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A cost-effectiveness analysis of reduced viral transmission with baloxavir marboxil versus oseltamivir or no treatment for seasonal and pandemic influenza management in the United Kingdom. 英国季节性流感和大流行性流感管理中使用巴洛沙韦 marboxil 与使用奥司他韦或不使用治疗方法相比,减少病毒传播的成本效益分析。
IF 1.8 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-06-12 DOI: 10.1080/14737167.2024.2365421
Svenn Alexander Kommandantvold, Annabelle Lemenuel-Diot, Chris Skedgel, Richard Pitman, Peter Rouse, Hassan Zaraket, Hao Zhou, Marie-Helene Blanchet Zumofen

Background: Baloxavir marboxil is an oral, single-dose, cap-dependent endonuclease inhibitor that reduces the duration of influenza symptoms and rapidly stops viral shedding. We developed a susceptible, exposed, infected, recovered (SEIR) model to inform a cost-effectiveness model (CEM) of baloxavir versus oseltamivir or no antiviral treatment in the UK.

Research design and methods: The SEIR model estimated the attack rates among otherwise healthy and high-risk individuals in seasonal and pandemic settings. The CEM assumed that a proportion of infected patients would receive antiviral treatment. Results were reported at the population level (per 10,000 at risk of infection).

Results: The SEIR model estimated greater reductions in infections with baloxavir. In a seasonal setting, baloxavir provided incremental cost-effectiveness ratios (ICERs) of £1884 per quality-adjusted life-year (QALY) gained versus oseltamivir and a dominant cost-effectiveness position versus no antiviral treatment in the total population; ICERs of £2574/QALY versus oseltamivir and £128/QALY versus no antiviral treatment were seen in the high-risk population. Baloxavir was also cost-effective versus oseltamivir or no antiviral treatment and reduced population-level health system occupancy concerns during a pandemic.

Conclusion: Baloxavir treatment resulted in the fewest influenza cases and was cost-effective versus oseltamivir or no antiviral treatment from a UK National Health Service perspective.

背景介绍巴洛沙韦(Baloxavir marboxil)是一种口服、单剂量、瓶盖依赖性内切酶抑制剂,可缩短流感症状持续时间并迅速阻止病毒脱落。我们开发了一个易感、暴露、感染、康复(SEIR)模型,为英国的巴洛沙韦与奥司他韦或无抗病毒治疗的成本效益模型(CEM)提供信息:SEIR 模型估算了在季节性和大流行环境中原本健康的高危人群的发病率。CEM假定一定比例的感染者将接受抗病毒治疗。结果按人群水平(每 10,000 名有感染风险的人)进行报告:结果:根据 SEIR 模型估计,使用巴洛沙韦可更大程度地降低感染率。在季节性环境中,巴洛沙韦与奥司他韦相比,每获得一个质量调整生命年(QALY)的增量成本效益比(ICER)为 1884 英镑,与不进行抗病毒治疗相比,在总人口中的成本效益处于优势地位;在高风险人群中,与奥司他韦相比,ICER 为 2574 英镑/QALY,与不进行抗病毒治疗相比,ICER 为 128 英镑/QALY。与奥司他韦或不进行抗病毒治疗相比,巴洛沙韦的成本效益也很高,并可减少大流行期间人口层面的卫生系统占用问题:结论:从英国国民健康服务的角度来看,巴洛沙韦治疗导致的流感病例最少,与奥司他韦或无抗病毒治疗相比具有成本效益。
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引用次数: 0
Cost-effectiveness of a multicomponent-adherence intervention in fracture liaison services. 骨折联络服务中多成分坚持干预的成本效益。
IF 1.8 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-06-12 DOI: 10.1080/14737167.2024.2366439
Lieke Maas, Annelies Boonen, Nannan Li, Caroline E Wyers, Joop P Van den Bergh, Mickaël Hiligsmann

Background: This study aims to assess the lifetime cost-effectiveness of a multi-component adherence intervention (MCAI), including a patient decision aid and motivational interviewing, compared to usual care in patients with a recent fracture attending fracture liaison services (FLS) and eligible for anti-osteoporosis medication (AOM).

Research design and methods: Data on AOM initiation and one-year persistence were collected from a quasi-experimental study conducted between 2019 and 2023 in two Dutch FLS centers. An individual level, state-transition Markov model was used to simulate lifetime costs and quality-adjusted life years (QALYs) with a societal perspective of MCAI vs usual care. One-way and probabilistic sensitivity analyses were conducted including variation in additional FLS and MCAI costs (no MCAI cost in baseline).

Results: MCAI was associated with gain in QALYs (0.0012) and reduction in costs (-€16) and is therefore dominant. At the Dutch willingness-to-pay threshold of €50,000/QALY, MCAI remained cost-effective when increasing costs of the FLS visit or the yearly maintenance cost for MCAI up to +€60. Probabilistic sensitivity analysis demonstrated MCAI to be dominant in 54% of the simulations and cost-effective in 87% with a threshold of €50,000/QALY.

Conclusions: A MCAI implemented in FLS centers may lead to cost-effective allocation of resources in FLS care, depending on extra costs.

研究背景本研究旨在评估与常规护理相比,多组分依从性干预(MCAI)的终生成本效益,包括患者决策辅助工具和动机访谈,适用于近期骨折并接受骨折联络服务(FLS)且符合抗骨质疏松症药物治疗(AOM)的患者:2019-2023年期间,在荷兰的两个FLS中心开展了一项半实验性研究,收集了AOM的启动数据和一年的持续数据。研究采用了个人水平的状态转换马尔可夫模型,从社会角度模拟MCAI与常规治疗的终生成本和质量调整生命年(QALYs)。进行了单向和概率敏感性分析,包括FLS和MCAI额外费用的变化(基线无MCAI费用):结果:MCAI 与 QALYs 收益(0.0012)和成本降低(-16 欧元)相关,因此占主导地位。荷兰的支付意愿阈值为 50,000 欧元/QALY,当 FLS 访问成本或 MCAI 的年度维护成本增加到 +60 欧元时,MCAI 仍然具有成本效益。概率敏感性分析表明,在 54% 的模拟中,MCAI 占主导地位,在 87% 的模拟中,MCAI 具有成本效益,阈值为 50,000 欧元/QALY:在 FLS 中心实施 MCAI 可使 FLS 护理中的资源分配具有成本效益,具体取决于额外成本。
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引用次数: 0
Cost-effectiveness analysis of pembrolizumab plus chemotherapy versus placebo plus chemotherapy for HER2-negative advanced gastric/gastroesophageal junction cancer in the Chinese healthcare system. 在中国医疗体系中,HER2阴性晚期胃癌/胃食管交界处癌的pembrolizumab联合化疗与安慰剂联合化疗的成本效益分析。
IF 1.8 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-07-15 DOI: 10.1080/14737167.2024.2378983
Wenwang Lang, Lian Deng, Meijun Lu, Ming Ouyang

Background: This study compares first-line pembrolizumab plus chemotherapy with chemotherapy alone for patients with HER2-negative advanced gastric cancer (GC) and gastroesophageal junction cancer (GEJC) in China.

Methods: A Markov state-transition model was developed based on the phase 3 randomized KEYNOTE-859 clinical trial data. The health state utility values and direct medical costs were derived from the KEYNOTE-859 clinical trial, the relevant literature, and local charges. The measured outcomes included quality-adjusted life-years (QALYs) and the incremental cost-effectiveness ratio (ICER). Probabilistic and one-way sensitivity analyses (OWSA) were performed to assess the uncertainty of the model.

Results: In the base analysis, the incremental effectiveness and cost of pembrolizumab plus chemotherapy versus chemotherapy alone were 0.22 QALYs and $16,627.31, respectively, resulting in an ICER of $76,936.60/QALY, which is higher than the willingness-to-pay threshold in China ($35,864.61/QALY). Subgroup analyses revealed that the ICERs of pembrolizumab plus chemotherapy versus chemotherapy alone were $72,762.68 and $34,813.70 in the populations with PD-L1 CPS of 1 or higher (CPS ≥ 1) and PD-L1 CPS ≥ 10 (CPS ≥ 10), respectively.

Conclusions: As first-line therapy for patients with locally advanced or metastatic HER2-negative GC/GEJC in China, pembrolizumab plus chemotherapy is less cost-effective than chemotherapy alone, however, in the CPS ≥ 10 subgroup is more.

背景:本研究比较了中国HER2阴性晚期胃癌(GC)和胃食管交界处癌(GEJC)患者一线使用pembrolizumab联合化疗与单纯化疗的疗效:方法:根据 KEYNOTE-859 3 期随机临床试验数据,建立马尔可夫状态转换模型。健康状态效用值和直接医疗费用来自 KEYNOTE-859 临床试验、相关文献和当地收费标准。测量结果包括质量调整生命年(QALYs)和增量成本效益比(ICER)。为评估模型的不确定性,进行了概率和单向敏感性分析(OWSA):在基础分析中,pembrolizumab联合化疗与单独化疗的增量有效性和成本分别为0.22 QALYs和16627.31美元,ICER为76936.60美元/QALY,高于中国的支付意愿阈值(35864.61美元/QALY)。亚组分析显示,在PD-L1 CPS大于或等于1(CPS≥1)和PD-L1 CPS≥10(CPS≥10)的人群中,pembrolizumab联合化疗与单纯化疗的ICER分别为72762.68美元和34813.70美元:结论:在中国,作为局部晚期或转移性HER2阴性GC/GEJC患者的一线治疗,pembrolizumab联合化疗的成本效益低于单用化疗,但在CPS≥10的亚组中,pembrolizumab联合化疗的成本效益更高。
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引用次数: 0
The cost-of-illness of multiple sclerosis in Jordan. 约旦多发性硬化症的疾病成本。
IF 2.3 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-18 DOI: 10.1080/14737167.2024.2406797
Ibrahim Alabbadi,Sara Al-Ajlouny,Yazan Alsoud,Ayah Bani Hani,Bayan A Arar,Eman M Massad,Suhaib Muflih,Mays Shawawrah
BACKGROUNDMultiple Sclerosis (MS) is a chronic neurological autoimmune disease that imposes a significant financial burden on healthcare systems. This study aims to determine the cost of illness for MS in Jordan, a country where data on the economic impact of MS are scarce. The objective of this study is to assess both direct and indirect costs associated with MS care in Jordan's public healthcare system.METHODSData were collected during the year 2020-2021, annual cost of illness was estimated using a cross-sectional snowball sampling design. Eligible patients completed a self-reported questionnaire to provide sociodemographic, physician visit, and diagnostic and laboratory test data. We estimated indirect costs using an adjusted Human Capital Approach.RESULTSThis study included 383 people with MS (PwMS), 73.1% of whom were female and 61.4% between 26 and 45. Nearly 79.6% of PwMS took Disease Modifying Therapies (DMTs), and 40% had relapses in the year 2020-2021. One-third use non-DMTs and equipment for assistance like canes and walkers. The average annual cost per patient was 11,719 USD, with direct costs amounting to 11,252 USD and indirect costs at 467 USD. The total cost for all participants was 748,299 USD. The estimated cost of non-DMT, medical tools, diagnostic tests, and hospitalization per patient was 53 USD, 51 USD, 99 USD, and 235 USD respectively.CONCLUSIONThe high costs for Disease Modifying Therapies (DMTs) state the necessity of resource optimization in Jordan public healthcare facilities. Such findings yield policy-informing actionable insights, suggesting strategic investments in more cost-effective DMTs with potential improvement in accessibility and reduction in the overall economic burden faced by both patients and governments.
背景多发性硬化症(MS)是一种慢性神经系统自身免疫性疾病,给医疗系统带来了巨大的经济负担。约旦缺乏有关多发性硬化症经济影响的数据,本研究旨在确定约旦多发性硬化症的疾病成本。本研究的目的是评估约旦公共医疗系统中与多发性硬化症护理相关的直接和间接成本。方法在 2020-2021 年期间收集数据,采用横截面滚雪球式抽样设计估算年度疾病成本。符合条件的患者填写了一份自我报告问卷,以提供社会人口学、医生就诊、诊断和实验室检查数据。我们使用调整后的人力资本法估算了间接成本。结果本研究纳入了 383 名多发性硬化症患者(PwMS),其中 73.1% 为女性,61.4% 年龄在 26 岁至 45 岁之间。近 79.6% 的多发性硬化症患者接受了疾病改变疗法 (DMT),40% 的患者在 2020-2021 年期间复发。三分之一的患者使用非 DMT 和辅助设备,如手杖和助行器。每位患者的年均费用为 11,719 美元,其中直接费用为 11,252 美元,间接费用为 467 美元。所有参与者的总费用为 748,299 美元。每位患者的非 DMT、医疗工具、诊断检测和住院费用估计分别为 53 美元、51 美元、99 美元和 235 美元。这些研究结果为制定政策提供了可操作的启示,建议对更具成本效益的 DMT 进行战略性投资,从而提高可及性,减轻患者和政府的总体经济负担。
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引用次数: 0
Improved medication adherence in COPD patients using tiotropium or tiotropium olodaterol with the HealthPrize digital behavior change program. 使用噻托溴铵或噻托溴铵奥洛他特罗的慢性阻塞性肺病患者通过HealthPrize数字行为改变计划提高了用药依从性。
IF 1.8 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 Epub Date: 2024-01-04 DOI: 10.1080/14737167.2023.2296561
Katrina S Firlik, Vamshi Ruthwik Anupindi, Vincent Hayes, Mitchell DeKoven, Asif Shaikh, Jessica Franchino-Elder

Objective: To assess the impact of the HealthPrize RespiPoints™ program on treatment adherence and persistence in adults with chronic obstructive pulmonary disease (COPD).

Methods: In this retrospective cohort study, program participants and nonparticipants receiving tiotropium bromide (TIO) or TIO and olodaterol between 1 January 2015-31 March 2020 were propensity score matched (PSM), from the linked database of the HealthPrize patient list and IQVIA PharMetrics® Plus. Treatment adherence, persistence, healthcare resource utilization, and costs were compared. Multivariable logistic regression models assessed the odds of adherence (≥80% proportion of days covered [PDC]), adjusted risk of discontinuation, and adjusted total healthcare costs.

Results: Program participants (n = 262) demonstrated a 44% greater adherence during followup than nonparticipants (n = 262) (mean [standard deviation] PDC: 0.72 [0.27] vs 0.50 [0.36], p < 0.0001). Participants had higher odds of adherence vs nonparticipants (adjusted odds ratio: 2.51; 95% confidence interval: 1.72-3.66, p < 0.0001) and a lower percentage of participants discontinued their index medication (19.85% vs 33.59%, p = 0.0004). Fewer participants were hospitalized during follow-up (13.74% vs 17.56%, p = 0.23); adjusted total medical costs were 24% lower (p = 0.08). Higher pharmacy costs partially offset lower healthcare costs.

Conclusions: Program participants showed improved COPD medication adherence and persistence compared to nonparticipants.

目的评估HealthPrize RespiPoints™计划对慢性阻塞性肺病(COPD)成人患者坚持治疗的影响:在这项回顾性队列研究中,从HealthPrize患者名单和IQVIA PharMetrics® Plus的链接数据库中对2015年1月1日至2020年3月31日期间接受噻托溴铵或噻托溴铵和奥洛他特罗治疗的计划参与者和非参与者进行倾向得分匹配(PSM)。比较了治疗依从性、持续性、医疗资源利用率和成本。多变量逻辑回归模型评估了坚持治疗的几率(覆盖天数比例≥80% [PDC])、调整后的停药风险和调整后的总医疗费用:计划参与者(n = 262)在随访期间的依从性比非参与者(n = 262)高出 44%(平均 [标准差] PDC:0.72 [0.27] vs 0.50 [0.36],p p = 0.0004)。随访期间住院的参与者较少(13.74% vs 17.56%,p = 0.23);调整后的医疗总费用降低了 24%(p = 0.08)。较高的药费部分抵消了较低的医疗费用:结论:与非参与者相比,该计划的参与者在慢性阻塞性肺病药物治疗的依从性和持续性方面都有所改善。
{"title":"Improved medication adherence in COPD patients using tiotropium or tiotropium olodaterol with the HealthPrize digital behavior change program.","authors":"Katrina S Firlik, Vamshi Ruthwik Anupindi, Vincent Hayes, Mitchell DeKoven, Asif Shaikh, Jessica Franchino-Elder","doi":"10.1080/14737167.2023.2296561","DOIUrl":"10.1080/14737167.2023.2296561","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of the HealthPrize RespiPoints™ program on treatment adherence and persistence in adults with chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>In this retrospective cohort study, program participants and nonparticipants receiving tiotropium bromide (TIO) or TIO and olodaterol between 1 January 2015-31 March 2020 were propensity score matched (PSM), from the linked database of the HealthPrize patient list and IQVIA PharMetrics® Plus. Treatment adherence, persistence, healthcare resource utilization, and costs were compared. Multivariable logistic regression models assessed the odds of adherence (≥80% proportion of days covered [PDC]), adjusted risk of discontinuation, and adjusted total healthcare costs.</p><p><strong>Results: </strong>Program participants (<i>n</i> = 262) demonstrated a 44% greater adherence during followup than nonparticipants (<i>n</i> = 262) (mean [standard deviation] PDC: 0.72 [0.27] vs 0.50 [0.36], <i>p</i> < 0.0001). Participants had higher odds of adherence vs nonparticipants (adjusted odds ratio: 2.51; 95% confidence interval: 1.72-3.66, <i>p</i> < 0.0001) and a lower percentage of participants discontinued their index medication (19.85% vs 33.59%, <i>p</i> = 0.0004). Fewer participants were hospitalized during follow-up (13.74% vs 17.56%, <i>p</i> = 0.23); adjusted total medical costs were 24% lower (<i>p</i> = 0.08). Higher pharmacy costs partially offset lower healthcare costs.</p><p><strong>Conclusions: </strong>Program participants showed improved COPD medication adherence and persistence compared to nonparticipants.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"829-843"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138802005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Engagement of medication users in the development and implementation of digital medication adherence technologies: a multi-stakeholder study. 让用药者参与数字用药依从性技术的开发和实施:一项多方利益相关者研究。
IF 1.8 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 Epub Date: 2024-07-01 DOI: 10.1080/14737167.2024.2373184
Dalma Hosszú, Alexandra L Dima, Francisca Leiva Fernández, Marie Paule Schneider, Liset van Dijk, Krisztina Tóth, Mark Duman, Wendy Davis, Cristian Andriciuc, Rebecca Egan, Bernard Vrijens, Przemyslaw Kardas, Noemi Bitterman, Iva Mucalo, Cristina Mihaela Ghiciuc, Tamás Ágh

Background: This study aims to create a comprehensive framework for the development and implementation of digital medication adherence technologies (DMATech), focusing on critical stages where engagement of medication users (MU) is considered meaningful, i.e. adds significant value, as agreed upon by participating stakeholders.

Methods: Through a literature review and expert consensus, a framework was outlined covering key DMATech development and implementation phases and steps. An in-person workshop with MU representatives and adherence experts, using the Nominal Group Technique, further refined these stages for MU engagement.

Results: The DMATech framework included three phases: 'Innovation,' 'Research and Development,' and 'Launch and Implementation,' each encompassing multiple steps. The workshop, attended by five MU representatives and nine adherence experts, identified critical stages for MU input including context analysis, ideation, proof of concept, prototype creation, DMATech's iteration, critical evaluation, healthcare implementation, real-world assessment, and improvement. Nevertheless, there was a divergence of consensus regarding the importance of MUs engagement in regulatory, financial, and marketing aspects.

Conclusions: This study provides a holistic framework for DMATech development and implementation and underscores the necessity of MU engagement at various stages. Modes of MU engagement cannot be generalized; a case-by-case evaluation of engagement strategies is essential.

背景:本研究旨在为数字用药依从性技术(DMATech)的开发和实施创建一个综合框架,重点关注参与的利益相关者一致认为药物使用者(MU)的参与有意义(即增加重大价值)的关键阶段:方法:通过文献综述和专家共识,概述了一个涵盖 DMATech 关键开发和实施阶段及步骤的框架。与医疗联盟(MU)代表和坚持治疗专家一起,利用 "名义小组技术"(Nominal Group Technique)召开了一次现场研讨会,进一步完善了这些阶段,以便医疗联盟参与其中:DMATech 框架包括三个阶段:"创新"、"研发 "和 "启动与实施",每个阶段都包含多个步骤。五位医疗联盟代表和九位坚持治疗专家参加了此次研讨会,并确定了医疗联盟参与的关键阶段,包括背景分析、构思、概念验证、原型创建、DMATech 迭代、关键评估、医疗保健实施、真实世界评估和改进。然而,对于医疗单位在监管、财务和营销方面参与的重要性,存在不同的共识:本研究为 DMATech 的开发和实施提供了一个整体框架,并强调了医疗单位在各个阶段参与的必要性。医疗单位的参与模式不能一概而论,必须对参与策略进行个案评估。
{"title":"Engagement of medication users in the development and implementation of digital medication adherence technologies: a multi-stakeholder study.","authors":"Dalma Hosszú, Alexandra L Dima, Francisca Leiva Fernández, Marie Paule Schneider, Liset van Dijk, Krisztina Tóth, Mark Duman, Wendy Davis, Cristian Andriciuc, Rebecca Egan, Bernard Vrijens, Przemyslaw Kardas, Noemi Bitterman, Iva Mucalo, Cristina Mihaela Ghiciuc, Tamás Ágh","doi":"10.1080/14737167.2024.2373184","DOIUrl":"10.1080/14737167.2024.2373184","url":null,"abstract":"<p><strong>Background: </strong>This study aims to create a comprehensive framework for the development and implementation of digital medication adherence technologies (DMATech), focusing on critical stages where engagement of medication users (MU) is considered meaningful, i.e. adds significant value, as agreed upon by participating stakeholders.</p><p><strong>Methods: </strong>Through a literature review and expert consensus, a framework was outlined covering key DMATech development and implementation phases and steps. An in-person workshop with MU representatives and adherence experts, using the Nominal Group Technique, further refined these stages for MU engagement.</p><p><strong>Results: </strong>The DMATech framework included three phases: 'Innovation,' 'Research and Development,' and 'Launch and Implementation,' each encompassing multiple steps. The workshop, attended by five MU representatives and nine adherence experts, identified critical stages for MU input including context analysis, ideation, proof of concept, prototype creation, DMATech's iteration, critical evaluation, healthcare implementation, real-world assessment, and improvement. Nevertheless, there was a divergence of consensus regarding the importance of MUs engagement in regulatory, financial, and marketing aspects.</p><p><strong>Conclusions: </strong>This study provides a holistic framework for DMATech development and implementation and underscores the necessity of MU engagement at various stages. Modes of MU engagement cannot be generalized; a case-by-case evaluation of engagement strategies is essential.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"853-860"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bridging the gap: enhancing medication adherence through research and innovation. 缩小差距:通过研究和创新提高服药依从性。
IF 1.8 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 Epub Date: 2024-07-09 DOI: 10.1080/14737167.2024.2378178
Tamás Ágh, Mickaël Hiligsmann
{"title":"Bridging the gap: enhancing medication adherence through research and innovation.","authors":"Tamás Ágh, Mickaël Hiligsmann","doi":"10.1080/14737167.2024.2378178","DOIUrl":"10.1080/14737167.2024.2378178","url":null,"abstract":"","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"773-775"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adherence to oral anticoagulants in patients with non-valvular atrial fibrillation: the role of patients' characteristics and out-of-pocket payments. 非瓣膜性心房颤动患者坚持服用口服抗凝药:患者特征和自付费用的作用。
IF 1.8 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 Epub Date: 2024-07-10 DOI: 10.1080/14737167.2024.2377663
Siraj Al-Obaidi, Rima Hijazeen, Rasha M Arabyat, Ibrahim Alabbadi

Background: Recent practice guidelines favor direct oral anticoagulants (DOACs) over warfarin for primary stroke prevention in patients with non-valvular atrial fibrillation (NVAF). However, challenges persist in Iraq's private pharmaceutical sector. DOACs have been sold at high and inconsistent retail prices and lack insurance coverage, leading to significant out-of-pocket (OOP) costs. The objective of this study is to investigate the impact of OOP costs on oral anticoagulants (OAC) adherence among NVAF patients.

Research design and methods: This multicenter cross-sectional study interviewed 359 eligible patients attending three private cardiology clinics within Iraq's southern region from December 2022 to February 2023. The 8-item Morisky Adherence Scale evaluated patient adherence. Statistical analyses, including descriptive analysis, ANOVA, and chi-square. p < 0.05 was considered statistically significant.

Results: The most frequently prescribed OAC were DOACs (62.8%). Patient adherence level to OAC was chiefly medium (54.6%) with no significant difference in adherence based on OAC type. Patient adherence was significantly associated with monthly income (p = 0.001), number of daily pills (p = 0.006), and OACs' average monthly cost (p = 0.011).

Conclusion: Addressing the issue of cost-related non-adherence to OACs requires multiple actions. These include ensuring comprehensive health insurance coverage for OACs, increasing the use of affordable generic alternatives, and establishing effective cost-related discussions between healthcare providers and patients.

背景:在非瓣膜性心房颤动 (NVAF) 患者的中风一级预防中,近期的实践指南倾向于使用直接口服抗凝剂 (DOAC) 而非华法林。然而,伊拉克私营制药部门仍面临挑战。DOACs 的零售价格一直居高不下且不稳定,而且缺乏保险保障,导致自付费用(OOP)巨大。本研究旨在调查自付费用对 NVAF 患者坚持服用口服抗凝药(OAC)的影响:这项多中心横断面研究在 2022 年 12 月至 2023 年 2 月期间访问了在伊拉克南部地区三家私人心脏病诊所就诊的 359 名符合条件的患者。8项莫里斯基依从性量表评估了患者的依从性。统计分析包括描述性分析、方差分析和卡方检验:最常处方的 OAC 是 DOAC(62.8%)。患者对 OAC 的依从性主要处于中等水平(54.6%),OAC 类型不同,依从性也无显著差异。患者的依从性与月收入(p = 0.001)、每日服药次数(p = 0.006)和 OAC 的月平均费用(p = 0.011)有明显关系:解决与费用相关的不坚持使用 OACs 的问题需要采取多种措施。结论:要解决与费用相关的不坚持使用 OACs 的问题,需要采取多种措施,其中包括确保 OACs 的全面医疗保险覆盖范围、增加使用负担得起的非专利替代药物,以及在医疗服务提供者和患者之间建立有效的费用相关讨论。
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引用次数: 0
Assessing the economic impact of digital endpoints on medication adherence. 评估数字终点对坚持用药的经济影响。
IF 1.8 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 Epub Date: 2024-03-25 DOI: 10.1080/14737167.2024.2334893
Ahmad Z Al Meslamani, Nannan Li
{"title":"Assessing the economic impact of digital endpoints on medication adherence.","authors":"Ahmad Z Al Meslamani, Nannan Li","doi":"10.1080/14737167.2024.2334893","DOIUrl":"10.1080/14737167.2024.2334893","url":null,"abstract":"","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"783-785"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140193580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How can physicians improve medication adherence and outcomes in dermatological conditions? 医生如何提高皮肤病患者的用药依从性和疗效?
IF 1.8 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 Epub Date: 2024-06-24 DOI: 10.1080/14737167.2024.2370911
Jessica Q Duong, Ryan F Bloomquist, Steven R Feldman

Introduction: Medication non-adherence is a major contributor to suboptimal disease treatment across medical specialties and is a particular hurdle with topicals. While adherence is a patient behavior affected by many socioeconomic and health system factors, physicians can play an important role in encouraging good adherence.

Areas covered: We discuss methods for measuring adherence, including ethics of such research, provide select examples of dermatology-specific adherence studies, and conclude with physician-focused practices to improve patients' adherence. Articles were selected from a PubMed search spanning 2003 to 10 December 2023, using the following terms: 'dermatology,' 'medication,' 'treatment,' 'adherence,' 'compliance,' and 'intervention.'

Expert opinion: Poor adherence to treatment is a major cause of poor treatment outcomes. As the goal of medical care is to achieve successful treatment outcomes, encouraging good adherence may be as much a foundation of care as making the right diagnosis and prescribing the right treatment. Taking a doctor-centric perspective on reasons for non-adherence may be more productive than simply finding fault with the patient. Establishing trust and accountability is a foundation for good adherence; after establishing the provider-patient relationship, physicians can improve adherence by incorporating behavioral and counseling strategies, communicating through technology, and advocating for distribution of validated educational information.

导言:不遵医嘱用药是各专科疾病治疗效果不佳的主要原因,也是局部用药的一个特殊障碍。虽然用药依从性是一种受社会经济和医疗系统诸多因素影响的患者行为,但医生在鼓励良好的用药依从性方面可以发挥重要作用:我们讨论了测量依从性的方法,包括此类研究的伦理问题,提供了一些皮肤科依从性研究的实例,最后介绍了以医生为重点的提高患者依从性的方法。文章选自 2003 年至 2023 年 12 月 10 日的 PubMed 搜索,使用了以下术语:皮肤病学"、"药物"、"治疗"、"依从性"、"依从性 "和 "干预":治疗依从性差是导致治疗效果不佳的主要原因。医疗服务的目标是取得成功的治疗效果,因此,鼓励良好的依从性可能与做出正确的诊断和开出正确的治疗处方一样,都是医疗服务的基础。从以医生为中心的角度来看待不坚持治疗的原因,可能比简单地找病人的错更有成效。建立信任和责任感是良好依从性的基础;在建立医患关系后,医生可以通过纳入行为和咨询策略、通过技术交流以及倡导分发有效的教育信息来提高依从性。
{"title":"How can physicians improve medication adherence and outcomes in dermatological conditions?","authors":"Jessica Q Duong, Ryan F Bloomquist, Steven R Feldman","doi":"10.1080/14737167.2024.2370911","DOIUrl":"10.1080/14737167.2024.2370911","url":null,"abstract":"<p><strong>Introduction: </strong>Medication non-adherence is a major contributor to suboptimal disease treatment across medical specialties and is a particular hurdle with topicals. While adherence is a patient behavior affected by many socioeconomic and health system factors, physicians can play an important role in encouraging good adherence.</p><p><strong>Areas covered: </strong>We discuss methods for measuring adherence, including ethics of such research, provide select examples of dermatology-specific adherence studies, and conclude with physician-focused practices to improve patients' adherence. Articles were selected from a PubMed search spanning 2003 to 10 December 2023, using the following terms: 'dermatology,' 'medication,' 'treatment,' 'adherence,' 'compliance,' and 'intervention.'</p><p><strong>Expert opinion: </strong>Poor adherence to treatment is a major cause of poor treatment outcomes. As the goal of medical care is to achieve successful treatment outcomes, encouraging good adherence may be as much a foundation of care as making the right diagnosis and prescribing the right treatment. Taking a doctor-centric perspective on reasons for non-adherence may be more productive than simply finding fault with the patient. Establishing trust and accountability is a foundation for good adherence; after establishing the provider-patient relationship, physicians can improve adherence by incorporating behavioral and counseling strategies, communicating through technology, and advocating for distribution of validated educational information.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"799-806"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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