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Medical economics

I Aumann, K Rozanski, K Damm, J-M Graf von der Schulenburg
Aim of the Study: Through the promotion of smoking cessation premature mortality can be prevented. Therefore it is necessary to provide effective and cost-effective smoking cessation interventions. In Germany the cost of pharmacological smoking cessation measures are not yet reimbursed by the statutory health insurance. The aim of this study is to present the evidence on the cost-effectiveness of already approved pharmacological smoking cessation therapies and to evaluate their quality. Method: A systematic literature research was conducted in the databases by DIMDI (Medline, Embase, etc...
October 2016: Das Gesundheitswesen
Joanna P MacEwan, Felicia M Forma, Jason Shafrin, Ainslie Hatch, Darius N Lakdawalla, Jean-Pierre Lindenmayer
BACKGROUND: Poor medication adherence contributes to negative treatment response, symptom relapse, and hospitalizations in schizophrenia. Many health plans use claims-based measures like medication possession ratios or proportion of days covered (PDC) to measure patient adherence to antipsychotics. Classifying patients solely on the basis of a single average PDC measure, however, may mask clinically meaningful variations over time in how patients arrive at an average PDC level. OBJECTIVE: To model patterns of medication adherence evolving over time for patients with schizophrenia who initiated treatment with an oral atypical antipsychotic and, based on these patterns, to identify groups of patients with different adherence behaviors...
November 2016: Journal of Managed Care & Specialty Pharmacy
Jason Shafrin, Taylor T Schwartz, Darius N Lakdawalla, Felicia M Forma
BACKGROUND: Nonadherence to antipsychotic medication among patients with schizophrenia results in poor symptom management and increased health care and other costs. Despite its health impact, medication adherence remains difficult to accurately assess. New technologies offer the possibility of real-time patient monitoring data on adherence, which may in turn improve clinical decision making. However, the economic benefit of accurate patient drug adherence information (PDAI) has yet to be evaluated...
November 2016: Journal of Managed Care & Specialty Pharmacy
Roberto Nuño Solinís, Patricia Arratibel Ugarte, Ander Rojo, Yuri Sanchez Gonzalez
INTRODUCTION: The goal of chronic hepatitis C (CHC) treatment is to achieve a sustained virologic response (SVR). The new generation of direct-acting antivirals (DAAs) offers 90-100% SVR rates. However, access to these treatments is generally limited to patients with advanced liver disease. The aim of this review is to provide an overview of the clinical and economic benefits of achieving SVR and to better understand the full value of CHC treatment in all stages of liver disease. METHODS: A comprehensive literature review was performed using the PubMed, Embase, and Cochrane library databases to identify articles examining the clinical, economic, and quality of life benefits associated with SVR...
October 25, 2016: Infectious Diseases and Therapy
S Ballou, L Keefer
BACKGROUND: Despite the well-documented economic and psychosocial burden of irritable bowel syndrome (IBS), few studies have focused on the impact of IBS on daily activities. This study aims to quantitate impairment in daily activities among IBS patients and to evaluate the relationship between impairment, IBS, quality of life, and psychiatric symptoms. METHODS: A total of 179 participants meeting ROME-III criteria for IBS completed an online research survey evaluating the following variables: (i) the impact of IBS on daily activities, (ii) comorbid psychiatric diagnoses, (iii) symptom severity, (iv) quality of life, and (v) symptom-specific cognitive affective factors related to IBS...
October 25, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Edward Ivor Broughton, Lani Marquez
There is little evidence to direct health systems toward providing efficient interventions to address medical errors, defined as an unintended act of omission or commission or one not executed as intended that may or may not cause harm to the patient but does not achieve its intended outcome. We believe that lack of guidance on what is the most efficient way to reduce medical errors and improve the quality of health-care limits the scale-up of health system improvement interventions. Challenges to economic evaluation of these interventions include defining and implementing improvement interventions in different settings with high fidelity, capturing all of the positive and negative effects of the intervention, using process measures of effectiveness rather than health outcomes, and determining the full cost of the intervention and all economic consequences of its effects...
2016: Frontiers in Public Health
Sherif M Badawy, Lisa M Kuhns
BACKGROUND: The rate of chronic health conditions (CHCs) in children and adolescents has doubled in the past 20 years, with increased health care costs. Technology-based interventions have demonstrated efficacy to improving medication adherence. However, data to support the cost effectiveness of these interventions are lacking. OBJECTIVE: The objective of this study is to conduct an economic evaluation of text-messaging and smartphone-based interventions that focus on improving medication adherence in adolescents with CHCs...
October 25, 2016: JMIR MHealth and UHealth
Anita J Brogan, Sandra E Talbird, Ashley E Davis, Edward W Thommes, Genevieve Meier
Trivalent inactivated influenza vaccines (IIV3s) protect against two A strains and one B lineage; quadrivalent versions (IIV4s) protect against an additional B lineage. The objective was to assess projected health and economic outcomes associated with IIV4 versus IIV3 for preventing seasonal influenza in the US. A cost-effectiveness model was developed to interact with a dynamic transmission model. The transmission model tracked vaccination, influenza cases, infection-spreading interactions, and recovery over 10 years (2012-2022)...
October 26, 2016: Human Vaccines & Immunotherapeutics
Paul R Lewis, Jayraan Badiee, Michael J Sise, Richard Y Calvo, Jason B Brill, James D Wallace, Steven R Shackford, Casey E Dunne, Vishal Bansal, C Beth Sise
BACKGROUND: The American College of Surgeons Committee on Trauma devised process audit filters to identify opportunities for improvement (OFI), prevent adverse outcomes, and improve quality. Delay to the operating room for primary trauma laparotomy is a process audit filter that has not been definitively associated with improved outcomes. We sought to evaluate the effectiveness of delay to the operating room of greater than 2 hours (DOR) to independently identify an adverse outcome or an OFI at our Level I trauma center...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Jo Hunter-Adams, Landon Myer, Hanna-Andrea Rother
BACKGROUND: Infant feeding recommendations are of health importance, yet the extent to which migrant communities in low- and middle-income countries know or implement these recommendations is poorly understood. This study explores the perspectives of infant feeding amongst cross-border migrants in Cape Town, South Africa. METHODS: Between February and October 2013, semi-structured in-depth interviews (n = 23) were conducted face-to-face with Congolese, Somali and Zimbabwean mothers living in Cape Town...
2016: International Breastfeeding Journal
Jean Baptiste Briere, Kevin Bowrin, Robert Wood, Tim Holbrook, Jenna Roberts
AIMS: To describe the collective costs of vitamin K antagonist (VKA) treatment for stroke prevention in non-valvular atrial fibrillation (NVAF). VKA drug costs are relatively low but they necessitate frequent international normalized ratio (INR) monitoring. There are currently minimal data describing the economic impact of this in Mexico. MATERIALS AND METHODS: Cardiologists provided data on their NVAF patients (n = 400) to quantify direct medical costs (INR testing, appointments, drug costs)...
October 25, 2016: Journal of Medical Economics
So Youn Park, Ivo Kwon, In Hwan Oh
When thinking about priority setting in access to healthcare resources, decision-making requires that cost-effectiveness is balanced against medical ethics. The burden of disease has emerged as an important approach to the assessment of health needs for political decision-making. However, the disability adjusted life years approach hides conceptual and methodological issues regarding the claims and value of disabled people. In this article, we discuss ethical issues that are raised as a consequence of the introduction of evidence-based health policy, such as economic evidence, in establishing resource allocation priorities...
November 2016: Journal of Korean Medical Science
Y Ke, X Y Zhang, S Ramakrishna, L M He, G Wu
Polyhydroxyalkanoates (PHAs) are a class of natural polyesters as carbon and energy reserves by >300 species of microorganisms. They are fully biodegradable, biocompatible and piezoelectric biopolymers that have attracted much attention recently as the biomaterial of choice for medical applications. However, the toughness, processability and hydrophilicity of PHAs need to tune to expand their applications as tissue engineering scaffolds or drug delivery systems. Reactive polymer blending is one of the most economic and versatile way to produce materials combining the desired properties via forming the compatibilizing agents in situ or inducing the chemico-physical interactions between polymer blends...
January 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
George L Bakris, John M Burkart, Eric D Weinhandl, Peter A McCullough, Michael A Kraus
Hypertension is a cardinal feature of end-stage renal disease (ESRD). Hypertensive nephropathy is the primary cause of ESRD for nearly 30% of patients, and the prevalence of hypertension is >85% in new patients with ESRD. In contemporary hemodialysis (HD) patients, mean predialysis systolic blood pressure (SBP) is nearly 150mmHg, and about 70%, 50%, and 40% use β-blockers, calcium channel blockers, and renin-angiotensin system inhibitors, respectively. Predialysis SBP generally exhibits a U-shaped association with mortality risk...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Alexander Konnopka, Hans-Helmut König, Claudia Kaufmann, Nina Egger, Beate Wild, Joachim Szecsenyi, Wolfgang Herzog, Dieter Schellberg, Rainer Schaefert
BACKGROUND: Collaborative group intervention (CGI) in patients with functional somatic syndromes (FSS) has been shown to improve mental quality of life. OBJECTIVE: To analyse incremental cost-utility of CGI compared to enhanced medical care in patients with FSS. METHODS: An economic evaluation alongside a cluster-randomised controlled trial was performed. 35 general practitioners (GPs) recruited 300 FSS patients. Patients in the CGI arm were offered 10 group sessions within 3months and 2 booster sessions 6 and 12months after baseline...
November 2016: Journal of Psychosomatic Research
J Suriya, S Bharathiraja, P Manivasagan, S-K Kim
Actinobacteria constitute rich sources of novel biocatalysts and novel natural products for medical and industrial utilization. Although actinobacteria are potential source of economically important enzymes, the isolation and culturing are somewhat tough because of its extreme habitats. But now-a-days, the rate of discovery of novel compounds producing actinomycetes from soil, freshwater, and marine ecosystem has increased much through the developed culturing and genetic engineering techniques. Actinobacteria are well-known source of their bioactive compounds and they are the promising source of broad range of industrially important enzymes...
2016: Advances in Food and Nutrition Research
Aideen Maguire, John Moriarty, Dermot O'Reilly, Mark McCann
PURPOSE: Educational attainment has been shown to be positively associated with mental health and a potential buffer to stressful events. One stressful life event likely to affect everyone in their lifetime is bereavement. This paper assesses the effect of educational attainment on mental health post-bereavement. METHODS: By utilising large administrative datasets, linking Census returns to death records and prescribed medication data, we analysed the bereavement exposure of 208,332 individuals aged 25-74 years...
October 21, 2016: Quality of Life Research
Magaly Rodriguez de Bittner, Viktor V Chirikov, Ian M Breunig, Roxanne W Zaghab, Fadia Tohme Shaya
OBJECTIVE: To determine the effectiveness and cost savings of a real-world, continuous, pharmacist-delivered service with an employed patient population with diabetes over a 5-year period. SETTING: The Patients, Pharmacists Partnerships (P(3) Program) was offered as an "opt-in" benefit to employees of 6 public and private self-insured employers in Maryland and Virginia. Care was provided in ZIP code-matched locations and at 2 employers' worksites. PRACTICE DESCRIPTION: Six hundred two enrolled patients with type 1 and 2 diabetes were studied between July 2006 and May 2012 with an average follow-up of 2...
October 18, 2016: Journal of the American Pharmacists Association: JAPhA
Danilo Solano, Juan Carlos Navarro, Antonio León-Reyes, Washington Benítez-Ortiz, Richar Rodríguez-Hidalgo
Tapeworms Taenia solium and Taenia saginata are the causative agents of taeniasis/cysticercosis. These are diseases with high medical and veterinary importance due to their impact on public health and rural economy in tropical countries. The re-emergence of T. solium as a result of human migration, the economic burden affecting livestock industry, and the large variability of symptoms in several human cysticercosis, encourage studies on genetic diversity, and the identification of these parasites with molecular phylogenetic tools...
October 18, 2016: Experimental Parasitology
Philip Tack, Jan Victor, Paul Gemmel, Lieven Annemans
BACKGROUND: Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes. METHODS: Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans...
October 21, 2016: Biomedical Engineering Online
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