The Best of Both Worlds : An Example Mixed Methods Approach to Understand Men’s Preferences for the Treatment of Lower Urinary Tract Symptoms

Funded by Astellas Pharma Europe and Chief Scientist Office DI, SH, VW and MR are employed by the University of Aberdeen and performed the research. CM and JN are employees of Astellas Pharma EMEA, which funded the study in an unrestricted contract. All authors were involved in writing or reviewing the manuscript. Ethical approval was obtained from the College Ethics Research Board of the College of Life Science and Medicine, University of Aberdeen (CERB/2013/8/942). The Health Economics Research Unit (HERU) is supported by the Chief Scientist Office (CSO) at the Scottish Government Health and Social Care Directorate.Peer reviewedPostprin

Men’s preferences for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia : a discrete choice experiment

HERU is supported by the Chief Scientist Office (CSO) at the Scottish Government Health and Social Care Directorate. Sebastian Heidenreich acknowledges financial support from the Institute of Applied Health Science, University of Aberdeen. Medical writing support was provided by Tyrone Daniel from Bioscript Medical, and was funded by Astellas Pharma Europe Ltd. Presented in part as a poster at the ISPOR 17th Annual European Congress, November 8–12, 2014, Amsterdam, The Netherlands. The poster’s abstract was published in Value in Health. 2014;17 (7):A472. Open Access JournalPeer reviewedPublisher PD

Effectiveness of the capsaicin 8% patch in the management of peripheral neuropathic pain in European clinical practice: the ASCEND study

Background In randomised studies, the capsaicin 8% patch has demonstrated effective pain relief in patients with peripheral neuropathic pain (PNP) arising from different aetiologies. Methods ASCEND was an open-label, non-interventional study of patients with non-diabetes-related PNP who received capsaicin 8% patch treatment, according to usual clinical practice, and were followed for ≤52 weeks. Co-primary endpoints were percentage change in the mean numeric pain rating scale (NPRS) ‘average daily pain’ score from baseline to the average of Weeks 2 and 8 following first treatment; and median time from first to second treatment. The primary analysis was intended to assess analgesic equivalence between post-herpetic neuralgia (PHN) and other PNP aetiologies. Health-related quality of life (HRQoL, using EQ-5D), Patient Global Impression of Change (PGIC) and tolerability were also assessed. Results Following first application, patients experienced a 26.6% (95% CI: 23.6, 29.62; n = 412) reduction in mean NPRS score from baseline to Weeks 2 and 8. Equivalence was demonstrated between PHN and the neuropathic back pain, post-operative and post-traumatic neuropathic pain and ‘other’ PNP aetiology subgroups. The median time from first to second treatment was 191 days (95% CI: 147, 235; n = 181). Forty-four percent of all patients were responders (≥30% reduction in NPRS score from baseline to Weeks 2 and 8) following first treatment, and 86.9% (n = 159/183) remained so at Week 12. A sustained pain response was observed until Week 52, with a 37.0% (95% CI: 31.3, 42.7; n = 176) reduction in mean NPRS score from baseline. Patients with the shortest duration of pain (0–0.72 years) experienced the highest pain response from baseline to Weeks 2 and 8. Mean EQ-5D index score improved by 0.199 utils (responders: 0.292 utils) from baseline to Week 2 and was maintained until Week 52. Most patients reported improvements in PGIC at Week 2 and at all follow-up assessments regardless of number of treatments received. Adverse events were primarily mild or moderate reversible application site reactions. Conclusion In European clinical practice, the capsaicin 8% patch provided effective and sustained pain relief, substantially improved HRQoL, improved overall health status and was generally well tolerated in a heterogeneous PNP population

Measuring collective action intention toward gender equality across cultures

Collective action is a powerful tool for social change and is fundamental to women and girls’ empowerment on a societal level. Collective action towards gender equality could be understood as intentional and conscious civic behaviors focused on social transformation, questioning power relations, and promoting gender equality through collective efforts. Various instruments to measure collective action intentions have been developed, but to our knowledge none of the published measures were subject to invariance testing. We introduce the gender equality collective action intention (GECAI) scale and examine its psychometric isomorphism and measurement invariance, using data from 60 countries (N = 31,686). Our findings indicate that partial scalar measurement invariance of the GECAI scale permits conditional comparisons of latent mean GECAI scores across countries. Moreover, this metric psychometric isomorphism of the GECAI means we can interpret scores at the country-level (i.e., as a group attribute) conceptually similar to individual attributes. Therefore, our findings add to the growing body of literature on gender based collective action by introducing a methodologically sound tool to measure collective action intentions towards gender equality across cultures

Measuring collective action intention toward gender equality across cultures

Collective action is a powerful tool for social change and is fundamental to women and girls’ empowerment on a societal level. Collective action towards gender equality could be understood as intentional and conscious civic behaviors focused on social transformation, questioning power relations, and promoting gender equality through collective efforts. Various instruments to measure collective action intentions have been developed, but to our knowledge none of the published measures were subject to invariance testing. We introduce the gender equality collective action intention (GECAI) scale and examine its psychometric isomorphism and measurement invariance, using data from 60 countries (N = 31,686). Our findings indicate that partial scalar measurement invariance of the GECAI scale permits conditional comparisons of latent mean GECAI scores across countries. Moreover, this metric psychometric isomorphism of the GECAI means we can interpret scores at the country-level (i.e., as a group attribute) conceptually similar to individual attributes. Therefore, our findings add to the growing body of literature on gender based collective action by introducing a methodologically sound tool to measure collective action intentions towards gender equality across cultures.info:eu-repo/semantics/acceptedVersio

Psychometric Properties and Correlates of Precarious Manhood Beliefs in 62 Nations

Precarious manhood beliefs portray manhood, relative to womanhood, as a social status that is hard to earn, easy to lose, and proven via public action. Here, we present cross-cultural data on a brief measure of precarious manhood beliefs (the Precarious Manhood Beliefs scale [PMB]) that covaries meaningfully with other cross-culturally validated gender ideologies and with country-level indices of gender equality and human development. Using data from university samples in 62 countries across 13 world regions (N = 33,417), we demonstrate: (1) the psychometric isomorphism of the PMB (i.e., its comparability in meaning and statistical properties across the individual and country levels); (2) the PMB’s distinctness from, and associations with, ambivalent sexism and ambivalence toward men; and (3) associations of the PMB with nation-level gender equality and human development. Findings are discussed in terms of their statistical and theoretical implications for understanding widely-held beliefs about the precariousness of the male gender role

Cost-Effectiveness of Capsaicin 8% Patch Compared with Pregabalin for the Treatment of Patients with Peripheral Neuropathic Pain in Scotland.

We evaluated the cost-effectiveness of capsaicin 8% patch (QUTENZA™) versus pregabalin in patients with PNP from the perspective of the National Health Service (NHS) and Personal and Social Services in Scotland, UK. A decision-tree cost-effectiveness model was developed for non-diabetic patients with peripheral neuropathic pain (PNP) who were pregabalin-naïve and had not achieved adequate pain relief or tolerated conventional first- or second-line treatments. Patients entering the model received either a single application of capsaicin 8% patch or titrated daily dosing with pregabalin; after 8 weeks patients were classified as responders, non-responders, or were assumed to discontinue treatment due to intolerable adverse events. Responders continued to receive baseline treatment at intervals observed in clinical practice. Non-responders and those who discontinued treatment were assumed to receive last-line therapy (duloxetine). The base-case time horizon was 2 years. Model inputs for effectiveness, discontinuations and health-state utilities were taken from a head-to-head non-inferiority study (ELEVATE, NCT01713426). Other inputs were obtained from published sources or clinical expert opinion. Costs were expressed in GBP 2013/14. Results were presented as incremental cost-effectiveness ratios (ICER), i.e. cost per quality-adjusted life-year (QALY) gained. Model assumptions were tested with scenario analyses. Parameter uncertainty was tested using one-way and probabilistic sensitivity analyses. Compared with dose-optimized pregabalin, capsaicin 8% patch was the dominant treatment strategy (total cost difference, -£11; total QALY gain, 0.049). Capsaicin 8% patch was also the dominant treatment strategy versus pregabalin in 6 out of 7 scenario analyses. The model was most sensitive to variation in time to capsaicin 8% patch retreatment (maximum ICER, £7,951/QALY at lower-bound 95% confidence interval). At a willingness-to-pay threshold of £20,000/QALY, the probability of capsaicin 8% patch being cost-effective versus pregabalin was 97%. Capsaicin 8% patch is a cost-effective treatment option compared with dose-optimized pregabalin in patients with PNP who have failed one or more previous systemic treatments

Cost-effectiveness of solifenacin compared with oral antimuscarinic agents for the treatment of patients with overactive bladder in the UK

Objective: To evaluate the cost-effectiveness of solifenacin 5 mg/day versus other oral antimuscarinic agents used for overactive bladder (OAB) from a UK National Health Service (NHS) perspective. Study design: In a Markov model, hypothetical patients received solifenacin 5 mg/day or a comparator antimuscarinic, after which they could switch to an alternative antimuscarinic. The model estimated incremental cost-effectiveness ratios (ICER), expressed as cost per quality-adjusted life year (QALY) over a 5-year period. Results: Solifenacin 5 mg/day was the dominant treatment strategy (i.e., less costly and more effective) versus tolterodine extended-release (ER) 4 mg/day, fesoterodine 4 and 8 mg/day, oxybutynin ER 10 mg/day and solifenacin 10 mg/day, and was cost-effective (i.e., ICERs below the £30,000 per QALY threshold generally applied in the NHS) versus oxybutynin immediate release (IR) 10 mg/day, tolterodine IR 4 mg/day and trospium chloride 60 mg/day. The probability of solifenacin 5 mg/day being dominant/cost-effective at a willingness-to-pay threshold of £30,000 per QALY was 57–98%. Conclusions: Solifenacin 5 mg/day appears to be a cost-effective strategy for the treatment of OAB over a 5-year timeframe compared with other oral antimuscarinic agents in the UK. These findings are important for decision-makers considering the economic implications of selecting treatments for OAB

Model inputs: efficacy and utilities.

<p>Model inputs: efficacy and utilities.</p