Publications by authors named "Maria-Pilar Astier-Pena"

Objectives: To investigate the factors influencing medication errors made by informal caregivers while providing care at home.

Methods: A cross-sectional study based on an online survey, which included both structured and open-ended questions, was conducted in Spain. The survey comprised 49 questions to collect self-reported avoidable medication errors made by caregivers at home.

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Background: This article aims to examine patient safety in general practice during COVID-19.

Methods: In total, 5489 GP practices from 37 European countries and Israel filled in the online self-reported PRICOV-19 survey between November 2020 and December 2021. The outcome measures include 30 patient safety indicators on structure, process, and outcome.

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Background: The COVID-19 vaccination campaign in several European countries involved collaboration between public health and Primary Health Care (PHC).

Objective: To highlight the role of PHC professionals in the COVID-19 vaccination rollout, specifically in terms of vaccine administration, communication and contributing to vaccination population coverage.

Methods: A descriptive retrospective study of the COVID-19 vaccination campaign across 28 European countries was conducted, covering data from December 2020 to November 2021.

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Unlabelled: Patient safety reporting and learning systems (PSRLS) are tools to promote patient safety culture in healthcare organisations (HCO). Many PRSLS are locally developed. WHO Global Action Plan on Patient Safety 2021-2030 urges governments to deploy policies for healthcare risk management including PSRLS.

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This study aimed to evaluate gender-based disparities in preventable adverse events due to low-value practices (LVPs) in primary care. A retrospective cohort study in Alicante, Spain. A total of 1,516 patient records were examined, finding that older individuals and women experienced more LVP-related events.

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Background: The COVID-19 pandemic has necessitated changes in European healthcare systems, with a significant proportion of COVID-19 cases being managed on an outpatient basis in primary healthcare (PHC). To alleviate the burden on healthcare facilities, many European countries developed contact-tracing apps and symptom checkers to identify potential cases. As the pandemic evolved, the European Union introduced the Digital COVID-19 Certificate for travel, which relies on vaccination, recent recovery, or negative test results.

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Background: Primary Health Care (PHC) plays a crucial role in managing the COVID-19 pandemic, with only 8% of cases requiring hospitalization. However, PHC COVID-19 data often goes unnoticed on European government dashboards and in media discussions. This project aims to examine official information on PHC patient care during the COVID-19 pandemic in Europe, with specific objectives: (1) Describe PHC's clinical pathways for acute COVID-19 cases, including long-term care facilities, (2) Describe PHC COVID-19 pandemic indicators, (3) Develop COVID-19 PHC activity indicators, (4) Explain PHC's role in vaccination strategies, and (5) Create a PHC contingency plan for future pandemics.

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The initial APEAS study, conducted in June 2007, examined adverse events (AEs) in Spanish Primary Healthcare (PHC). Since then, significant changes have occurred in healthcare systems. To evaluate these changes, a study was conducted in the Camp de Tarragona PHC region (CTPHC) in June 2019.

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Background: Changes in demographics with an older population, the illness panorama with increasing prevalence of non-communicable diseases, and the shift from hospital care to home-based care place demand on primary health care, which requires multiprofessional collaboration and team-based organization of work. The COVID-19 pandemic affected health care in various ways, such as heightened infection control measures, changing work practices, and increased workload.

Objectives: This study aimed to investigate the association between primary care practices' organization, and quality and safety changes during the COVID-19 pandemic.

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Article Synopsis
  • Primary Health Care (PHC) in Spain played a crucial role in managing COVID-19 by organizing practices that ensured quality and safety, with variations based on regional prevalence of the virus.
  • A study involving 266 Primary Care Providers (PCPs) highlighted that most were in high prevalence areas, primarily serving elderly and chronic patients, yet structural differences across regions were minimal.
  • The findings indicated greater use of remote services and administrative support in high prevalence regions, but most PCPs felt government support was insufficient, leading to delays in care for urgent conditions.
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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 factors and approaches to mitigate them.

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Background: During the COVID-19 pandemic, the majority of patients received ambulatory treatment, highlighting the importance of primary health care (PHC). However, there is limited knowledge regarding PHC workload in Europe during this period. The utilization of COVID-19 PHC indicators could facilitate the efficient monitoring and coordination of the pandemic response.

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Background And Aim: Primary health care (PHC) supported long-term care facilities (LTCFs) in attending COVID-19 patients. The aim of this study is to describe the role of PHC in LTCFs in Europe during the early phase of the pandemic.

Methods: Retrospective descriptive study from 30 European countries using data from September 2020 collected with an ad hoc semi-structured questionnaire.

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Article Synopsis
  • - The study highlights how the COVID-19 pandemic exacerbated health inequities among vulnerable populations and examines the collaboration between public health (PH) and primary health care (PHC) to address these challenges across eight different countries.
  • - Findings reveal that all countries used outreach strategies for vulnerable groups, digital assessment tools in PHC, but faced issues with underrepresentation at decision-making levels and poor communication between PH and PHC.
  • - The research emphasizes the need for better coordination and integration of PH and PHC to effectively respond to health crises, suggesting that understanding social determinants of health is crucial for improving outcomes for at-risk populations.
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Patient safety is high on the policy agenda internationally. Learning from safety incidents is a core component in achieving the important goal of increasing patient safety. This study explores the legal frameworks in the countries to promote reporting, disclosure, and supporting healthcare professionals (HCPs) involved in safety incidents.

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Introduction: Evidence shows that gender has a substantial impact on health behaviours, access to and use of health systems and health system responses. This study aims to assess gender bias in patients subjected to low-value practices in the primary care setting and to develop recommendations for reducing adverse events that women experience for this reason.

Methods And Analysis: A Delphi study will be performed to reach a consensus on the 'Do Not Do' recommendations with a possible gender bias.

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This manuscript describes the factors that have led to the spread of low-value practices (LVP) and the main initiatives to reverse them. The paper highlights the strategies that have proven to be most useful over the years, from the alignment of clinical practice with "do not do" recommendations, to quaternary prevention and the risks associated with interventionism. Reversing LVP requires a planned process with a multifactorial approach engaging the different actors involved.

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Background: The indicators of the pandemic have been based on the total number of diagnosed cases of COVID-19, the number of people hospitalized or in intensive care units, and deaths from the infection. The aim of this study is to describe the available data on diagnostic tests, health service used for the diagnosis of COVID-19, case detection and monitoring.

Method: Descriptive study with review of official data available on the websites of the Spanish health councils corresponding to 17 Autonomous Communities, 2 Autonomous cities and the Ministry of Health.

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Article Synopsis
  • - The study aimed to analyze how primary health care (PHC) managed COVID-19 treatment across 30 European countries, highlighting both the commonalities and differences in patients' clinical pathways during the pandemic.
  • - Data was collected through questionnaires completed by general practitioners (GPs) regarding PHC workflows as of September 2020, revealing that case detection and testing occurred in 27 out of 30 countries, while specialized COVID-19 clinics were only present in 8.
  • - The findings showed varied practices in mandatory isolation, sick leave certification by GPs, and the availability of patient isolation resources, indicating that differences among countries should be addressed for better management in future health crises.
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Article Synopsis
  • The study aims to analyze available data on COVID-19 diagnostics and health services in Spain, focusing on infection rates, hospitalization, and mortality statistics.
  • It involves a descriptive review of official data from health councils across 17 Autonomous Communities and 2 cities, collecting information on testing, contact tracing, and service utilization.
  • Findings reveal inconsistencies in data availability; while most regions report on diagnosed cases and mortality, information on health service use and specific diagnostic tests is often lacking, with some regions providing little to no data.
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Article Synopsis
  • The COVID-19 pandemic significantly altered primary care, prompting training practices to adapt their clinical work and teaching methods to ensure safe and effective care.
  • A study named PRICOV-19 assessed primary care practices across 38 countries to examine how being a training practice impacted safety culture, including factors like professional well-being and adherence to safety protocols.
  • Results showed that training practices had a stronger safety culture, lower risk of adverse mental health events, and more effective patient flow measures, suggesting that increasing educational involvement in primary care could enhance overall quality and safety.
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Background: The frequency of low-value practices (LVPs) in the healthcare system is a worldwide challenge. This study aimed to evaluate the LVPs trend in Spanish primary care (PC), its frequency in both sexes, and estimate its related extra cost.

Methods: A multicentric, retrospective, and national research project was conducted.

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The greatest asset of any health system is its professionals, and they must be cared for in order to take care. It is necessary to emphasize that they are key for the resilience of our health systems. This is particularly important in crisis times and especially important for primary health care.

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