A Framework for Applying Health Technology Assessment in Cyprus: Thoughts, Success Stories, and Recommendations

AbstractObjectivesHealth care decision making, assessment, and procurement of medicines is a complex, human resource–demanding, and time-consuming process. A thorough evaluation of all factors involved is necessary to optimize the process. The objective of this study was to describe and analyze the current stage of health technology assessment (HTA) in Cyprus.MethodsLiterature research and private communication with all involved parties and competent authority. Moreover, data, decisions, and recommendations of the Drug’s Committee were used.ResultsCyprus is a latecomer in this field. HTA has entered a growing phase after the 2007 reform. It has not reached its full potential, and the current state is applicable only to the public sector, because of the nonexistence of a national health system. Therefore, this poses both a great challenge and a great barrier considering maximization of the value of money spent and health access equity.ConclusionsThere is definitely enough space and clear necessity for further dissemination, and early successes indicate that steps should be taken toward the introduction of an HTA procedure that will cover both private and public sectors. The introduction of a national health system will further enhance the uptake of HTA, optimize the process, and use the common knowledge strategy for evidence-based decision making

Implementing shared-decision-making for diabetes care across country settings: what really matters to people?

Context: Growing evidence of improved clinical outcomes and patient/professional satisfaction supports shared-decision-making (SDM) services as an effective primary care interventions for diabetes. However, only a few countries have actually adopted them (e.g. England). In other European countries (e.g. Cyprus) there is awareness that patients play a crucial role in decision-making, and SDM services could be considered as innovative strategies to promote the actual implementation of patient rights legislation and strengthen primary care. Objective: to understand preferences of people with diabetes when choosing their care, and how they value alternative SDM services compared to their ‘current’ option. Preferences were collected from patients based in England, where SDM is already in place at national level, and Cyprus, where people are new to it, using a discrete-choice-experiment (DCE) survey. Results: Cypriots valued choosing alternative SDM services compared to their ‘current’ option, whereas the English preferred their status quo to other services. Having the primary-care-physician as healthcare provider, receiving compassionate care, receiving detailed and accurate information about their care, continuity of care, choosing their care management and treatment, and reduced waiting time were the SDM characteristics that Cypriots valued; the English preferred similar factors, apart from information/continuity of care. Conclusion: People with diabetes do value SDM and different SDM models may fit different groups according to their personal experience and country specific settings

Comparison of validation protocols for blood pressure measuring devices in children and adolescents

Accuracy of blood pressure (BP) measurement is important for the evaluation of hypertension in children and adolescents, and it is critically dependent upon the accuracy of the BP measuring device. A device that could pass validated protocols with reliable accuracy would be desirable in clinical and research settings. Several scientific organizations have published recommendations on the validation of different BP measuring devices. Most of them focus on adults but separate recommendations and validation criteria for BP devices intended for use in children and adolescents are included in some validation protocols. In this review, we compare the validation criteria for BP measuring devices among consensus documents from different scientific organizations focusing on the pediatric population and we discuss the evidence gaps targeting the needs for validated BP measuring devices in children and adolescents. We also highlight common pitfalls in the validation studies of BP measuring devices in children and adolescents using the example of office BP devices