The direct costs of drug-induced skin reactions

Objective The aim of the study was an assessment of direct costs of patients hospitalised for for skin adverse drug reactions during 2002–2012 in the Department of Dermatology at the Military Institute of Medicine (Ministry of Defence) in Warsaw. The analysis was carried out from the perspectives of the public payer and service provider. Material and Methods The retrospective study was carried out in a group of 164 adult patients due to skin adverse drug reactions. Analysis was based on data from patient medical records and medical orders which provided information on the used resources, including diagnostic tests, medical consultations, medicinal products, hospitalisation duration, together with cost estimation, regardless of the treatment being the cause of the skin reaction. Results According to the International Statistical Classification of Diseases and Related Health Problems(ICD) diagnosis and scores, assigned by the National Healthcare Fund, it has been estimated that patient hospitalisation at the Department of Dermatology for skin drug reaction incurred costs at the average amount of €717.00 per patient. The complex diagnostics and pharmacotherapy of the same group of patients generated costs for the hospital at the average amount of €680 per patient. Conclusions As a result of the analysis, the therapy for skin adverse drug effects generates significant costs, both for the payer and the service provider. Since the costs are comparable, it seems that the pricing of medical procedures by the public payer is adequate for the costs incurred by the medical service provider

Hair loss impact on quality of life of patients with oncological diseases – pilot study

In oncological treatment hair loss is one of the adverse events related to the use of cytostatic drugs. Hair loss is a problem that to affects people’s well-being and quality of life. The aim of the study was to check the impact of hair loss in those patients who alopecia induced by cytotoxic drug therapy. The study performed from March to April 2018, and it was focused on the adult population of oncological patients who developed alopecia during oncological chemotherapy The study was conducted among 25 people. For that purpose a self – designed two questionnaires were developed: one concerning the quality of life and the other – the Hair Loss Impact Vignette (HLIV) and validated through the study. Hair loss in men has little or no effect on shopping, housework and sports, while in women it only affects housework. Both in case of women and men, it has a very strong influence on social life, perception in the environment and contacts with partners, family and friends. The quality of life related to hair loss was the overall result was -0,74 and it is considered as a low. 78,9% of the interviewed women strongly agreed that losing their hair negatively affects their social life or leisure time activities. Both women and men in the vast majority of respondents declared feeling discomfort and depression in connection with the hair loss. Most of the surveyed women believe that the loss of eyebrows and eyelashes is as negative an experience as the loss of the hair on the head. For the majority of men surveyed, the scalp hair is more important than the eyebrows and eyelashes. The study shows that hair loss in the course of cancer therapy with cytotoxic drugs has the greatest impact on the quality of life in relation to the social functioning and social activities, however does not significantly affect the individual activities. The pilot study for HLIV vignette validation confirms that the tool is appropriate for use to assess the impact of the hair loss on patients’ daily activities

SCHIZOPHRENIA CAUSES SIGNIFICANT BURDEN TO PATIENTS’ AND CAREGIVERS’ LIVES

Background: Schizophrenia is a serious public health problem and is ranked among the most disabling diseases in the world. The sub-study presented here was part of a larger project to characterize the burden of schizophrenia on healthcare systems and on individuals living with the disease in Central and Eastern Europe (CEE). Aims: This sub-study aimed to assess and analyze the impact of schizophrenia on many aspects of the lives of patients and caregivers. Methods: Psychiatrists from selected centers in seven Central and Eastern European countries were asked to complete a questionnaire in order to collect information about the disease history, characteristics, treatment protocols and resources used for each randomly selected patient. All data were statistically analyzed and compared between countries. Results: Data from 961 patients with schizophrenia (mean age 40.7 years, 45.1% female) were included in the analysis. The mean number of days spent in hospital per patient per year across all seven countries was 25.3 days. Hospitalization occurred on average once per year, with psychiatrist visits 9.4 times per year. Of the patients in the study, 61% were single, 12% divorced and 22% married or cohabiting. Almost 84% were living with relatives or a partner; only 17% lived alone and, on average, 25% of patients received support from social workers. Relatives provided care for approximately 60% of patients and 4% of them had to stop working in order to do so. Twenty-nine percent of the patients were unemployed, and 56% received a disability pension or were retired, with only 19% in full-time employment or education. Conclusion: Schizophrenia has a significant effect on the lives of patients and caregivers and impacts their social integration

Epidemiology and Treatment Guidelines of Negative Symptoms in Schizo-phrenia in Central and Eastern Europe: A Literature Review

AIM: To gather and review data describing the epidemiology of schizophrenia and clinical guidelines for schizophrenia therapy in seven Central and Eastern European countries, with a focus on negative symptoms. Methods : A literature search was conducted which included publications from 1995 to 2012 that were indexed in key databases. Results : Reports of mean annual incidence of schizophrenia varied greatly, from 0.04 to 0.58 per 1,000 population. Lifetime prevalence varied from 0.4% to 1.4%. One study reported that at least one negative symptom was present in 57.6% of patients with schizophrenia and in 50-90% of individuals experiencing their first episode of schizophrenia. Primary negative symptoms were observed in 10-30% of patients. Mortality in patients with schizophrenia was greater than in the general population, with a standardized mortality ratio of 2.58-4.30. Reasons for higher risk of mortality in the schizophrenia population included increased suicide risk, effect of schizophrenia on lifestyle and environment, and presence of comorbidities. Clinical guidelines overall supported the use of second-generation antipsychotics in managing negative symptoms of schizophrenia, although improved therapeutic approaches are needed. Conclusion : Schizophrenia is one of the most common mental illnesses and poses a considerable burden on patients and healthcare resources alike. Negative symptoms are present in many patients and there is an unmet need to improve treatment offerings for negative symptoms beyond the use of second-generation antipsychotics and overall patient outcomes

Real world data supporting identification of the pharmacist’s role in obesity and overweight treatment in Poland – a preliminary report

Introduction. Obesity is a significant health and economic problem, both for the patient and the health care system. An essential element in the prevention and treatment of each disease is the engagement of all groups of healthcare professionals. In our study, we performed an analysis of the real world data, obtained from a survey of the medical and socioeconomic problems associated with overweight and obesity. We aimed to identify the pharmacist’s role in the management of overweight and obese patients, including their individualized education in an outpatient setting. Material and methods. The study material consisted of responses obtained from a specially designed questionnaire. Our findings indicate that the study patients had easy access to a pharmacist’s professional knowledge, relevant to comprehensive treatment of obesity. In addition, our data indicates a lack of patient knowledge of a healthy lifestyle and an inability to implement such knowledge in practice. Results. The community pharmacist should actively provide support to patients with obesity (including the primary obesity and those who want to lose excessive body mass for health-related and also for aesthetic reasons) and the management of their weight. The results of our study should be considered as an introduction to further research to facilitate the understanding of problems and expectations of patients and to prepare pharmacists to perform pharmaceutical care (PC) in this regard. Conclusion. One of the potential options to protect society against the obesity epidemic is an education about the risks inherent to obesity and promotion of a healthy lifestyle

The direct costs of drug-induced skin reactions

Objective The aim of the study was an assessment of direct costs of patients hospitalised for for skin adverse drug reactions during 2002–2012 in the Department of Dermatology at the Military Institute of Medicine (Ministry of Defence) in Warsaw. The analysis was carried out from the perspectives of the public payer and service provider. Material and Methods The retrospective study was carried out in a group of 164 adult patients due to skin adverse drug reactions. Analysis was based on data from patient medical records and medical orders which provided information on the used resources, including diagnostic tests, medical consultations, medicinal products, hospitalisation duration, together with cost estimation, regardless of the treatment being the cause of the skin reaction. Results According to the International Statistical Classification of Diseases and Related Health Problems(ICD) diagnosis and scores, assigned by the National Healthcare Fund, it has been estimated that patient hospitalisation at the Department of Dermatology for skin drug reaction incurred costs at the average amount of €717.00 per patient. The complex diagnostics and pharmacotherapy of the same group of patients generated costs for the hospital at the average amount of €680 per patient. Conclusions As a result of the analysis, the therapy for skin adverse drug effects generates significant costs, both for the payer and the service provider. Since the costs are comparable, it seems that the pricing of medical procedures by the public payer is adequate for the costs incurred by the medical service provider