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Cost, health economics, health services research

Manuela Deidda, Kathleen Anne Boyd, Helen Minnis, Julia Donaldson, Kevin Brown, Nicole R S Boyer, Emma McIntosh
INTRODUCTION: Children who have experienced abuse and neglect are at increased risk of mental and physical health problems throughout life. This places an enormous burden on individuals, families and society in terms of health services, education, social care and judiciary sectors. Evidence suggests that early intervention can mitigate the negative consequences of child maltreatment, exerting long-term positive effects on the health of maltreated children entering foster care. However, evidence on cost-effectiveness of such complex interventions is limited...
March 14, 2018: BMJ Open
Catriona Crossan, Hakim-Moulay Dehbi, Hilarie Williams, Neil Poulter, Anthony Rodgers, Stephen Jan, Simon Thom, Joanne Lord
INTRODUCTION: The 'Use of a Multi-drug Pill in Reducing cardiovascular Events' (UMPIRE) trial was a randomised controlled clinical trial evaluating the impact of a polypill strategy on adherence to indicated medication in a population with established cardiovascular disease (CVD) of or at high risk thereof. The aim of Researching the UMPIRE Processes for Economic Evaluation in the National Health Service (RUPEE NHS) is to estimate the potential health economic impact of a polypill strategy for CVD prevention within the NHS using UMPIRE trial and other relevant data...
March 14, 2018: BMJ Open
David J Cottrell, Alex Wright-Hughes, Michelle Collinson, Paula Boston, Ivan Eisler, Sarah Fortune, Elizabeth H Graham, Jonathan Green, Allan O House, Michael Kerfoot, David W Owens, Eirini-Christina Saloniki, Mima Simic, Sandy Tubeuf, Amanda J Farrin
BACKGROUND: Self-harm in adolescents is common and repetition rates high. There is limited evidence of the effectiveness of interventions to reduce self-harm. OBJECTIVES: To assess the clinical effectiveness and cost-effectiveness of family therapy (FT) compared with treatment as usual (TAU). DESIGN: A pragmatic, multicentre, individually randomised controlled trial of FT compared with TAU. Participants and therapists were aware of treatment allocation; researchers were blind to allocation...
March 2018: Health Technology Assessment: HTA
Jagnoor Jagnoor, Sheree Bekker, Shobha Chamania, Tom Potokar, Rebecca Ivers
OBJECTIVES: This study aimed to identify priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India. DESIGN: Qualitative inquiry; data were collected through semistructured in-depth interviews and focus group discussions. SETTING: Nine sites in urban and rural settings across India, through primary, secondary and tertiary health facilities. PARTICIPANTS: Healthcare providers, key informants, burns survivors and/or their carers...
March 8, 2018: BMJ Open
Mark Hofmeister, Ally Memedovich, Laura E Dowsett, Laura Sevick, Tamara McCarron, Eldon Spackman, Tania Stafinski, Devidas Menon, Tom Noseworthy, Fiona Clement
BACKGROUND: The aim of palliative care is to improve the quality of life of patients and families through the prevention and relief of suffering. Frequently, patients may choose to receive palliative care in the home. The objective of this paper is to summarize the quality and primary outcomes measured within the palliative care in the home literature. This will synthesize the current state of the literature and inform future work. METHODS: A scoping review was completed using PRISMA guidelines...
March 7, 2018: BMC Palliative Care
Mary Sawtell, Lorna Sweeney, Meg Wiggins, Cathryn Salisbury, Sandra Eldridge, Lauren Greenberg, Rachael Hunter, Inderjeet Kaur, Christine McCourt, Bethan Hatherall, Gail Findlay, Joanne Morris, Sandra Reading, Adrian Renton, Ruth Adekoya, Belinda Green, Belinda Harvey, Sarah Latham, Kanta Patel, Logan Vanlessen, Angela Harden
BACKGROUND: The provision of high-quality maternity services is a priority for reducing inequalities in health outcomes for mothers and infants. Best practice includes women having their initial antenatal appointment within the first trimester of pregnancy in order to provide screening and support for healthy lifestyles, well-being and self-care in pregnancy. Previous research has identified inequalities in access to antenatal care, yet there is little evidence on interventions to improve early initiation of antenatal care...
March 5, 2018: Trials
Shijie Ren, Iñigo Bermejo, Emma Simpson, Ruth Wong, David L Scott, Adam Young, Matt Stevenson
As part of its single technology appraisal process, the National Institute for Health and Care Excellence invited the manufacturer (Eli Lilly) of baricitinib (BARI; Olumiant® ; a Janus kinase inhibitor that is taken orally) to submit evidence of its clinical and cost effectiveness for the treatment of moderate to severe rheumatoid arthritis (RA) after the failure of disease-modifying antirheumatic drugs (DMARDs). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG)...
March 3, 2018: PharmacoEconomics
Sandra Varey, Alejandra Hernández, Tom M Palmer, Céu Mateus, Joann Wilkinson, Mandy Dixon, Christine Milligan
INTRODUCTION: The Lancashire and Cumbria Innovation Alliance (LCIA) Test Bed is a partnership between the National Health Service in England, industry (led by Philips) and Lancaster University. Through the implementation of a combination of innovative health technologies and practices, it aims to determine the most effective and cost-effective ways of supporting frail older people with long-term conditions to remain well in the community. Among the Test Bed's objectives are to improve patient activation and the ability of older people to self-care at home, reduce healthcare system utilisation, and deliver increased workforce productivity...
February 28, 2018: BMJ Open
Mark Olfson, Tony B Amos, Carmela Benson, Jacquelyn McRae, Steven C Marcus
BACKGROUND: Although the clinical and health economic characteristics of commercially insured adults with treatment-resistant depression (TRD) have been well characterized, little is known about TRD in the Medicaid population. OBJECTIVE: To describe clinical and health economic characteristics of adult Medicaid beneficiaries with TRD. METHODS: Retrospective longitudinal cohort analyses were performed with Truven Health MarketScan Medicaid Database (2008-2014), focusing on adults with major depressive disorder (MDD) following an index antidepressant prescription...
March 2018: Journal of Managed Care & Specialty Pharmacy
Sabrina Storgaard Sørensen, Morten Berg Jensen, Kjeld Møller Pedersen, Lars Ehlers
OBJECTIVES: To examine the heterogeneity in cost-effectiveness analyses of patient-tailored complex interventions. METHODS: Latent class analysis (LCA) was performed on data from a randomized controlled trial evaluating a patient-tailored case management strategy for patients suffering from chronic obstructive pulmonary disease (COPD). LCA was conducted on detailed process variables representing service variation in the intervention group. Features of the identified latent classes were compared for consistency with baseline demographic, clinical, and economic characteristics for each class...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Samuel I Watson, Yen-Fu Chen, Julian F Bion, Cassie P Aldridge, Alan Girling, Richard J Lilford
INTRODUCTION: This protocol concerns the evaluation of increased specialist staffing at weekends in hospitals in England. Seven-day health services are a key policy for the UK government and other health systems trying to improve use of infrastructure and resources. A particular motivation for the 7-day policy has been the observed increase in the risk of death associated with weekend admission, which has been attributed to fewer hospital specialists being available at weekends. However, the causes of the weekend effect have not been adequately characterised; many of the excess deaths associated with the 'weekend effect' may not be preventable, and the presumed benefits of improved specialist cover might be offset by the cost of implementation...
February 23, 2018: BMJ Open
David A Turner, Rebekah Fong Soe Khioe, Lee Shepstone, Elizabeth Lenaghan, Cyrus Cooper, Neil Gittoes, Nicholas C Harvey, Richard Holland, Amanda Howe, Eugene McCloskey, Terence W O'Neill, David Torgerson, Richard Fordham
The SCOOP study was a two-arm randomized controlled trial conducted in the UK in 12,483 eligible women aged 70 to 85 years. It compared a screening program using the FRAX® risk assessment tool in addition to bone mineral density (BMD) measures versus usual management. The SCOOP study found a reduction in the incidence of hip fractures in the screening arm, but there was no evidence of a reduction in the incidence of all osteoporosis-related fractures. To make decisions about whether to implement any screening program, we should also consider whether the program is likely to be a good use of health care resources, ie, is it cost-effective? The cost per gained quality adjusted life year of screening for fracture risk has not previously been demonstrated in an economic evaluation alongside a clinical trial...
February 22, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Tim Kirkpatrick, Charlotte Lennox, Rod Taylor, Rob Anderson, Michael Maguire, Mark Haddad, Susan Michie, Christabel Owens, Graham Durcan, Alex Stirzaker, William Henley, Caroline Stevenson, Lauren Carroll, Cath Quinn, Sarah Louise Brand, Tirril Harris, Amy Stewart, Roxanne Todd, Sarah Rybczynska-Bunt, Rebecca Greer, Mark Pearson, Jenny Shaw, Richard Byng
INTRODUCTION: The 'Engager' programme is a 'through-the-gate' intervention designed to support prisoners with common mental health problems as they transition from prison back into the community. The trial will evaluate the clinical and cost-effectiveness of the Engager intervention. METHODS AND ANALYSIS: The study is a parallel two-group randomised controlled trial with 1:1 individual allocation to either: (a) the Engager intervention plus standard care (intervention group) or (b) standard care alone (control group) across two investigation centres (South West and North West of England)...
February 20, 2018: BMJ Open
Puttarin Kulchaitanaroaj, Zoltán Kaló, Robert West, Kei Long Cheung, Silvia Evers, Zoltán Vokó, Mickael Hiligsmann, Hein de Vries, Lesley Owen, Marta Trapero-Bertran, Reiner Leidl, Subhash Pokhrel
BACKGROUND: The evidence on the extent to which stakeholders in different European countries agree with availability and importance of tobacco-control interventions is limited. This study assessed and compared stakeholders' views from five European countries and compared the perceived ranking of interventions with evidence-based ranking using cost-effectiveness data. METHODS: An interview survey (face-to-face, by phone or Skype) was conducted between April and July 2014 with five categories of stakeholders - decision makers, service purchasers, service providers, evidence generators and health promotion advocates - from Germany, Hungary, the Netherlands, Spain, and the United Kingdom...
February 14, 2018: BMC Health Services Research
Edward Burn, Alexander D Liddle, Thomas W Hamilton, Sunil Pai, Hemant G Pandit, David W Murray, Rafael Pinedo-Villanueva
BACKGROUND AND OBJECTIVE: Patients with anteromedial arthritis who require a knee replacement could receive either a unicompartmental knee replacement (UKR) or a total knee replacement (TKR). This review has been undertaken to identify economic evaluations comparing UKR and TKR, evaluate the approaches that were taken in the studies, assess the quality of reporting of these evaluations, and consider what they can tell us about the relative value for money of the procedures. METHODS: A search of MEDLINE, EMBASE and the Centre for Reviews and Dissemination National Health Service Economic Evaluation Database was undertaken in January 2016 to identify relevant studies...
December 2017: PharmacoEconomics Open
S Coyle, S Kinsella, B Lenehan, J M Queally
BACKGROUND: As healthcare systems come under ever-increasing pressure to provide more care with fewer resources, emphasis is being placed on value-based systems that maximise quality and minimize cost. The aim of this study was to determine which interventions in fracture care have been demonstrated to be cost effective. METHODS: A systemic review of cost-utility studies on the management of fractures from 1976 to 2015 was carried out using a search of the Cost-Effectiveness Analysis Registry, National Health Service Economic Evaluation Database (NHS EED) and MEDLINE...
January 31, 2018: Injury
Frank J Lebeda, Jeffrey J Zalatoris, Julia B Scheerer
Introduction: This position paper summarizes the development and the present status of Department of Defense (DoD) and other government policies and guidances regarding cloud computing services. Due to the heterogeneous and growing biomedical big datasets, cloud computing services offer an opportunity to mitigate the associated storage and analysis requirements. Having on-demand network access to a shared pool of flexible computing resources creates a consolidated system that should reduce potential duplications of effort in military biomedical research...
February 7, 2018: Military Medicine
Thomas J Dilworth, Pamela W Klein, Renée-Claude Mercier, Matthew E Borrego, Bernadette Jakeman, Steven D Pinkerton
BACKGROUND: Pharmacists have demonstrated the ability to improve patient adherence to antiretroviral therapy (ART). OBJECTIVE: To determine the clinical and economic effects of a pharmacist-administered ART adherence clinic for patients living with human immunodeficiency virus (HIV). METHODS: This pilot study with a pretest-posttest design examined the effect of a pharmacy adherence clinic on patient HIV viral load and CD4 count over a 6-month period...
February 2018: Journal of Managed Care & Specialty Pharmacy
My-Linh Nguyen Luong, Kim L Bennell, Michelle Hall, Anthony Harris, Rana S Hinman
BACKGROUND: Most adults fail to meet global physical activity guidelines set out by the World Health Organization. In recent years, behavioural economic principles have been used to design novel interventions that increase physical activity. Immediate financial rewards, for instance, can motivate an individual to change physical activity behaviour by lowering the opportunity costs of exercise. This systematic review will summarise the evidence about the effectiveness of financial incentive interventions for improving physical activity in adults...
January 25, 2018: Systematic Reviews
Melina Dritsaki, Oliver Rivero-Arias, Alastair Gray, Catherine Ball, Jagdeep Nanchahal
BACKGROUND: Dupuytren's disease (DD) is a common and progressive, fibroproliferative disorder of the palmar and digital fascia of the hand. Various treatments have been recommended for advanced disease or to retard progression of early disease and to prevent deterioration of the finger contracture and quality of life. Recent studies have tried to evaluate the clinical and cost-effectiveness of therapies for DD, but there is currently no systematic assessment and appraisal of the economic evaluations...
January 25, 2018: BMC Musculoskeletal Disorders
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