Economic burden of medication-overuse headache in Iran: direct and indirect costs

Background and objective: Medication-overuse headache (MOH) as a secondary chronic headache imposes a considerable burden on both individuals and societies. Nevertheless, little is known about the burden of MOH in Iran. Therefore, in the current study, we aimed to quantify the annual cost of MOH among Iranian patients. Methods: In this cross-sectional study, 84 patients were recruited. Demographic data, headache attack characteristics, related disability, and information about the economic burden of MOH were collected through face-to-face interview. Direct medical and nonmedical costs as well as indirect costs were included in our cost analysis. The prevalence-based approach was applied to estimate the economic burden of MOH. Results: We found that MOH patients in Iran spend averagely 1046 for medical services, 132 for nonmedical services, and 1432 due to lost productivity per year. The per-person annual cost of MOH was US2610, and the total annual cost for Iran was 10,179,000,000, with direct and indirect cost accounting for 45 and 55, respectively. Conclusion: MOH leads to substantial healthcare costs and significant loss of productivity in Iran. Therefore, raising awareness in this area especially for policymakers can use in future health planning and lead to resource allocation in the field of disabling type of headache disorders such as MOH. Our findings also provide a different insight into the burden of MOH, which are likely closer to the actual costs in middle- and low-income countries, and also it could be a sample of such a study in western Asia. © 2020, Fondazione Società Italiana di Neurologia

A survey on students\' attitude toward teachers’ educational characteristics in Birjand University of Medical Sciences in 2014

Introduction : In universities of medical sciences, teachers are known as key elements in education and research . Therefore, evaluating performance is the best way to quality control academic members in a medical educational system. The current study aimed to investigate students' attitudes towards current teaching characteristics of teachers in Birjand University of Medical Sciences . Method: Using a standard electronic questionnaire, the attitude of the students was assessed toward their teachers’ characteristics and teaching . Then, the final semester exams and the total average scores of the students was automatically called from the university database and loaded in learning management system’s database. The data was analyzed using T-test and analysis of covariance. Results: From seven different faculties, a total of 827 participants enrolled into this study. The average score of the students’ attitude towards teaching of their teachers was 4.16 out of 5, showing a high satisfaction of the students regarding instructional elements of their teachers’ characteristics . The faculty of emergency medicine had the highest mid and highest average of satisfaction based on the students’ attitude among other faculties. Also, there was a significant difference between male and females regarding their attitudes’ scores (P<0.05). Conclusions: Teachers’ evaluation provides a background for competition, selecting superior teachers from student perspective and also helping students for choosing their teachers in next years' courses. Teacher evaluation should not be only restricted to students attitudes’ scores. It is expected to provide various protocols in order to bring teachers’ evaluation scores into reality

Assessment of Utility in Migraine: Mapping the Migraine-Specific Questionnaire to the EQ-5D-5L

Introduction: There are increasing demands for studies of cost-effectiveness to allocate resources for disease prevention and treatment strategies. The aim of this study is to measure quality of life in migraineurs, based on the Migraine-Specific Questionnaire (MSQ) and EQ-5D-5L, and thereafter map an algorithm to estimate health-state utility values from the MSQ in individuals with migraine. Methods: In this cross-sectional study conducted between May and July 2018 in a tertiary headache clinic in Tehran, Iran, migraineurs diagnosed based on International Classification of Headache Disorders (ICHD)-3β were enrolled and were asked to complete the MSQ questionnaire and EQ-5D questionnaire. The Spearman correlation coefficient (�) was calculated to measure the correlation between the EQ-5D-5L and MSQ v2.1 domains� score. A P value of &lt;.05 was considered statistically significant. After statistical analysis, several regression models were presented to map the results of the MSQ domains to the utility index, and the preferred model was achieved based on goodness of fit and the model's predictive performance. Results: The preferred MSQ algorithm had approximately the same prediction errors in all migraineurs, episodic and chronic migraine (root mean square error 0.24, 0.24, and 0.23, respectively). The preferred MSQ model explained a variance of 0.26 (R2) in episodic and 0.38 in chronic migraine in the EQ-5D-5L questionnaire. Conclusion: The preferred MSQ mapping algorithm will be suitable in estimating health state utilities in trials of patients with migraine that contain MSQ scores but lack utility values. © 202