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Papers by sandra ros
Expert Review of Pharmacoeconomics & Outcomes Research
BACKGROUND : Multi-criteria decision analysis (MCDA) was proposed to surmount arbitrary clinical ... more BACKGROUND : Multi-criteria decision analysis (MCDA) was proposed to surmount arbitrary clinical decisions in the field of biological therapies for psoriatic patients. At the same time, MCDA may further highlight the potential of bimekizumab for the treatment of moderate-to-severe psoriasis, compared to placebo, adalimumab, ustekinumab, secukinumab and even ixekizumab and risankizumab. RESEARCH DESIGN AND METHODS : The EVIDEM framework was adapted to reflect relevant criteria for the assessment. Estimated values were obtained by means of an additive linear model combining weights and scores assigned by a multidisciplinary committee of 12 experts. Consistency and replicability were evaluated through an alternative weighting method and a re-test. RESULTS : Bimekizumab was assessed by the committee as an intervention with a positive value contribution for the treatment of moderate-to-severe psoriasis in comparison to any of the alternatives. The drug provides a substantial therapeutical benefit and improves the health results reported by the patients, as it combines a higher level of clearance, rapidity and persistence with a similar safety and tolerability profile. CONCLUSIONS : Under a methodology with increasing use in the health field, bimekizumab was evaluated as a drug with a high added value for the treatment of moderate-to-severe psoriasis when compared to six different alternatives.
Piel, 2021
Resumen Antecedentes y objetivo Analizar el impacto, las necesidades actuales y las expectativas ... more Resumen Antecedentes y objetivo Analizar el impacto, las necesidades actuales y las expectativas futuras de los pacientes con psoriasis en Espana. Materiales y metodos Encuesta estructurada en formato electronico cerrado, generada por un grupo multidisciplinar de profesionales (dermatologia, enfermeria, farmacia hospitalaria, psicologia y pacientes con psoriasis). La encuesta fue enviada por la asociacion de pacientes «Accion Psoriasis», a sus socios y seguidores (7.143 contactos) mediante correo electronico y redes sociales. Se envio el 24 de enero y se cerro el 17 de marzo de 2019. Se realizo un estudio descriptivo y bivariado. Resultados Se analizaron 1.265 encuestas. El 53% de los respondedores considera que su psoriasis es moderada o grave, y el 73% esta en tratamiento, el 18% con terapias biologicas. Del 27% de los pacientes que no reciben tratamiento, el 52% refiere una psoriasis moderada-grave. Casi el 31% refiere estar muy poco o poco satisfecho con el tratamiento recibido, y el 49,5% no mantiene la piel totalmente aclarada de forma sostenida. El 40% de los pacientes considera muy importante la posible aparicion de acontecimientos adversos y el 46% que estos sean graves. Solo el 35,7% de los encuestados se visualizan en el futuro en una situacion de total control de su enfermedad, y solo el 33,5% se imagina un futuro sin preocupaciones por los acontecimientos adversos. Conclusiones El impacto fisico, emocional y social de la psoriasis en los pacientes es muy alto. Un porcentaje importante de los pacientes considera estar insatisfecho con su tratamiento actual, tiene necesidades no cubiertas y las expectativas futuras no son en general muy positivas.
Transplantation, 2020
Introduction: Non-adherence is a main issue after heart transplantation. The main objective of th... more Introduction: Non-adherence is a main issue after heart transplantation. The main objective of this study is to evaluate if a mHealth-based strategy is better than the conventional approach to improve adherence in adults heart transplanted recipients and to asses patients experience of therapeutic regimens. Methods: This is a single-center randomized controlled trial (RCT). Adult HTx recipients who were >1.5 years post-transplant were randomly assigned 1:1 to the control group or intervention group. Control group patients received usual care and the intervention group received a mHealth based care strategy using the mHeart software (mobile application).
Psoriasis: Targets and Therapy, 2015
Psoriasis is a frequent inflammatory disease with a chronic and relapsing course. Therefore, pati... more Psoriasis is a frequent inflammatory disease with a chronic and relapsing course. Therefore, patients with psoriasis are likely to undergo different treatments for long periods of time. Traditionally, therapies used in psoriasis have been associated with poor levels of adherence due to the complexity of the regimens and the poor results obtained with the topical therapies. These poor outcomes are associated with high levels of frustration and anxiety, which decrease adherence and worsen the disease. With the recent introduction of highly efficacious biologic therapies, patients can achieve very good and prolonged responses. However, most patients with psoriasis have mild disease and may be treated with skin-directed therapies. Therefore, it is important to develop strategies to improve adherence in order to achieve better outcomes, and to improve the overall quality of life. Hence, acknowledging the causes of nonadherence is crucial for implementing these strategies. In this summary, we review the causes of nonadherence, and we provide behavioral strategies in order to improve adherence and, ultimately, the outcome of patients with psoriasis.
Pediatric Psychodermatology, 2012
Actas dermo-sifiliograficas, 2013
Objective: To evaluate health-related quality of life (HRQOL), patient satisfaction, and adherenc... more Objective: To evaluate health-related quality of life (HRQOL), patient satisfaction, and adherence to treatment in patients with moderate or severe atopic dermatitis on maintenance therapy. Material and methods: We performed a national, multicenter, cross-sectional, epidemiological study in adults and children with moderate or severe atopic dermatitis of at least 16 months' duration who were receiving maintenance therapy. We used the Dermatology Life Quality Index (DLQI), the children's version of this scale (cDLQI), and the Morisky medication adherence scale. Visual analog scales were used to measure treatment satisfaction. We used the Mann-Whitney U test to compare HRQOL between patients with moderate and severe disease and the Wilcoxon test to compare the frequency and duration of flares before and after the start of maintenance therapy. Results: We studied 141 children and 141 adults; the prevalence of moderate AD in these groups was 85.8% and 79.4%, respectively. The impact of AD on HRQOL was mild to moderate. Maintenance therapy led to a significant decrease in the frequency and duration of flares (P < .001). While treatment satisfaction was high in both groups, adherence was poor (18.4%-42.6% in children and 14.9%-27.0% in adults). Conclusions: Patients with moderate and severe AD receiving maintenance therapy experience a reduction in the number and duration of flares and an improvement in HRQOL. While treatment satisfaction is high, adherence rates could be improved.
European journal of dermatology : EJD
This work studies atopic dermatitis in the following terms: impact on patients' life; patient... more This work studies atopic dermatitis in the following terms: impact on patients' life; patients' satisfaction and attitudes toward topical pharmacological treatment and medical recommendations (regarding hygienic and preventive strategies) and patients' and dermatologists' impressions of severity at the moment of consultation. To this end, an epidemiological, multicentre, cross-sectional study was carried out. In total, 191 dermatologists collected data from 322 patients (163 children, 159 adults). Poor agreement between specialists' and patients' criteria was found and patients with higher severity of affectation showed higher impacts on sleep/rest, emotional and school/ professional fulfillment (p<0.001). Moreover, reported compliance with pharmacological treatment and medical recommendations was high but…
Actas Dermo-Sifiliográficas, 2014
F.J. Ortiz de Frutos et al médicos de cuidado fueron las recomendaciones más seguidas. El 41,6 y ... more F.J. Ortiz de Frutos et al médicos de cuidado fueron las recomendaciones más seguidas. El 41,6 y el 27,6% (adultos y pediátricos, respectivamente) consideraba que su grado de control era insuficiente y se asoció con la gravedad de la DA en adultos (p = 0,014). Conclusiones: El grado de control actual de la DA es mejorable, especialmente en adultos. Aunque los pacientes indican seguir las recomendaciones médicas, un porcentaje significativo no aplica correctamente los tratamientos. Parece necesario potenciar la educación sobre la enfermedad y su manejo para mejorar el grado de control y potenciar su CVRS.
Actas Dermo-Sifiliográficas, 2014
Resumen Hoy en día se acepta que la psoriasis moderada-grave repercute de forma global en la salu... more Resumen Hoy en día se acepta que la psoriasis moderada-grave repercute de forma global en la salud del individuo mucho más allá de la clínica cutánea, y se emplean medidas de calidad de vida relacionada con la salud (QoL) para evaluar tanto la afectación percibida por el paciente como la respuesta de la misma al tratamiento. Sin embargo, las medidas de QoL disponibles se refieren a un momento o período concreto de la vida del paciente, de forma transversal, y no disponemos de estudios longitudinales que evalúen en qué medida el impacto de la enfermedad va condicionando todas y cada una de las vertientes de la vida del paciente-bienestar físico, psicológico, relaciones sociales y emocionales, decisiones vocacionales y laborales, etc.-modificando sus perspectivas. Para referirnos este impacto continuado y acumulativo se ha introducido un nuevo concepto, que se conoce como discapacidad acumulada en el transcurso vital (Cumulative Life Course Impairment [CLCI]) y constituye un nuevo paradigma de evaluación del impacto de la psoriasis en la QoL del paciente. A diferencia de las medidas y escalas convencionales, que focalizan la evaluación en un momento o período concreto de la vida del paciente, de forma transversal, en el CLCI se tiene en cuenta el impacto acumulativo que la afectación provocada por la psoriasis tiene longitudinalmente a lo largo de la vida del paciente, interfiriendo con el máximo desarrollo potencial del paciente y con su perspectiva vital si la psoriasis no hubiese existido. El resultado final será distinto para cada paciente, en función de las circunstancias que interactúen en cada momento, derivadas de la interacción entre la carga de la estigmatización, las comorbilidades físicas y psicológicas asociadas a la enfermedad y de las estrategias de afrontamiento y los factores externos que puedan intervenir, modulados por los estilos de personalidad de cada paciente.
Actas Dermo-Sifiliográficas, 2013
Introduction and objectives: To evaluate health-related quality of life (HRQOL), patient satisfac... more Introduction and objectives: To evaluate health-related quality of life (HRQOL), patient satisfaction, and adherence to treatment in patients with moderate or severe atopic dermatitis on maintenance therapy. Material and methods: We performed a national, multicenter, cross-sectional, epidemiological study in adults and children with moderate or severe atopic dermatitis of at least 16 months' duration who were receiving maintenance therapy. We used the Dermatology Life Quality Index (DLQI), the children's version of this scale (cDLQI), and the Morisky medication adherence scale. Visual analog scales were used to measure treatment satisfaction. We used the Mann-Whitney U test to compare HRQOL between patients with moderate and severe disease and the Wilcoxon test to compare the frequency and duration of flares before and after the start of maintenance therapy. Results: We studied 141 children and 141 adults; the prevalence of moderate AD in these groups was 85.8% and 79.4%, respectively. The impact of AD on HRQOL was mild to moderate. Maintenance therapy led to a significant decrease in the frequency and duration of flares (P<.001). While treatment satisfaction was high in both groups, adherence was poor (18.4%-42.6% in children and 14.9%-27.0% in adults). Conclusions: Patients with moderate and severe AD receiving maintenance therapy experience a reduction in the number and duration of flares and an improvement in HRQOL. While treatment satisfaction is high, adherence rates could be improved.
Acta Dermato-Venereologica, 2022
Psoriasis is a chronic, systemic inflammatory disease that affects the skin, with a high impact o... more Psoriasis is a chronic, systemic inflammatory disease that affects the skin, with a high impact on patients’ quality of life. The aim of this study was to identify and determine the relative importance of unmet needs in the management of moderate-to-severe psoriasis in Spain, from a multi-stakeholder perspective. A mixed method-approach was used to collect information, design a questionnaire and a discrete-choice exercise, and elicit the unmet needs through a multidisciplinary committee composed of 12 experts. A total of 65 unmet needs were identified and categorized into 4 areas: clinical, patient-related, decision-making process, and social. Decision-making process unmet needs were perceived as the most pressing ones, followed by social, clinical and patient-related. Individually, the need to incorporate outcomes that are important to the patients and to have treatments that achieve total clearance with a rapid onset of action and long-term persistence were the most important unme...
Expert Review of Pharmacoeconomics & Outcomes Research
BACKGROUND : Multi-criteria decision analysis (MCDA) was proposed to surmount arbitrary clinical ... more BACKGROUND : Multi-criteria decision analysis (MCDA) was proposed to surmount arbitrary clinical decisions in the field of biological therapies for psoriatic patients. At the same time, MCDA may further highlight the potential of bimekizumab for the treatment of moderate-to-severe psoriasis, compared to placebo, adalimumab, ustekinumab, secukinumab and even ixekizumab and risankizumab. RESEARCH DESIGN AND METHODS : The EVIDEM framework was adapted to reflect relevant criteria for the assessment. Estimated values were obtained by means of an additive linear model combining weights and scores assigned by a multidisciplinary committee of 12 experts. Consistency and replicability were evaluated through an alternative weighting method and a re-test. RESULTS : Bimekizumab was assessed by the committee as an intervention with a positive value contribution for the treatment of moderate-to-severe psoriasis in comparison to any of the alternatives. The drug provides a substantial therapeutical benefit and improves the health results reported by the patients, as it combines a higher level of clearance, rapidity and persistence with a similar safety and tolerability profile. CONCLUSIONS : Under a methodology with increasing use in the health field, bimekizumab was evaluated as a drug with a high added value for the treatment of moderate-to-severe psoriasis when compared to six different alternatives.
Piel, 2021
Resumen Antecedentes y objetivo Analizar el impacto, las necesidades actuales y las expectativas ... more Resumen Antecedentes y objetivo Analizar el impacto, las necesidades actuales y las expectativas futuras de los pacientes con psoriasis en Espana. Materiales y metodos Encuesta estructurada en formato electronico cerrado, generada por un grupo multidisciplinar de profesionales (dermatologia, enfermeria, farmacia hospitalaria, psicologia y pacientes con psoriasis). La encuesta fue enviada por la asociacion de pacientes «Accion Psoriasis», a sus socios y seguidores (7.143 contactos) mediante correo electronico y redes sociales. Se envio el 24 de enero y se cerro el 17 de marzo de 2019. Se realizo un estudio descriptivo y bivariado. Resultados Se analizaron 1.265 encuestas. El 53% de los respondedores considera que su psoriasis es moderada o grave, y el 73% esta en tratamiento, el 18% con terapias biologicas. Del 27% de los pacientes que no reciben tratamiento, el 52% refiere una psoriasis moderada-grave. Casi el 31% refiere estar muy poco o poco satisfecho con el tratamiento recibido, y el 49,5% no mantiene la piel totalmente aclarada de forma sostenida. El 40% de los pacientes considera muy importante la posible aparicion de acontecimientos adversos y el 46% que estos sean graves. Solo el 35,7% de los encuestados se visualizan en el futuro en una situacion de total control de su enfermedad, y solo el 33,5% se imagina un futuro sin preocupaciones por los acontecimientos adversos. Conclusiones El impacto fisico, emocional y social de la psoriasis en los pacientes es muy alto. Un porcentaje importante de los pacientes considera estar insatisfecho con su tratamiento actual, tiene necesidades no cubiertas y las expectativas futuras no son en general muy positivas.
Transplantation, 2020
Introduction: Non-adherence is a main issue after heart transplantation. The main objective of th... more Introduction: Non-adherence is a main issue after heart transplantation. The main objective of this study is to evaluate if a mHealth-based strategy is better than the conventional approach to improve adherence in adults heart transplanted recipients and to asses patients experience of therapeutic regimens. Methods: This is a single-center randomized controlled trial (RCT). Adult HTx recipients who were >1.5 years post-transplant were randomly assigned 1:1 to the control group or intervention group. Control group patients received usual care and the intervention group received a mHealth based care strategy using the mHeart software (mobile application).
Psoriasis: Targets and Therapy, 2015
Psoriasis is a frequent inflammatory disease with a chronic and relapsing course. Therefore, pati... more Psoriasis is a frequent inflammatory disease with a chronic and relapsing course. Therefore, patients with psoriasis are likely to undergo different treatments for long periods of time. Traditionally, therapies used in psoriasis have been associated with poor levels of adherence due to the complexity of the regimens and the poor results obtained with the topical therapies. These poor outcomes are associated with high levels of frustration and anxiety, which decrease adherence and worsen the disease. With the recent introduction of highly efficacious biologic therapies, patients can achieve very good and prolonged responses. However, most patients with psoriasis have mild disease and may be treated with skin-directed therapies. Therefore, it is important to develop strategies to improve adherence in order to achieve better outcomes, and to improve the overall quality of life. Hence, acknowledging the causes of nonadherence is crucial for implementing these strategies. In this summary, we review the causes of nonadherence, and we provide behavioral strategies in order to improve adherence and, ultimately, the outcome of patients with psoriasis.
Pediatric Psychodermatology, 2012
Actas dermo-sifiliograficas, 2013
Objective: To evaluate health-related quality of life (HRQOL), patient satisfaction, and adherenc... more Objective: To evaluate health-related quality of life (HRQOL), patient satisfaction, and adherence to treatment in patients with moderate or severe atopic dermatitis on maintenance therapy. Material and methods: We performed a national, multicenter, cross-sectional, epidemiological study in adults and children with moderate or severe atopic dermatitis of at least 16 months' duration who were receiving maintenance therapy. We used the Dermatology Life Quality Index (DLQI), the children's version of this scale (cDLQI), and the Morisky medication adherence scale. Visual analog scales were used to measure treatment satisfaction. We used the Mann-Whitney U test to compare HRQOL between patients with moderate and severe disease and the Wilcoxon test to compare the frequency and duration of flares before and after the start of maintenance therapy. Results: We studied 141 children and 141 adults; the prevalence of moderate AD in these groups was 85.8% and 79.4%, respectively. The impact of AD on HRQOL was mild to moderate. Maintenance therapy led to a significant decrease in the frequency and duration of flares (P < .001). While treatment satisfaction was high in both groups, adherence was poor (18.4%-42.6% in children and 14.9%-27.0% in adults). Conclusions: Patients with moderate and severe AD receiving maintenance therapy experience a reduction in the number and duration of flares and an improvement in HRQOL. While treatment satisfaction is high, adherence rates could be improved.
European journal of dermatology : EJD
This work studies atopic dermatitis in the following terms: impact on patients' life; patient... more This work studies atopic dermatitis in the following terms: impact on patients' life; patients' satisfaction and attitudes toward topical pharmacological treatment and medical recommendations (regarding hygienic and preventive strategies) and patients' and dermatologists' impressions of severity at the moment of consultation. To this end, an epidemiological, multicentre, cross-sectional study was carried out. In total, 191 dermatologists collected data from 322 patients (163 children, 159 adults). Poor agreement between specialists' and patients' criteria was found and patients with higher severity of affectation showed higher impacts on sleep/rest, emotional and school/ professional fulfillment (p<0.001). Moreover, reported compliance with pharmacological treatment and medical recommendations was high but…
Actas Dermo-Sifiliográficas, 2014
F.J. Ortiz de Frutos et al médicos de cuidado fueron las recomendaciones más seguidas. El 41,6 y ... more F.J. Ortiz de Frutos et al médicos de cuidado fueron las recomendaciones más seguidas. El 41,6 y el 27,6% (adultos y pediátricos, respectivamente) consideraba que su grado de control era insuficiente y se asoció con la gravedad de la DA en adultos (p = 0,014). Conclusiones: El grado de control actual de la DA es mejorable, especialmente en adultos. Aunque los pacientes indican seguir las recomendaciones médicas, un porcentaje significativo no aplica correctamente los tratamientos. Parece necesario potenciar la educación sobre la enfermedad y su manejo para mejorar el grado de control y potenciar su CVRS.
Actas Dermo-Sifiliográficas, 2014
Resumen Hoy en día se acepta que la psoriasis moderada-grave repercute de forma global en la salu... more Resumen Hoy en día se acepta que la psoriasis moderada-grave repercute de forma global en la salud del individuo mucho más allá de la clínica cutánea, y se emplean medidas de calidad de vida relacionada con la salud (QoL) para evaluar tanto la afectación percibida por el paciente como la respuesta de la misma al tratamiento. Sin embargo, las medidas de QoL disponibles se refieren a un momento o período concreto de la vida del paciente, de forma transversal, y no disponemos de estudios longitudinales que evalúen en qué medida el impacto de la enfermedad va condicionando todas y cada una de las vertientes de la vida del paciente-bienestar físico, psicológico, relaciones sociales y emocionales, decisiones vocacionales y laborales, etc.-modificando sus perspectivas. Para referirnos este impacto continuado y acumulativo se ha introducido un nuevo concepto, que se conoce como discapacidad acumulada en el transcurso vital (Cumulative Life Course Impairment [CLCI]) y constituye un nuevo paradigma de evaluación del impacto de la psoriasis en la QoL del paciente. A diferencia de las medidas y escalas convencionales, que focalizan la evaluación en un momento o período concreto de la vida del paciente, de forma transversal, en el CLCI se tiene en cuenta el impacto acumulativo que la afectación provocada por la psoriasis tiene longitudinalmente a lo largo de la vida del paciente, interfiriendo con el máximo desarrollo potencial del paciente y con su perspectiva vital si la psoriasis no hubiese existido. El resultado final será distinto para cada paciente, en función de las circunstancias que interactúen en cada momento, derivadas de la interacción entre la carga de la estigmatización, las comorbilidades físicas y psicológicas asociadas a la enfermedad y de las estrategias de afrontamiento y los factores externos que puedan intervenir, modulados por los estilos de personalidad de cada paciente.
Actas Dermo-Sifiliográficas, 2013
Introduction and objectives: To evaluate health-related quality of life (HRQOL), patient satisfac... more Introduction and objectives: To evaluate health-related quality of life (HRQOL), patient satisfaction, and adherence to treatment in patients with moderate or severe atopic dermatitis on maintenance therapy. Material and methods: We performed a national, multicenter, cross-sectional, epidemiological study in adults and children with moderate or severe atopic dermatitis of at least 16 months' duration who were receiving maintenance therapy. We used the Dermatology Life Quality Index (DLQI), the children's version of this scale (cDLQI), and the Morisky medication adherence scale. Visual analog scales were used to measure treatment satisfaction. We used the Mann-Whitney U test to compare HRQOL between patients with moderate and severe disease and the Wilcoxon test to compare the frequency and duration of flares before and after the start of maintenance therapy. Results: We studied 141 children and 141 adults; the prevalence of moderate AD in these groups was 85.8% and 79.4%, respectively. The impact of AD on HRQOL was mild to moderate. Maintenance therapy led to a significant decrease in the frequency and duration of flares (P<.001). While treatment satisfaction was high in both groups, adherence was poor (18.4%-42.6% in children and 14.9%-27.0% in adults). Conclusions: Patients with moderate and severe AD receiving maintenance therapy experience a reduction in the number and duration of flares and an improvement in HRQOL. While treatment satisfaction is high, adherence rates could be improved.
Acta Dermato-Venereologica, 2022
Psoriasis is a chronic, systemic inflammatory disease that affects the skin, with a high impact o... more Psoriasis is a chronic, systemic inflammatory disease that affects the skin, with a high impact on patients’ quality of life. The aim of this study was to identify and determine the relative importance of unmet needs in the management of moderate-to-severe psoriasis in Spain, from a multi-stakeholder perspective. A mixed method-approach was used to collect information, design a questionnaire and a discrete-choice exercise, and elicit the unmet needs through a multidisciplinary committee composed of 12 experts. A total of 65 unmet needs were identified and categorized into 4 areas: clinical, patient-related, decision-making process, and social. Decision-making process unmet needs were perceived as the most pressing ones, followed by social, clinical and patient-related. Individually, the need to incorporate outcomes that are important to the patients and to have treatments that achieve total clearance with a rapid onset of action and long-term persistence were the most important unme...