Background Schizophrenia is a severe mental disorder that often manifests within the first three decades of life. Its prognosis is uncertain and may result in a prolonged treatment that could extend throughout the entire lifespan of the patient. Antipsychotic drugs are characterized by a high interindividual variability when considering therapeutic effect and emergence of adverse effects. Such interindividual variability is thought to be associated primarily with pharmacokinetic matters. Objective The objective of this study was to evaluate the economic impact of the application of the 5-Step Precision Medicine model (5SPM), an approach based on the pharmacogenetic analysis of the primary genes involved in the metabolism of the therapy for each patient, restructuring treatment as necessary. Patients and Methods One hundred eighty-eight psychiatry patients were analysed for single nucleotide polymorphisms on genes CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A5 and ABCB1. Information on patients’ diagnosis, pharmacotherapy, and hospitalizations was collected. Results We achieved a cost–benefit ratio of 3.31–3.59 with a reduction of direct cost (hospitalizations plus pharmacotherapy) with a reduction of total cost in 67% of the patients who underwent the clinical intervention. Conclusion A rational Precision Medicine-based approach to psychiatric patients could result in a reduction on number of drugs required to control exacerbations, and the underlying pathologies, reducing the risk of adverse effects and improving adherence to treatment, leading to a potential decrease in direct costs. This methodology has been shown to be cost-dominant and, being based on a pharmacogenetic analysis, it has a lifelong nature, as the data obtained can be applied to other medical disciplines.

Background The development of new aetiological premises, such as the microbiota-gut-brain axis theory, evidences the influence of dietary and nutritional patterns on mental health, affecting the patient's quality of life in terms of physical and cardiovascular health. The aim was to determine the impact of a nutritional programme focused on increasing the intake of prebiotic and probiotic food on cardio-metabolic status in individuals with schizophrenia spectrum disorders in the contextual setting of the SARS-CoV-2 era. Methods A randomised clinical trial (two-arm, double-blind, balanced-block, six-month intervention) was conducted in a group of 50 individuals diagnosed with schizophrenia spectrum disorder during the SARS-CoV-2 confinement period. The control group received conventional dietary counselling on an individual basis. In the intervention group, an individual nutritional education programme with a high content of prebiotics and probiotics (dairy and fermented foods, green leafy vegetables, high-fibre fruit, whole grains, etc.) was established. Data on cardiovascular status were collected at baseline, three and six months. In addition, anthropometric parameters were analysed monthly. Results Forty-four subjects completed follow-up and were analysed. Statistical differences (p < 0.05) were found in all anthropometric variables at baseline and six months of intervention. A 27.4% reduction in the prevalence of metabolic syndrome risk factors in all its components was evidenced, leading to a clinically significant improvement (decrease in cardiovascular risk) in the intervention group at six months. Conclusions The development of a nutritional programme focused on increasing the dietary content of prebiotics and probiotics effectively improves the cardio-metabolic profile in schizophrenia spectrum disorders. Therefore, nursing assumes an essential role in the effectiveness of dietary interventions through nutritional education and the promotion of healthy lifestyles. Likewise, nursing acquires a relevant role in interdisciplinary coordination in confinement contexts. Trial registration The study protocol complied with the Declaration of Helsinki for medical studies; the study received ethical approval from referral Research Ethics Committee in November 2019 (reg. no. 468) and retrospectively registered in clinicaltrials.gov (NCT04366401. First Submitted: 28th April 2020; First Registration: 25th June 2020).

Introducción: La satisfacción del paciente es uno de los grandes retos que persigue conseguir el sistema sanitario y que repercute de forma positiva en la esfera biopsicosocial del paciente. Constituye una prioridad de los profesionales sanitarios el velar por dicha satisfacción y ello pasa por conocer las necesidades del paciente para luego marcar objetivos que el personal debe cumplir. Objetivo: Analizar la satisfacción del paciente en diálisis a partir de la producción científica existente. Material y Método: Se ha realizado una revisión integrativa mediante una búsqueda en las bases de datos Pubmed, Cuiden, Google académico y Medes. Se incluyeron artículos científicos originales y de revisión, en inglés y español, excluyendo aquellos artículos que no presentaban resultados o que no estuviesen en texto completo. Resultados: Se revisaron 17 artículos que se ajustaron a los criterios de selección. Los principales resultados encontrados se agruparon en los siguientes aspectos: factores determinantes en el nivel de satisfacción del paciente, herramientas de valoración de la satisfacción, rol de enfermería y áreas de mejora. Conclusiones: Los factores más influyentes en la satisfacción del paciente en diálisis son, principalmente, la confianza transmitida y disposición del personal sanitario, trato personalizado, amabilidad y seguridad transmitida, la destreza para puncionar, entre otros. Respecto a los instrumentos de medida, no existe un instrumento de medida específico, para evaluar la satisfacción del paciente en diálisis. Los atributos más satisfactorios que destacan en la enfermería, son amabilidad, disposición e interés, preparación técnica profesional, trato personalizado, confianza y seguridad clínica.

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