A strategic reflection for the management and implementation of CAR-T therapy in Spain: an expert consensus paper

CAR-T cell therapy represents a therapeutic revolution in the prognosis and treatment of patients with certain types of hematological cancer. However, they also pose new challenges in the healthcare, regulatory and financial fields. The aim of the RET-A project was to undertake a strategic reflection on the management of CAR-T therapies within the Spanish National Health System, to agree on recommendations that will help to better deal with the new context introduced by these cell therapies in the present and in the future. This think tank involved 40 key agents and opinion leaders. The experts identified three great challenges for implementing advanced therapies in Spain: therapeutic individualisation, with a multidisciplinary approach; acceleration of access times, by minimizing bureaucracy; and increase in the number of centers qualified to manage the CAR-T therapies in the NHS. The experts agreed on the ideal criteria for designating those qualified centers. They also agreed on a comprehensive CAR-T care pathway with the timings and roles which would ideally be involved in each part of the process.

Análisis de las estrategias dirigidas a aumentar la cobertura de vacunación antigripal en personas de 65 años y más / Analysis of strategies aimed at increasing influenza vaccination coverage in people aged 65 and over

Objetivo: Identificar las iniciativas más efectivas para potenciar la vacunación en personas ≥65 años en España.Métodos: Estudio observacional transversal a partir de una encuesta a socios de la Sociedad Española de Médicos de AtenciónPrimaria (n=371). Análisis descriptivo y multivariante de 21 potenciales estrategias de fomento de la vacunación.Resultados: Recomendar la vacunación (15,3%), medios de comunicación/redes sociales (11,5%) y captación activa (10,4%) sepercibieron como las medidas más eficaces. En el análisis multivariante, las de impacto positivo sobre la vacunación fueron:recomendaciones profesionales/institucionales (+23,8 puntos porcentuales, pp), detección oportunista (13,9 pp), recordatorioinformático de registro (10,6 pp), registro de personas no vacunadas (9,1 pp), facilitación de solicitud de citas (8,9 pp) e inclusiónde nuevas estrategias en la cartera de servicios (6,9 pp).Conclusiones: Las medidas más efectivas para este colectivo incluyen acciones a nivel macro, meso y micro para facilitar el accesoa la vacuna, explotando el potencial de las nuevas tecnologías.(AU)

Objective: To identify the most effective initiatives to promote vaccination in people aged ≥65 years in Spain.Methods: Cross-sectional observational study based on a survey of members of the Spanish Society of Primary Care Physicians(n=371). Descriptive and multivariate analysis of 21 potential vaccination promotion strategies.Results: Recommending vaccination (15.3%), media/social networks (11.5%) and active recruitment (10.4%) were perceived asthe most effective measures. In multivariate analysis, those with a positive impact on vaccination were: professional/institutionalrecommendations (+23.8 percentage points, pp), opportunistic screening (13.9 pp), computerised registration reminder (10.6 pp), registration of unvaccinated persons (9.1 pp), facilitation of appointment request (8.9 pp) and inclusion of new strategies in theservice portfolio (6.9 pp).Conclusions: The most effective measures for this group include actions at macro, meso and micro levels to facilitate access to thevaccine, exploiting the potential of new technologies.(AU)