization has proven efficacy, but its effectiveness and potential as an Integrated Care Service in a real world setting deserves to be explored. Objective To evaluate implementation and 10 years follow-up of Home Hospitalization and Early Discharge as an Integrated Care Service in an urban healthcare district in Barcelona. Methods Pro...
Article
Full-text available
Background: Clinical management of patients with chronic obstructive pulmonary disease (COPD) shows potential for improvement provided that patients' heterogeneities are better understood. The study addresses the impact of comorbidities and its role in health risk assessment. Objective: To explore the potential of health registry information to...
Article
Full-text available
Background Chronic obstructive pulmonary disease (COPD) patients often show skeletal muscle dysfunction that has a prominent negative impact on prognosis. The study aims to further explore underlying mechanisms of skeletal muscle dysfunction as a characteristic systemic effect of COPD, potentially modifiable with preventive interventions (i.e. musc...
Article
Full-text available
Objective: The aim of this study was to assess the impact of personalized prehabilitation on postoperative complications in high-risk patients undergoing elective major abdominal surgery. Summary background data: Prehabilitation, including endurance exercise training and promotion of physical activity, in patients undergoing major abdominal surg...
Article
Full-text available
Breath analysis holds the promise of a non-invasive technique for the diagnosis of diverse respiratory conditions including COPD and lung cancer. Breath contains small metabolites that may be putative biomarkers of these conditions. However, the discovery of reliable biomarkers is a considerable challenge in the presence of both clinical and instru...
Book
Full-text available
Foreword The PITES Telemedicine and e-Health innovation platform constitutes a network intervention framework for research and innovation in solutions, services and tools based on Information and Communications Technologies (ICTs) aimed at supporting the new assistance models. Formally, PITES is a grouping of nodes of technological innovation based...
Chapter
Full-text available
Objectives: The PITES-ISA node in Catalonia focuses on integrated care services for chronic patients with a personalized medicine foundation and a three-fold objective: i) Regional deployment of healthcare services; ii) Catalan test-bed for international leadership as 4-star EIP-AHA reference site; and iii) Transfer and exploitation of new products...
Poster
Full-text available
Prehabilitation, including endurance exercise training and promotion of physical activity, in patients undergoing major abdominal surgery has been postulated as an effective preventive intervention to reduce postoperative complications. However, the existing studies provide controversial results likely explained by weaknesses in study designs. More...
Conference Paper
Background: Prehabilitation (PREHAB), including endurance exercise training and promotion of physical activity, in patients undergoing major abdominal surgery has been postulated as an effective preventive intervention to reduce postoperative complications. However, the existing studies provide controversial results and show a clear bias toward low...
Article
Systems medicine and systems biology have inherent educational challenges. These have largely been addressed either by providing new masters programs or by redesigning undergraduate programs. In contrast, short courses can respond to a different need: they can provide condensed updates for professionals across academia, the clinic, and industry. Th...
Article
Full-text available
Introduction: Abnormalities of autonomic function have been reported in patients with chronic obstructive pulmonary disease (COPD). Our objectives were to identify determinants of abnormal heart rate recovery at 1 min (HRR1) following completion of the 6-min walk test (6MWT) in COPD and to establish whether abnormal HRR1 predicts acute exacerbatio...
Article
Full-text available
Forced spirometry testing is gradually becoming available across different healthcare tiers including primary care. It has been demonstrated in earlier work that commercially available spirometers are not fully able to assure the quality of individual spirometry manoeuvres. Thus a need to expand the availability of high quality spirometry assessmen...
Article
Full-text available
Recent advances on prospective monitoring and retrospective analysis of health information at national or regional level are generating high expectations for the application of Big Data technologies that aim to analyze at real time high-volumes and/or complex of data from healthcare delivery (e.g., electronic health records, laboratory and radiolog...
Article
Full-text available
Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases (CRD) as a model. The CRD action plan includes (i) AIRWAYS integrated care pathways (ICPs), (ii) the joint initiative between the...
Article
Motivation: Skeletal muscle dysfunction is a systemic effect in one-third of patients with chronic obstructive pulmonary disease (COPD), characterized by high reactive-oxygen-species (ROS) production and abnormal endurance training-induced adaptive changes. However, the role of ROS in COPD remains unclear, not least because of the lack of appropri...