Effects of once-daily extended release quetiapine fumarate on patient-reported outcomes in patients with generalized anxiety disorder

Jean Endicott,1 Henrik Svedsäter,2 Julie C Locklear21Department of Psychiatry, Columbia University, New York, NY; 2AstraZeneca Pharmaceuticals, Wilmington, DE, USABackground: We evaluated the effects of once-daily extended-release quetiapine fumarate (quetiapine XR) on patient-reported outcomes in generalized anxiety disorder (GAD).Methods: This is a report of a pooled analysis from three acute 8-week, randomized, placebo-controlled, fixed-dose (50, 150, 300 mg/day) studies and a 52-week maintenance flexible dose (50–300 mg/day) study of quetiapine XR monotherapy in patients with GAD. Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) percent maximum total scores (items 1–14), item 15 ("satisfaction with medication"), item 16 ("overall life satisfaction"), and Pittsburgh Sleep Quality Index (PSQI) global scores are reported. Sheehan Disability Scale (SDS) total scores were also assessed (maintenance study only).Results: The acute studies showed significant improvements at week 8 in Q-LES-Q-SF percent maximum total score with quetiapine XR 150 mg/day (P < 0.001) and item 16 with quetiapine XR 50 (P < 0.05) and 150 mg/day (P < 0.001) versus placebo; PSQI global scores significantly improved with quetiapine XR 50, 150, and 300 mg/day versus placebo (P < 0.001). The maintenance study showed significant benefits versus placebo with quetiapine XR 50–300 mg/day in Q-LES-Q-SF percent total score, item 15 and item 16 scores, PSQI global score, and SDS total score.Conclusion: Quetiapine XR 150 mg/day (acute studies) and 50–300 mg/day (maintenance study) improved quality of life, overall functioning, and sleep quality in patients with GAD.Keywords: atypical antipsychotic, anxiety disorders, quality of life, sleep quality, functioning, randomized studie

Economic and humanistic burden of illness in generalized anxiety disorder: an analysis of patient survey data in Europe

Samira Toghanian,1 Marco DiBonaventura,2 Krister Järbrink,1 Julie C Locklear31AstraZeneca R&D, Mölndal, Sweden; 2Kantar Health, New York, NY, USA; 3AstraZeneca Pharmaceuticals, Wilmington, DE, USABackground: Whilst studies suggest that generalized anxiety disorder (GAD) represents a considerable health care burden in Europe, there is a paucity of published evidence. This study investigated the burden of illness associated with GAD across five European countries (France, Germany, Italy, Spain, and the UK).Methods: Information from the 2008 European National Health and Wellness Survey database was analyzed. Bivariate, multivariate, and cost analyses were used to compare patients with GAD and propensity-matched controls.Results: Compared with non-GAD controls, patients with GAD had more comorbidities and were more likely to smoke but less likely to be employed, use alcohol, or take exercise. They also had significantly worse health-related quality of life, and significantly greater work impairment and resource use, which increased as GAD severity increased. Within-country analyses demonstrated results similar to those for the five European countries overall, with the largest differences in resource use between patients with GAD and non-GAD controls documented in France and Germany. The average mean differences in direct costs were relatively small between the GAD groups and controls; however, indirect costs differed substantially. Costs were particularly high in Germany, mainly due to higher salaries leading to higher costs associated with absence from work. The limitation of this study was that the data were from a self-reported Internet survey, making them subject to reporting bias and possibly sample bias.Conclusion: Across all five European countries, GAD had a significant impact on work impairment, resource use, and economic costs, representing a considerable individual and financial burden that increased with severity of disease. These data may help us to understand better the burden and costs associated with GAD.Keywords: generalized anxiety disorder, Europe, economic burden, burden of illnes

Maternal health in Central America: The role of medicinal plants in the pregnancy-related health and well-being of indigenous women in Central America

Over the past 20 years, Central America (CA) has made considerable progress in improving the health status of its populations. However, in some countries, the overall health status remains below average with poor outcomes concentrated geographically among the poor and Indigenous populations. Although Indigenous people make up the second largest population in CA, these populations have less access to healthcare, and funding for initiatives to improve maternal health is scarce. In many communities across CA, women continue to rely heavily on plant-based medicines for health and well-being, and yet there is a paucity of information regarding the safety and efficacy of these therapies. Sourced from available academic, governmental, and gray literature, in both English and Spanish, this chapter reviews maternal health issues among the Indigenous, Ladino, and other ethnic women of CA, evaluates the role of traditional medicine practices and their influence on maternal health outcomes, and reviews the existing scientific evidence supporting the use of traditional (i.e., plant-based) medicines for pregnancy-related health conditions.UCR::Vicerrectoría de Docencia::Ciencias Básicas::Facultad de Ciencias::Escuela de QuímicaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigaciones en Productos Naturales (CIPRONA