Open Access
Impact of a multidisciplinary approach to polypharmacy management in community-dwelling older adults: insights from a specialized outpatient clinic
(Wiley, 2025-02-18) Roncal Belzunce, Victoria; Gutiérrez Valencia, Marta; Cedeño Veloz, Bernardo Abel; San Miguel Elcano, Ramón; Marín Epelde, Itxaso; Galbete Jiménez, Arkaitz; Preciado Goldaracena, Javier; Ezpeleta, María Irache; Garaioa-Aramburu, Karmele; Martínez Velilla, Nicolás; Ciencias de la Salud; Osasun Zientziak
Objectives: The increase in polypharmacy among older adults increases the risk of drug-related problems, making multidisci-plinary interventions essential. This study evaluated the impact of a multidisciplinary polypharmacy consultation on medicationmanagement and outcomes in older outpatients.Methods: This prospective observational study at a Spanish teaching hospital involved geriatricians, clinical pharmacists, andnurses. Older adults (≥ 75 years) with polypharmacy underwent medication review at baseline and at 3 and 6 months. Data onmedication use, adherence to Screening Tool of Older Person's Prescriptions (STOOP) criteria, and anticholinergic burden wereanalyzed.Results: The study included 104 older adults (mean age 86.2 years; 66% female). An average of 3.6 recommendations per par-ticipant was made (63.8% acceptance rate). Common drug-related problems were adverse effects (20%), non-adherence (18.1%), and incorrect dose/regimen (14.4%). Interventions led to an average reduction of 1.7 medications per patient, with 1.3 dosage orregimen changes and 1.1 new prescriptions. The mean number of medications decreased from 9.6 at baseline to 8.9 at 3 months(p < 0.001) and remained below baseline at 6 months. STOPP criteria violations per patient dropped from 1.2 to 1.0 (p = 0.036). Of the 126 medications flagged by STOPP criteria, 68.3% were addressed, 24.6% discontinued, mainly psychotropics, and 89.3%of these discontinuations were maintained. The anticholinergic burden decreased from 1.3 to 1.1 at 3 months (p = 0.036) andremained below baseline at 6 months.Conclusions: A multidisciplinary clinic effectively managed polypharmacy in older adults by reducing medication load andimproving appropriateness per STOPP criteria, highlighting the importance of proactive medication management.Trial Registration: ClinicalTrials.gov: NCT05408598 (March 1, 2022).
Open Access
Clinical outcomes of out-of-office versus in-office blood pressure monitoring in adults with hypertension
(Wiley, 2025-05-06) Roncal Belzunce, Victoria; Ramón Espinoza, Fernanda; Gutiérrez Valencia, Marta; Leache, Leire; Saiz Fernández, Luis Carlos; Erviti López, Juan; Ciencias de la Salud; Osasun Zientziak
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: to assess the effects of out-of-office compared to in-office blood pressure (BP) monitoring for improving clinical outcomes in adults with hypertension.
Open Access
Optipharm: enhancing pharmacological management skills in healthcare students for geriatric care through gamified e-learning
(Elsevier, 2024-07-14) Roncal Belzunce, Victoria; Gutiérrez Valencia, Marta; Echeverría-Beistegui, Icíar; Martínez Velilla, Nicolás; Ciencias de la Salud; Osasun Zientziak
Background: Complexities in older patient care and frequent polypharmacy requires tailored tools, specific skills and interdisciplinary collaborations. Traditional disease-centered education often overlooks these issues. Despite digital gamification's relevance in health education, limited exploration exists for gamified platforms addressing polypharmacy, especially within comprehensive geriatric assessment (CGA). Objective: This study outlines Optipharm's design, a gamified e-learning tool designed to enhance health students' education in managing polypharmacy among older adults. It also assesses its usability using a validated scale. Methods: Optipharm development utilized gamification techniques guided by pedagogical principles. Learning objectives addressed clinical and educational gaps in older adult care. Hosted on a Moodle system, the platform housed a structured clinical case as a SCORM file, a usability scale, a certificate of achievement, and a literature library. Optipharm was assessed by 304 medical students from the University of Navarre, Spain, using the SUS-G-Sp scale. Results: An immersive gamified e-learning tool simulating clinical practice settings was developed, requiring users to assume the role of healthcare professionals in multidisciplinary outpatient consultations. The interface, with a 2D cartoon-style aesthetic, aligns with learning objectives, integrating engaging storytelling and clear instructions for CGA in Phase 1 and pharmacological optimization in Phase 2. The evaluation of Optipharm's usability revealed very positive perceptions among users, with high agreement rates on usability items. Conclusion: Optipharm represents a pioneering gamified tool designed to simulate clinical scenarios, allowing users to engage as healthcare professionals within multidisciplinary teams and address medication-related challenges in older patients with polypharmacy. It provides a secure, interactive learning environment with clear educational objectives and seamless integration of gamification elements, enhancing users¿ knowledge and skills in managing complex medication regimens. As a platform for experiential learning and knowledge exchange, Optipharm contributes to shaping the future of health education and fostering a culture of patient-centred care among future healthcare professionals.
Open Access
System usability scale for gamified e-learning courses: cross-cultural adaptation and measurement properties of the Spanish version
(Taylor & Francis, 2025-05-13) Roncal Belzunce, Victoria; Gutiérrez Valencia, Marta; Martínez Velilla, Nicolás; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
This study aimed to translate and culturally adapt the System Usability Scale for Gamified E-learning Courses (SUS-G scale) to the Spanish population and evaluate its factor structure. A cross-sectional study was conducted in two phases: translation and cultural adaptation of the SUS-G scale, followed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), with 103 and 201 participants, respectively. A total of 304 students were enrolled in the study. The EFA revealed three correlated factors: User Experience (16 items), Educational Usability (nine items), and Usability (four items). The 29-item structure showed adequate-to-excellent goodness-of-fit indices and good internal consistency in CFA. The Spanish version of the SUS-G was validated and found to be reliable. The final instrument, with 29 items across three dimensions, can assess the usability of gamified e-learning courses among Spanish-speaking university students.

Gutiérrez Valencia, Marta

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