The Vall d'Hebron University Hospital is a public and university affiliated hospital founded in 1955. It belongs to the Catalan Health Institute and is the hospital complex with the highest volume of interventions in Catalonia, Spain. It is located at the bottom of Collserola, at the north of Barcelona, and its influence area includes the districts of Horta-Guinardó, Nou Barris and Sant Andreu. In actuality, it is the most important hospital complex in Catalonia. A study from 2009 places the Vall d'Hebron University Hospital among the four most important reference centers in Spain, and one of the twenty most important hospitals in the country.The hospital complex is divided into three separate areas: the general hospital, the maternity hospital, and the orthopedics and rehabilitation hospital. It also has an outpatient surgical unit at Parc Sanitari Pere Virgili. It currently employs over 7.000 professionals and has an annual budget of 580 million euros (2012). The hospital has 1.146 beds (182 reserved for critical patients), 45 operating rooms, 381 outpatient offices, and 3 emergency departments.
Introduction and objectives Shared decision-making (SDM) is a core component of patient-centred care, with proven benefits for decision quality and satisfaction. However, its implementation in hospital settings remains limited. This study aimed to describe the development of a SDM model and to evaluate its feasibility, acceptability, and preliminary effects through two pilot implementation studies. Methods We used a mixed-methods design including the co-creation of an SDM implementation model and two comparative pilot evaluations. Development involved a multidisciplinary team. Pilot implementation was tested with patients with class 3 obesity (n=50) and advanced chronic kidney disease (ACKD; n=38) recruited from outpatient services. The SDM model is a six-step framework comprising clinical decision prioritisation, co-creation of patient decision aids, healthcare professional training, and staged implementation following the three-talk model. Outcomes included feasibility (recruitment and ≥80% process completion), intervention acceptability, and preliminary decision quality indicators (knowledge, satisfaction, decisional conflict) and SDM process measures (SDM-Q-9, CollaboRATE). Results Feasibility thresholds were achieved in both pathways, with high adherence. In obesity, SDM participants reported greater knowledge (80.0% vs 48.8%; p<0.001) and higher decision satisfaction (28.0 vs 24.2; p=0.022). In ACKD, SDM participants also showed significantly higher knowledge (91.1% vs 37.1%; p<0.001), while satisfaction and process outcomes were similar between groups. Conclusion Our SDM model is a feasible and acceptable framework for the integration of SDM into hospital workflows. Its pilot implementation improved patient knowledge and engagement, supporting its scalability and further evaluation of long-term impact and sustainability.
Men who have sex with men and women (MSMW) represent a key population in HIV prevention and sexual health. Despite being described as a “bridge population,” they are often categorized as bisexual or grouped within broader MSM or LGBT+ labels. This cross-sectional study analysed data from 3,548 MSM recruited between 2018 and 2021 at two sexual health clinics and two community-based services in Barcelona and Madrid. Participants were classified as frequent or occasional MSMW based on lifetime penetrative intercourse with women and compared to exclusively MSM. Poisson regression models with robust variance were explored, adjusting or stratifying by living openly their sexuality. Additional models examined disclosure as a dependent variable among MSMW and those recently sexually active with women. Overall, 7.2
Coexisting type 2 inflammatory diseases such as allergic rhinitis (AR), atopic dermatitis (AD), chronic rhinosinusitis (CRS) and/or nasal polyposis (NP), eosinophilic esophagitis (EoE), and urticaria are common in asthma. RAPID (NCT04287621), a global prospective registry, aimed to characterize patients with asthma initiating dupilumab in a real-world clinical setting. This analysis investigated the prevalence of coexisting type 2 inflammatory diseases in these patients. Patients aged ≥ 12 years initiating dupilumab for asthma (primary indication) according to country-specific prescribing information were enrolled in RAPID. Patients had regular assessments at 1 month and thereafter every 3 months for up to 3 years, per standard of care across study sites. At the time of analysis, 205 patients were enrolled. Mean age of patients (stratified by type 2 coexisting disease) ranged from 42.3 to 57.3 years and mean body mass index from 29.9 to 31.8 kg/m2. Most patients were female (67.3
