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Access type: UnknownAuthor: search.filters.author.Camila Montesinos-Guevara

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    Item type:Publication,
    Educational interventions and contextual factors for optimising antibiotic prescription in paediatric uncomplicated acute respiratory tract infections in primary care: scoping review of reviews
    (Springer Science and Business Media LLC, 2025-05-26)
    Usue Elizondo-Alzola
    ;
    Claudio Rocha
    ;
    Leire Leache
    ;
    Montserrat León-García
    ;
    Luis Carlos Saiz
    Background: Inappropriate antibiotic prescription in paediatric uncomplicated acute respiratory tract infections (ARTIs) in primary care (PC) settings contributes to antimicrobial resistance. We aimed (1) to identify and describe educational interventions and their components to optimise antibiotic prescription for paediatric uncomplicated ARTIs in PC, and (2) to map contextual factors that may influence antibiotic prescription and the implementation of interventions. Methods: We searched three electronic databases (Medline, CINAHL and Epistemonikos) to identify reviews on the effectiveness of educational interventions and contextual factors, for optimising antibiotic prescription (Concept) in paediatric uncomplicated ARTIs (Population) in PC (Context). We included reviews that reported explicitly the search strategy used. Two previously calibrated reviewers independently screened the literature, extracted data, and assessed the methodological limitations. We applied the “best-fit framework synthesis approach”, based on the main constructs of the Consolidated Framework for Implementation Research, and coded the data deductively by groups of analysis for reviews reporting effectiveness (e.g. antibiotic or consultation rate) or by thematic synthesis for reviews reporting contextual factors (e.g. healthcare professionals’ knowledge) based on a logic model. Results: We identified 11 reviews evaluating education intervention and their characteristics, including 182 interventions with at least one educational component (educational intervention plus another type, educational or non-educational), with 136 providing information on characteristics and effectiveness. Successful interventions’ characteristics were related to the kind of intervention (e.g. communication skill training), mode of delivery (e.g. face to face), and target population (e.g. parents/caregivers). From the 22 reviews on contextual factors, healthcare professionals’ attitudes and perceptions, knowledge, and health system and professionals’ teams’ organization (inner setting), were the most frequent themes; less information was available on individuals´ characteristics (parents/children) and on outer setting (e.g. policies). Conclusion: We identified a large number of heterogeneous educational interventions. Combining educational interventions plus another type targeting both parents/caregivers and healthcare professionals, and considering their needs and their context may improve antibiotic prescribing in children. Further research is needed on consultation rate, knowledge, attitudes, and satisfaction outcomes and contextual factors, as well as on the cost-effectiveness of the interventions. Registration: The protocol was published in OSF iRegistries in May 2021 (Elizondo-Alzola, U).
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    Item type:Publication,
    Quality Assessment of Clinical Practice Guidelines for the Management and Surgical Treatment of Female Stress Urinary Incontinence
    (Wiley, 2025-01-10)
    Mario Vásquez-Peralta
    ;
    Alison Simancas-Racines
    ;
    Juan Marcos Parise-Vasco
    ;
    Camila Montesinos-Guevara
    ;
    SIMANCAS RACINES, DANIEL ALEJANDRO  
    Clinical practice guidelines (CPGs) are tools developed to support evidence‐based decision making in healthcare. However, despite the availability of CPGs for the surgical management of female stress urinary incontinence (FSUI), their methodological quality has not been evaluated. The aim of this study was to assess the methodological quality of published guidelines for the surgical management of FSUI using the AGREE II tool. A systematic search of CPGs published between 2017 and 2023 was performed in databases including MEDLINE/PubMed, LILACS, Scopus, and Trip Medical Database. Data extraction and guideline selection were performed independently by two reviewers, as was the assessment using the AGREE II instrument. Of 1459 initial records, six guidelines met the eligibility criteria. The scores for each domain evaluated were as follows: scope and purpose (45.83%; SD: 22.69), stakeholder participation (30.56%; SD: 29.03), development (48.56%; SD: 30.42), presentation clarity (58.80%; SD: 22.25), applicability (24.04%; SD: 26.36), and editorial independence (44.87%; SD: 32.88). One of the six included CPGs was rated as high quality and recommended for clinical practice. Three CPGs with modifications were recommended because there were still areas that needed improvement to enhance their quality, and two CPGs were not recommended for clinical practice because the six domains evaluated scored below 60%. According to these findings, it is essential that new CPGs developed for the surgical management of FSUI adhere to greater methodological rigor to ensure that recommendations are based on the best available evidence. Furthermore, guidelines should take into account patient values and clinical expertise to improve and facilitate effective healthcare decision making.