Academic literature on the topic 'High cost medications'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the lists of relevant articles, books, theses, conference reports, and other scholarly sources on the topic 'High cost medications.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Journal articles on the topic "High cost medications"
1
Gipson, Gregory, Janet L. Kelly, Christy M. McKinney, and Andrew A. White. "Optimizing Prescribing Practices of High-Cost Medications With Computerized Alerts in the Inpatient Setting." American Journal of Medical Quality 32, no. 3 (May 16, 2016): 278–84. http://dx.doi.org/10.1177/1062860616649660.
Full textAbstract:
Current literature does not consistently show a benefit to providing medication cost information to inpatient health care prescribers. This study assessed the effectiveness of computerized provider order entry alerts that displayed the cost of a high-cost medication alongside a lower cost alternative, targeting 3 high-cost medications. Medication utilization during the one year prior to the intervention was compared to usage in the year after implementation. Reduced utilization of high-cost medications was found when comparing pre to post. Ipratropium hydrofluoroalkane and fluticasone hydrofluoroalkane metered dose inhaler utilization were reduced by 29% and 62%, respectively ( P < .001 for both). A 71% decrease in intravenous chlorothiazide was observed ( P < .001); however, its effect was unable to be separated from implementation of a heart failure diuretic protocol during the study period. Overall, these results suggest computerized medication cost alerts that recommend a lower cost therapeutic alternative are effective in changing prescribing practices.
2
Hlatky, Mark A. "Willingness to Pay for High-Cost Medications." Circulation 141, no. 15 (April 14, 2020): 1225–26. http://dx.doi.org/10.1161/circulationaha.120.045966.
Full text
3
Monsen, Craig B., Joshua M. Liao, Barak Gaster, Kevin J. Flynn, and Thomas H. Payne. "The effect of medication cost transparency alerts on prescriber behavior." Journal of the American Medical Informatics Association 26, no. 10 (April 11, 2019): 920–27. http://dx.doi.org/10.1093/jamia/ocz025.
Full textAbstract:
Abstract Objective The purpose of this study was to determine if medication cost transparency alerts provided at time of prescribing led ambulatory prescribers to reduce their use of low-value medications. Materials and Methods Provider-level alerts were deployed to ambulatory practices of a single health system from February 2018 through April 2018. Practice sites included 58 primary care and 152 specialty care clinics totaling 1896 attending physicians, residents, and advanced practice nurses throughout western Washington. Prescribers in the randomly assigned intervention arm received a computerized alert whenever they ordered a medication among 4 high-cost medication classes. For each class, a lower cost, equally effective, and safe alternative was available. The primary outcome was the change in prescribing volume for each of the 4 selected medication classes during the 12-week intervention period relative to a prior 24-week baseline. Results A total of 15 456 prescriptions for high-cost medications were written during the baseline period including 7223 in the intervention arm and 8233 in the control arm. During the intervention period, a decrease in daily prescribing volume was noted for all high-cost medications including 33% for clobetasol propionate (p < .0001), 59% for doxycycline hyclate (p < .0001), 43% for fluoxetine tablets (p < .0001), and a non-significant 3% decrease for high-cost triptans (p = .65). Prescribing volume for the high-cost medications overall decreased by 32% (p < .0001). Conclusion Medication cost transparency alerts in an ambulatory setting lead to more cost-conscious prescribing. Future work is needed to predict which alerts will be most effective.
4
Stern, Craig. "Specialty Pharmaceuticals – Utilization Management." Journal of Contemporary Pharmacy Practice 64, no. 3 (September 1, 2017): 15–23. http://dx.doi.org/10.37901/jcphp16-00011.
Full textAbstract:
Specialty medications are complicated, treat complicated diseases, and are costly. Yet, even if their cost was to be decreased by 50%, many of the specialty medications would still be too costly either with high copays, or be unaffordable under any circumstance. Hence the use and oversight of Specialty medications is more complex than just cost: effectiveness, risk and cost must be evaluated concurrently. Utilization is actually the great multiplier. No matter the individual cost of a medication, uncontrolled expansion of medication use leads to more drugs, and therefore, higher drug spend. Utilization management of Specialty medications is, thus, a multifactorial process that is as important as cost management. Human Insulin was the first of the so-called “Specialty Medication.” Specialty treatments followed for orphan and previously untreated diseases. Treatments for chronic diseases followed where Specialty medications replaced older small molecules. The major complication was that the cost of these new treatments rivals, and often exceeds, acute care hospital stays. Unfortunately, evidence has not always matched the comparative benefits of Specialty medications over their small molecule counterparts. As a result, the explosion of new Specialty medications has also stimulated the need for strong evidence that these medications are significant improvements over prior therapies. If so, how can they be affordable? Utilization management of Specialty medications shares many of the same elements that have been used for decades to monitor and manage all treatments; namely, prior authorization, drug utilization review, step therapy, and quantity limits. This paper will examine the approach to utilization management of Specialty medications with the goals of providing a template for providers to participate in this management as well as to understand the metrics applied when these medications are submitted for payment.
5
Cinar, Pelin, Tracy Lin, and Kevin Rodondi. "Best practice alert and cost transparency information for high cost oncology medications." Journal of Clinical Oncology 36, no. 30_suppl (October 20, 2018): 323. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.323.
Full textAbstract:
323 Background: Oncology medication cost is often absent from therapy decision process until issues arise with payer denial resulting in potential patient financial toxicity. To incorporate cost, Best Practice Alert (BPA) and Cost Transparency Information (CTI) for high cost oncology medication (HCOM) were implemented into prescribing platform as care coordination tools. Methods: Ten HCOM were identified in gastrointestinal (GI) and breast oncology groups for which BPA and CTI were developed. Over a 6 month period, HCOM prescriptions triggered BPAs to alert providers and to place automated referrals to social work (SW). CTI – with drug costs and comparable treatment plan(s) – were posted in prescribing platform. Descriptive analyses examined differences in total payment to hospital and patients out-of-pocket payments (OPP) between treatment plans. Pre- and post-intervention surveys evaluated oncologists’ perception and behavior toward treatment cost. Results: The analysis included 162 patients and 1406 medication claims. In the GI group, BPAs effectively identified treatments incurring higher mean total payment (diff = 46733, p < 0.001) and higher mean OPP (diff = 115, p < 0.001). For the breast group, the impact was mixed. BPAs identified treatments with higher total payment at the 90% quantile (p < 0.001) and higher mean total payment (diff = 72612, p < 0.001), but there was no statistically significant difference in OPP between treatments. Pre-intervention survey (n = 26, 50% response rate) indicated 46% of oncologists rarely discuss medication cost with patients and 35% rarely refer patients to SW. Only 4% of oncologists strongly agreed that they could easily acquire cost information. Post-intervention survey highlighted that CTI improved oncologists’ awareness of medication costs, but BPA exerted no substantial influence on provider behaviors. Conclusions: BPA intervention effectively highlighted treatment cost and accurately identified patients at risk for financial toxicity. The lack of statistically significant difference in oncologists’ behavior and perception may be due to a small sample size. Comments from providers suggest that BPA combined with OPP would be more useful in reducing financial toxicity.
6
Hammond, Drayton A., Tiffany Chiu, Jacob T. Painter, and Nikhil Meena. "Nonpharmacist Health Care Providers’ Knowledge of and Opinions Regarding Medication Costs in Critically Ill Patients." Hospital Pharmacy 53, no. 3 (November 6, 2017): 188–93. http://dx.doi.org/10.1177/0018578717739005.
Full textAbstract:
Purpose: Medication cost is frequently overlooked when treating critically ill patients. Stewardship of health care resources in high-utilization settings is imperative. This study was conducted to determine nonpharmacist health care providers’ knowledge and perceptions of medication costs in a medical intensive care unit (MICU). Methods: Nonpharmacist health care providers in a MICU completed a 27-item survey. The survey queried perceptions regarding medication cost, cost-limiting strategies, and most/least expensive medications in 8 classes, medication price ranges, and intravenous-to-oral comparisons for commonly prescribed medications. Responses were analyzed using descriptive statistics and compared between providers using Fisher exact tests. Results: Among 98 health care providers (76 medical trainees, 5 attending physicians, 17 nurses), when ordering a medication, 49% consider its cost. Few (15%) providers considered themselves knowledgeable regarding medication costs with no difference between providers ( P = .174). Attending physicians were more aware of the most/least expensive medications than residents (correct out of 16: 9.6 vs 8.5, P = .044). The correct price ranges for select medications (11%-36%, P = .373) and intravenous-to-oral relative costs (3%-49%, P = .596) were similarly low. Most (59%) believed pharmacists limit expensive medication use, particularly senior physicians (58% resident vs 100% attending, P = .007). Conclusion: In spite of a goal of cost consideration, most nonpharmacist health care providers are unaware of medication costs and fail to include them in decision making. These knowledge gaps and perceptions should inform future efforts to improve knowledge and attitudes regarding medication costs.
7
Fox, Erin R., and Linda S. Tyler. "Potential Association between Drug Shortages and High-Cost Medications." Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy 37, no. 1 (November 28, 2016): 36–42. http://dx.doi.org/10.1002/phar.1861.
Full text
8
Gleason, Patrick, Catherine I. Starner, Brent W. Gunderson, Jeremy A. Schafer, and H. Scott Sarran. "Association of Prescription Abandonment with Cost Share for High-Cost Specialty Pharmacy Medications." Journal of Managed Care Pharmacy 15, no. 8 (October 2009): 648–58. http://dx.doi.org/10.18553/jmcp.2009.15.8.648.
Full text
9
Zhang, Yichen, Haishaerjiang Wushouer, Sheng Han, Mengyuan Fu, Xiaodong Guan, Luwen Shi, and Anita Wagner. "The impacts of government reimbursement negotiation on targeted anticancer medication price, volume and spending in China." BMJ Global Health 6, no. 7 (July 2021): e006196. http://dx.doi.org/10.1136/bmjgh-2021-006196.
Full textAbstract:
IntroductionNew targeted therapies have changed cancer treatment in the past decades. However, high prices of targeted anticancer medications have increased economic burden for both patients and health insurance systems. In July 2017, China implemented combined medication price negotiation and mandatory reimbursement policies for 15 targeted anticancer medications. This study assesses effects of the policy on hospital procurement prices, volumes and spending.MethodsUsing a quasi-experimental interrupted time series design, we analysed procurement data from the Chinese Medical Economic Information of 789 public hospitals in 30 provinces between January 2016 and September 2018. The intervention group consisted of 15 targeted anticancer medications with negotiated prices in 2017. The comparison group consisted of six targeted anticancer medications without negotiated prices by 2018. The effective date of the policy was September 2017.ResultsAfter the implementation of the 2017 medication price negotiation and reimbursement policy, cost per defined daily dose (DDD) of the 15 targeted anticancer medications dropped US$71.21 on average from an average US$169.24/DDD before (p=0.000). Compared with what would have happened without the intervention, cost/DDD of price-negotiated medications decreased by 48.9% (p=0.000), procurement volumes increased by 143.0% (p=0.000) and hospital medication spending decreased by 6.9% (p=0.146).ConclusionsThe 2017 medication price negotiation and reimbursement policy decreased targeted medication procurement costs per DDD, increased volumes procured and at least temporarily contained spending. These changes should result in better access to and affordability of targeted anticancer medications in China.
10
Jackson, Kristy, and Milap C. Nahata. "Rising Cost of Anticancer Medications in the United States." Annals of Pharmacotherapy 51, no. 8 (March 24, 2017): 706–10. http://dx.doi.org/10.1177/1060028017702406.
Full textAbstract:
With more than 1.6 million new cases of cancer occurring each year, anticancer medications are in high demand. Escalating prescription drug prices have become a significant concern. Anticancer medications are among the most expensive prescription medications, many of them exceeding $100 000 a year. The survival benefits of certain newer anticancer medications may be a few months more than that from the existing treatment but at a much higher price tag. Drug cost may play a substantial role in making treatment choices. Multiple factors leading to high prices and some potential solutions to lower them have been highlighted.
Dissertations / Theses on the topic "High cost medications"
1
Gallego, Gisselle. "Access to High Cost Medicines in Australian Hospitals." Thesis, The University of Sydney, 2006. http://hdl.handle.net/2123/1008.
Full textAbstract:
In the public hospital sector in Australia there is no dedicated scheme to offset costs associated with high cost medications (HCMs) to the institution or the public. (1) Concerns exist as to the equity of access and appropriate mechanisms to manage access to HCMs in public hospitals. (2) There are gaps in the literature as to how decisions are made, and in particular, decision-making processes by which ethical, clinical and economic considerations maybe taken into account. To date, limited work has been conducted regarding the use and funding of HCMs in public hospitals. There are no published data on perceptions, concerns and attitudes, among health care decision-makers or among the community-at-large about access to HCMs in public hospitals. The research reported in this thesis describes the decision-making process and criteria used by health care decision-makers to allocate resources to HCMs in public hospitals. The investigation triangulated quantitative and qualitative methods used to collect and analyse data. Four studies were conducted to describe the decision-making process and explore the perceptions, concerns and attitudes of health care decision-makers and the perceptions of members of the general public regarding access to HCMs in public hospitals. The first study, reported in Chapter Three, was a review of individual patient use (IPU) requests for non-formulary HCMs. This study showed that these requests had a significant impact on the capped expenditure of a public hospital. Subsequent to this review, a new policy and procedure for managing requests for HCMs for IPU was established. A high-cost drugs subcommittee (HCD-SC) operating under the auspices of the Drug and Therapeutics Committee (DTC) was created. The second study, reported in Chapter Four, described the operations of the newly formed HCD-SC. This study also evaluated the decision-making process using the ethical framework “accountability for reasonableness”. (3) Different factors were involved in decisions about access to HCMs and decisions were not solely based on effectiveness and cost. HCD-SC members considered it was important to have consistency in the way decisions were being made. The evaluation of this process allowed identification of good practices and gaps which were considered as opportunities for improvement. The third study, reported in Chapter Five, found that health care decision-makers in an Area Health Service echoed the concerns and agreed about the problems associated with access to HCMs expressed by the HCD-SC members. These studies concluded that the majority of decision-makers wanted an explicit, systematic process to allocate resources to HCMs. These studies also identified tensions between funding systems and hospital decision-making. According to participants there were no mechanisms in place to systematically capture, analyse and share the lessons learned between the macro level (ie. Federal, Pharmaceutical Benefits Scheme - PBS) and the meso level (ie. Institution, public hospital) regarding funding for HCMs. Furthermore, decision-makers considered there are strong incentives for cost-shifting between the Commonwealth and the States. Health care decision-makers also acknowledged the importance of public participation in decision-making regarding allocation of resources to HCMs in public hospitals. However the results of these studies showed that those decisions were not generally made in consultation with the community. Decision-makers perceived that the general public does not have good general knowledge about access to HCMs in public hospitals. A survey of members of the general public, reported in Chapter Six, was then conducted. The survey aimed to gather information about the knowledge and views of members of the general public about access to HCMs in public hospitals. Results of this fourth study showed that respondents had good general knowledge but were poorly informed about the specifics of funding of hospitals and HCMs in private and public hospitals. The results also offered support for the development of a process to involve community members in discussion on policy on the provision of treatment and services within health care institutions and specifically, to seek the views of members of the public on the provision of HCMs and expensive services within public hospitals. In summary, the research reported in this thesis has addressed the gaps in the literature as to how decisions are made, and in particular, the decision-making process and criteria used by health care decision-makers to allocate resources to HCMs in public hospitals. In a move towards more explicitness in decision-making regarding the allocation of scarce health care resources, the findings from these studies provide an evidence base for developing strategies to improve decision-making processes regarding access to HCMs the public sector.
2
Gallego, Gisselle. "Access to High Cost Medicines in Australian Hospitals." University of Sydney, 2006. http://hdl.handle.net/2123/1008.
Full textAbstract:
Doctor of Philosophy(PhD)In the public hospital sector in Australia there is no dedicated scheme to offset costs associated with high cost medications (HCMs) to the institution or the public. (1) Concerns exist as to the equity of access and appropriate mechanisms to manage access to HCMs in public hospitals. (2) There are gaps in the literature as to how decisions are made, and in particular, decision-making processes by which ethical, clinical and economic considerations maybe taken into account. To date, limited work has been conducted regarding the use and funding of HCMs in public hospitals. There are no published data on perceptions, concerns and attitudes, among health care decision-makers or among the community-at-large about access to HCMs in public hospitals. The research reported in this thesis describes the decision-making process and criteria used by health care decision-makers to allocate resources to HCMs in public hospitals. The investigation triangulated quantitative and qualitative methods used to collect and analyse data. Four studies were conducted to describe the decision-making process and explore the perceptions, concerns and attitudes of health care decision-makers and the perceptions of members of the general public regarding access to HCMs in public hospitals. The first study, reported in Chapter Three, was a review of individual patient use (IPU) requests for non-formulary HCMs. This study showed that these requests had a significant impact on the capped expenditure of a public hospital. Subsequent to this review, a new policy and procedure for managing requests for HCMs for IPU was established. A high-cost drugs subcommittee (HCD-SC) operating under the auspices of the Drug and Therapeutics Committee (DTC) was created. The second study, reported in Chapter Four, described the operations of the newly formed HCD-SC. This study also evaluated the decision-making process using the ethical framework “accountability for reasonableness”. (3) Different factors were involved in decisions about access to HCMs and decisions were not solely based on effectiveness and cost. HCD-SC members considered it was important to have consistency in the way decisions were being made. The evaluation of this process allowed identification of good practices and gaps which were considered as opportunities for improvement. The third study, reported in Chapter Five, found that health care decision-makers in an Area Health Service echoed the concerns and agreed about the problems associated with access to HCMs expressed by the HCD-SC members. These studies concluded that the majority of decision-makers wanted an explicit, systematic process to allocate resources to HCMs. These studies also identified tensions between funding systems and hospital decision-making. According to participants there were no mechanisms in place to systematically capture, analyse and share the lessons learned between the macro level (ie. Federal, Pharmaceutical Benefits Scheme - PBS) and the meso level (ie. Institution, public hospital) regarding funding for HCMs. Furthermore, decision-makers considered there are strong incentives for cost-shifting between the Commonwealth and the States. Health care decision-makers also acknowledged the importance of public participation in decision-making regarding allocation of resources to HCMs in public hospitals. However the results of these studies showed that those decisions were not generally made in consultation with the community. Decision-makers perceived that the general public does not have good general knowledge about access to HCMs in public hospitals. A survey of members of the general public, reported in Chapter Six, was then conducted. The survey aimed to gather information about the knowledge and views of members of the general public about access to HCMs in public hospitals. Results of this fourth study showed that respondents had good general knowledge but were poorly informed about the specifics of funding of hospitals and HCMs in private and public hospitals. The results also offered support for the development of a process to involve community members in discussion on policy on the provision of treatment and services within health care institutions and specifically, to seek the views of members of the public on the provision of HCMs and expensive services within public hospitals. In summary, the research reported in this thesis has addressed the gaps in the literature as to how decisions are made, and in particular, the decision-making process and criteria used by health care decision-makers to allocate resources to HCMs in public hospitals. In a move towards more explicitness in decision-making regarding the allocation of scarce health care resources, the findings from these studies provide an evidence base for developing strategies to improve decision-making processes regarding access to HCMs the public sector.
3
Burgos, Daniel, Eric Wong, and Kurt Weibel. "Impact of Automated Dispensing Technology on Medication Safety and Costs at an Inpatient Pharmacy." The University of Arizona, 2014. http://hdl.handle.net/10150/614205.
Full textAbstract:
Class of 2014 AbstractSpecific Aims: To compare two groups of automated dispensing technology and their impact on medication safety and costs at an inpatient pharmacy. Methods: A total of 784 medications were audited for Pyxis refill errors, 352 prior to and 432 post implementation of Boxpicker and the ATP High Speed Tablet Packager. Data were collected by obtaining refill reports for automated dispensing. Every other medication on the refill report was audited for errors in the corresponding location of the automated dispensing cabinet. The rate of reported errors was obtained from a self-reported error program, Patient Safety Net (PSN). Analysis related to costs included automated dispensing cabinet related inventory and costs associated with bulk repackaging. All data associated with costs were obtained from pharmacy financial records. Main Results: There was no significant difference in the Pyxis refill error rate between Pyxis PARx and Boxpicker (0.00284% versus 0.00231%, respectively, p =0.88). The total number of automated dispensing cabinet problems reported through Patient Safety Net transiently increased during and after implementation of new automated technology. Value of pharmacy inventory costs associated with automation was $674,460 prior to and $594,789 post implementation of technology. Bulk repackaging with the ATP High Speed Automatic Tablet Packager resulted in an estimated cost savings of $203,400 annually. Conclusion: Implementation of Boxpicker and ATP High Speed Tablet Packager resulted in no significant change in Pyxis refill error rates, a transient increase in reported automated dispensing cabinet problems, a decrease in inventory costs, and savings associated with bulk repackaging.
4
Schnoor, Jörg, Christina Rogalski, Roberto Frontini, Nils Engelmann, and Christoph-Eckhardt Heyde. "Case report of a medication error by look-alike packaging." Universitätsbibliothek Leipzig, 2015. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-162688.
Full textAbstract:
Background: The acronym LASA (look-alike sound-alike) denotes the problem of confusing similar- looking and/or sounding drugs accidentally. The most common causes of medication error jeopardizing patient safety are LASA as well as high workload. Case presentation: A critical incident report of medication errors of opioids for postoperative analgesia by lookalike packaging highlights the LASA aspects in everyday scenarios. A change to a generic brand of medication saved costs of up to 16% per annum. Consequently, confusion of medication incidents occurred due to the similar appearance of the newly introduced generic opioid. Due to consecutive underdosing no life-threatening situation arose out of this LASA based medication error. Conclusion: Current recommendations for the prevention of LASA are quite extensive; still, in a system with a lump sum payment per case not all of these security measures may be feasible. This issue remains to be approached on an individual basis, taking into consideration local set ups as well as financial issues.
5
Hanson, Kristin Anne. "Evaluation of a pharmacist-led medication management program in high-risk diabetic patients: impact on clinical outcomes, medication adherence, and pharmacy costs." Thesis, 2009. http://hdl.handle.net/2152/ETD-UT-2009-12-452.
Full textAbstract:
Diabetes mellitus is a group of metabolic disorders caused by a relative or absolute lack of insulin. Currently, 23.6 million Americans have diabetes. Diabetes can lead to serious microvascular and macrovascular complications, such as cardiovascular disease, blindness, kidney disease, lower-limb amputations, and premature death. Due to the potential cardiovascular complications and the high prevalence of co-morbid hypertension and/or hyperlipidemia in patients with diabetes, diabetes management should include close monitoring of blood glucose, blood pressure, and cholesterol levels.
Medical management of diabetic patients is costly; approximately 1 in every 10 health care dollars is currently spent treating diabetes. Studies have shown that in chronic conditions such as diabetes, increased medication use results in demonstrable improvements in health outcomes, reduced hospitalization rates, and decreased direct health care costs. To date no studies have evaluated the impact of a pharmacist-led intervention on diabetic medication adherence.
The purpose of this investigation was to analyze the impact of a pharmacist-led medication management program on medication adherence and pharmacy costs and to evaluate clinical measures of diabetes, hypertension, and hyperlipidemia. This study was a quasi-experimental, longitudinal, pre-post study, with a control group. Scott & White Health Plan (SWHP) patients with diabetes (type 1 or type 2), poor glycemic control (most recent A1C >7.5%), and living within 30 miles of participating pharmacies were invited to participate in the intervention which consisted of monthly appointments with a clinical pharmacist and a co-payment waiver for all diabetes medications and testing supplies. A total of 118 patients met study inclusion criteria and were enrolled in the intervention between August 2006 and July 2008. Intervention patients were matched on sex and age to SWHP patients with poor diabetes control living more than 30 miles from a participating pharmacy. To measure the impact of the intervention, medical and pharmacy data were evaluated for one year before and after the study enrollment date.
A significant difference was seen in the percentage of patients with type 1 diabetes in the intervention group (14) and the control group (3). The medication management program significantly improved A1C levels in intervention patients relative to controls (-1.1% vs. 0.6%) and was more effective in lowering A1Cs in type 2 diabetics than type 1 patients. Although the generalized linear model did not show that the intervention significantly improved the percentage of patients achieving the ADA goal A1C of <7% compared to controls, the multivariate logistic regression, which controlled for factors such as diabetes type, showed that patients participating in the intervention were 8.7 times more likely to achieve the A1C goal. Persistence with diabetic medications and the number of medications taken significantly increased in the intervention group; however, adherence rates, as measured by medication possession ratio (MPR), did not significantly improve relative to controls. The expenditure on diabetic medications and testing supplies increased substantially more in the intervention group than in the control group.
The percentage of patients adherent with antihypertensive medications (MPR ≥80%) increased from 76% to 91% in the intervention group and decreased from 68% to 63% in the control group (P<0.05); no significant difference in blood pressure control was observed. For hyperlipidemia medications, adherence and persistence increased and pharmacy costs decreased in both groups, likely due to the introduction of the first generic HMG-CoA reductase inhibitor into the market during the study period. Future research is needed on the impact of the intervention on medical resource utilization and costs.text
Books on the topic "High cost medications"
1
New York (State). Legislature. Senate. Committee on Corporations, Authorities, and Commissions. In the matter of high cost of patented pharmaceutical prescription medications: Legislative Office Building, Hearing Room B, Albany, New York, May 31, 2000, 10:10 a.m. to 3:25 p.m., Wednesday. Clifton Park, N.Y.]: Candyco Transcription Service, Inc., 2000.
Find full text
2
Dalbeth, Nicola. Anti-inflammatory agents for prophylaxis and flares. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198748311.003.0010.
Full textAbstract:
Acute gout requires rapid, effective treatment. Colchicine, non-steroidal anti-inflammatories, and corticosteroids are all effective; the choice of agent is dictated by the patient’s co-morbidities and concomitant medications. Interleukin-1 inhibitors are effective, but the high cost precludes routine use, and long-term safety data for repeated use are lacking.
3
Xu, Huji, Feng Huang, Chan-Bum Choi, and Tae-Hwan Kim. Axial spondyloarthritis in Asia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198734444.003.0028.
Full textAbstract:
The prevalence of axial spondyloarthritis (axSpA) in Chinese and Korean populations is not dissimilar to that in Caucasians. However, the age of onset is younger and peripheral arthritis of the lower limb is relatively more common. Multicenter studies have revealed similarities and differences among different ethnic backgrounds. For example, the dominant HLA-B27 subtype in Chinese SpA is B2704, while it is B2705 in Koreans. Both Chinese and Korean rheumatologists have adopted ASAS/EULAR guidelines to manage axSpA. TNFi are covered by insurance in Korea but not in China. Owing to early onset and the high cost of TNFi therapy, axSpA has placed enormous burdens on both patients and society in Asia. To achieve a higher HRQoL, rheumatologists are bringing forward cost-effective and treat-to-target therapeutic strategies by integrating nonpharmacological treatment, traditional medications, and biologics in a multimodality setting. Further basic and clinical studies in Asian populations are needed to improve decision-making in clinical practice.
4
Jacobs, Luann, Mary Kendell, Yael Flusberg, and Alice Berg. Energy Modalities and Aromatherapy. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190466268.003.0007.
Full textAbstract:
This chapter covers energy modalities and aromatherapy. The first part introduces subtle energy and biofield therapy as a complementary therapy for senior patients to stimulate innate healing forces and promote health and relaxation. Biofield therapies combine the use of touch and intention to help the older patient mitigate symptoms and improve functional status. They are safe and have no unwanted side effects. Reiki, internal qi gong therapy, and aromatherapy can be taught for self-care, further empowering the healing process and increasing exposure to the modality. Essential oil use can be an effective option or adjunct in the treatment of many geriatric health care needs. Advantages of using essential oils include flexibility in delivery methods, low cost compared with many prescription medications, and a high safety profile when used properly.
5
Kogan, Mikhail, and Kyle Meehan. Introduction. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190466268.003.0001.
Full textAbstract:
Integrative geriatrics is the new field of medicine that advocates for whole-person, patient-centered, primarily nonpharmacological approaches to the medical care of the elderly. Most current geriatric practices overprescribe medications and procedures and underuse nonpharmacological low-cost and high-touch methods. Integrative geriatrics interventions such as nutrition, movement therapies, and mind–body and spirituality approaches allow patients to follow a different path to their health care. This book provides detailed evidence-based information for all health care providers and advocates who work with the geriatric population. Directed toward providers in outpatient settings and to those who work in nursing homes, assisted living, independent living, and senior community centers, it also provides valuable information for leaders and politicians who are setting up policies and procedures for the care of the elderly who are looking for safer, less costly, and more patient-centered approaches.
6
Cosyns, Bernard, Thor Edvardsen, Krasimira Hristova, and Hyung-Kwan Kim. Left ventricle: systolic function. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0020.
Full textAbstract:
The assessment of left ventricular (LV) systolic function is one of the most important parts of correct diagnosis, selection of treatment strategy or medications, and prediction of prognosis. Although cardiac magnetic resonance imaging is generally accepted as the gold standard in vivo imaging modality for assessing LV systolic function, its practical use is limited due to its limited availability, high cost, and the presence of conditions precluding its performance such as a pacemaker, claustrophobia, and severe arrhythmia. Thus, transthoracic echocardiography is a first-line imaging modality employed in daily practice and has been widely used. Since the first attempts with M-mode approach, remarkable improvements have been made with the advent of two-dimensional echocardiography, and more recently three-dimensional echocardiography, with high accuracy and reproducibility. More sophisticated methodologies such as strain imaging, based on Doppler or speckle tracking techniques, provide a more sensitive and quantitative measurement of myocardial contractility, and are gaining a place in common daily practice. This chapter describes different modalities that have been used for assessment of LV systolic function based on echocardiography, and is grossly composed of two parts: LV global systolic function and LV regional or segmental systolic function. For better application of these conventional and novel methods of assessing LV systolic function, strengths and pitfalls of these techniques should be acknowledged.
7
Weil, Andrew. Integrative Geriatric Medicine. Edited by Mikhail Kogan. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190466268.001.0001.
Full textAbstract:
This book is a detailed, evidence-based reference on the field of integrative geriatric medicine. It is intended for all healthcare providers and advocates who work with the geriatric population—in outpatient settings and nursing homes, assisted and independent living facilities, and senior community centers. In addition, it will provide valuable information for leaders and politicians who are involved with implementing policies and procedures for the care of elderly patients and who are looking for safer, less costly, and more patient-centered approaches. Integrative geriatrics is a new field of medicine that advocates for a whole-person, patient-centered, primarily non-pharmacological approach to medical care of the elderly. Most current geriatric practices overprescribe medications and procedures and underutilize non-pharmacological, low-cost, high-touch methods. Patients, however, often show reluctance toward these standard practices because they often involve invasive interventions. The practice of integrative geriatrics is rooted in lifestyle interventions, such as nutrition, movement therapies, and mind-body and spirituality approaches, that allow patients to take a different path to their health, one that utilizes pharmaceuticals and invasive procedures only when safer integrative approaches are not available or not effective.
8
Khorgami, Zhamak, and Ali Aminian. Readmissions after Bariatric Surgery. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0016.
Full textAbstract:
Readmission after bariatric surgery occurs in about 5% of cases and increases the average costs up to 2.5-fold. Risk factors for readmission are dependent functional status, diabetes mellitus, steroid or immunosuppressant use, cardiac disease with intervention, bleeding disorders, longer operative time, concurrent splenectomy, high preoperative creatinine, low serum albumin, and occurrence of postoperative complications during index admission. The most common reasons for readmissions are procedure-related complications, including dehydration, abdominal pain, bleeding, anastomotic leak, gastrointestinal obstruction, and thromboembolic events. Measures that decrease readmissions after bariatric surgery include: effective preoperative education, thorough evaluation before discharge, appropriate discharge instruction with required medications, reasonable discharge disposition, 24-hour phone support, active follow-up of high-risk patients, walk-in clinic, hydration clinic, and training of other hospital teams to manage common complaints after bariatric surgery.
9
Veatch, Robert M., Amy Haddad, and E. J. Last. Benefiting the Patient and Others. Edited by Robert M. Veatch, Amy Haddad, and E. J. Last. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190277000.003.0005.
Full textAbstract:
Chapter 4 begins Part II of the book, a series of chapters dealing with basic ethical principles. This chapter takes up the principles that an action of a pharmacist is morally right insofar as it produces benefit and wrong insofar as it produces harm. The names of these principles are beneficence and nonmaleficence. First, considering benefit to the patient, cases deal with the relation of health to other benefits and whether benefits should be assessed on a case-by-case basis. Then the duties of the pharmacist to benefit society, specific nonpatients, the profession, and the pharmacist’s family are considered. The subject matter of the cases includes antihypertensive medication, high-dose chemotherapy, outdated drugs, health maintenance organization cost saving, and the tension between the pharmacist’s duty to the patient and his or her duty to family.
10
Neumann, Peter J., Joshua T. Cohen, and Daniel A. Ollendorf. The Right Price. Oxford University Press, 2021. http://dx.doi.org/10.1093/oso/9780197512883.001.0001.
Full textAbstract:
New medications can provide substantial benefits, but high prescription drug prices have led to calls to contain costs. Even after accounting for discounts and rebates, average prices of leading brand-name drugs in the United States are two to four times higher than in other wealthy countries, raising questions about what these higher prices are buying us. With the advent of ever more targeted and powerful treatments, including cell- and gene-based therapies with multimillion dollar price tags, the need for sensible drug pricing policies will intensify. Price controls, common in other countries, seem appealing, but these measures can discourage innovation. Moreover, on what basis should policymakers develop such controls? This book argues that pricing prescription drugs to reflect the value they bring to patients, families, and society achieves the right balance. The book reviews the distinguishing features of the prescription drug market and explains why simple solutions like price controls and importing drugs from countries with lower drug prices are problematic without explicit assessments of value. It then describes how economists measure value, how value assessment for drugs is now being used in the United States, and what must happen going forward to overcome challenges.
Book chapters on the topic "High cost medications"
1
"Introduction to Pharmaceutical Care and Medication Adherence." In Design and Quality Considerations for Developing Mobile Apps for Medication Management, 1–31. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-3832-6.ch001.
Full textAbstract:
Pharmaceutical care is a concept that involves identifying, solving and preventing drug-related problems, such as drug interactions, with regards to a patient's drug therapy. Cancer patients are at high risk of drug interactions due to the complex pharmacological profiles and narrow therapeutic indices of anticancer drugs. Furthermore, these patients tend to consume complementary and alternative medicines, thus predisposing them to a risk of herb-drug interactions. This can impact their adherence to anticancer therapies. Various factors are involved in medication non-adherence, such as the cost of medications and patients' beliefs about the value of their treatments. There is a need to understand the impact of non-adherence and optimize intervention strategies from a macro-, meso-, and micro-level. Chapter 1 introduces the concept of pharmaceutical care and the impact of oncology drug interactions and medication non-adherence in patients with cancer. The chapter will also provide an insight to the factors influencing medication adherence and the intervention strategies that have targeted non-adherence.
2
Damji, Ruksar Salim, Shamiha Chowdhury, and Zaib-Un-Nisa Munawar Hussain. "Diabetes Mellitus." In Research Anthology on Recent Advancements in Ethnopharmacology and Nutraceuticals, 872–901. IGI Global, 2022. http://dx.doi.org/10.4018/978-1-6684-3546-5.ch043.
Full textAbstract:
Diabetes mellitus is a chronic metabolic disorder which is at present rapidly growing to an alarming epidemic level. Various pathogenic processes are involved in the development of diabetes mellitus. This spectrums from autoimmune destruction of pancreatic beta cells with consequent deficiency of insulin to abnormalities that lead to resistance to the action of insulin. In the 21st century, the astounding rise in obesity, poor diet, and inactive lifestyles have increased the prevalence dramatically. Although several therapies are in use, Western medications are associated with adverse drug reactions and high cost of treatment. Therefore, there is currently a growing interest in herbal medicines to replace or supplement the Western medications. Extensive research is essential to enhance diagnoses, treatment, and to lessen healthcare expenditures. This chapter provides an overview of the classification, diagnosis, symptoms, complications, and economic burden of diabetes mellitus. Additionally, the authors discuss the current and upcoming therapies to treat this metabolic disorder.
3
Damji, Ruksar Salim, Shamiha Chowdhury, and Zaib-Un-Nisa Munawar Hussain. "Diabetes Mellitus." In Treating Endocrine and Metabolic Disorders With Herbal Medicines, 1–31. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-4808-0.ch001.
Full textAbstract:
Diabetes mellitus is a chronic metabolic disorder which is at present rapidly growing to an alarming epidemic level. Various pathogenic processes are involved in the development of diabetes mellitus. This spectrums from autoimmune destruction of pancreatic beta cells with consequent deficiency of insulin to abnormalities that lead to resistance to the action of insulin. In the 21st century, the astounding rise in obesity, poor diet, and inactive lifestyles have increased the prevalence dramatically. Although several therapies are in use, Western medications are associated with adverse drug reactions and high cost of treatment. Therefore, there is currently a growing interest in herbal medicines to replace or supplement the Western medications. Extensive research is essential to enhance diagnoses, treatment, and to lessen healthcare expenditures. This chapter provides an overview of the classification, diagnosis, symptoms, complications, and economic burden of diabetes mellitus. Additionally, the authors discuss the current and upcoming therapies to treat this metabolic disorder.
4
Ponnusamy, Senthil Kumar, and Femina Carolin Christopher. "Production Process in the Pharmaceutical Industry." In Global Supply Chains in the Pharmaceutical Industry, 158–79. IGI Global, 2019. http://dx.doi.org/10.4018/978-1-5225-5921-4.ch007.
Full textAbstract:
The most important stress related to the industrialized societies are diseases and health issues caused by taking medicines that are in unfavorable condition. The health issues caused due to the medications mainly depend on the quality of drugs. This is the main test confronted by any pharmaceutical organization wishing to guarantee its survival. The benefit in the pharmaceutical industries is higher. But now, the cost of the medicines is reduced as per the estimation is given by the government. Hence, pharmaceutical organizations now confront a moment of challenge to diminish costs through upgrading and enhancing their production methods. Based on the production process following in the pharmaceutical industries, the product quality can be varied and improved. This chapter prescribes the detailed information regarding the production practices that are followed in the pharmaceutical industries for the production of high-quality products.
5
Kumar, Upendra, Esha Tripathi, Surya Prakash Tripathi, and Kapil Kumar Gupta. "Deep Learning for Healthcare Biometrics." In Advances in Medical Technologies and Clinical Practice, 73–108. IGI Global, 2019. http://dx.doi.org/10.4018/978-1-5225-7525-2.ch004.
Full textAbstract:
Mistakes in healthcare systems such as a mix-up of records or confusing medical charts lead to the wrong medications to patients. Major tasks such as administrative costs, legal expenses, and liabilities incur high cost to the healthcare industry using traditional, inaccurate patient identification processes. This can be resolved by biometric technology. Only physiological features can be used for patient identification to eliminate need of SSN, insurance card, or date of birth during registration. A biometric template can be directly mapped to an electronic health record to accurately authenticate individuals on subsequent visits. This technology ensures no medical records can be mimicked and the right care is provided to the right patient. Deep learning provides a platform to solve identification and diagnostic problems arising in medicine and can be used in healthcare biometrics to analyze clinical parameters and their combinations for disease prognosis (e.g., prediction of disease, extracting medical knowledge, therapy planning, and support).
6
Halvorsen, Kjell H. "Pharmacist Involvement in Optimizing Medication Use in Nursing Homes." In Medication Safety in Municipal Health and Care Services, 193–206. Cappelen Damm Akademisk/NOASP, 2022. http://dx.doi.org/10.23865/noasp.172.ch9.
Full textAbstract:
Nursing home residents have many comorbidities, for which medication therapy is the treatment modality most utilized. The extensive use of medications among these residents is beneficial, but puts these individuals at high risk of experiencing adverse drug events. To optimize medication use in nursing home residents, we have witnessed an increased pharmacist involvement. This review presents how pharmacists can be involved in optimizing medication use among Norwegian nursing home residents. The review is based on a literature search (PubMed), knowledge of Norwegian nursing home studies involving pharmacists, and fifteen years of work experience. A conceptual framework guided the knowledge synthesis regarding the different work tasks identified at the individual, healthcare, and system level. Pharmacists contribute on different levels to ensure high-quality medication use in nursing homes, which means involvement in multidisciplinary teams to identify and solve medication-related problems. Collaboration with other healthcare professionals and teaching them about medication management are examples on the healthcare level. Involvement on the system level includes developing medication management procedures, providing medication statistics, investigating costs, and facilitating tender rounds. Studies investigating hard endpoints in nursing home residents were not identified. Although pharmacists as healthcare providers seem to be expanding their role, municipalities and the healthcare system seem to lack a strategy about how and where this resource can be used most effectively. Developing job descriptions for pharmacists, and preparing the healthcare setting and nursing homes for future challenges, should be prioritized.
7
Asante-Kwatia, Evelyn, Abraham Yeboah Mensah, Lord Gyimah, and Arnold Donkor Forkuo Yeboah Mensah. "The Ghanaian Flora as a Potential Source of Anthelmintic and Anti-Schistosomal Agents." In Pharmacognosy - Medicinal Plants [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.97417.
Full textAbstract:
Parasitic infections including schistosomiasis and soil transmitted helminthiasis are the most commonly encountered Neglected Tropical Diseases (NTDs) in the world. These diseases remain a major public health concern affecting millions of people especially those living in poor regions where access to effective conventional health care is a challenge. Interventions to control these infections in endemic areas have not been successful due to the high cost of drugs, limited availability as well as inequity of access to preventive chemotherapies. Another problem is the development resistance to the limited number of recommended medications due to their intensive use in both human and live-stock. There is an increasing awareness of the potential of natural products as chemotherapeutic agents to combat parasitic infections. Natural products may offer an unlimited source of chemically diverse drug molecules which may be safe, efficient, less toxic, less expensive and readily available for use especially in low-income countries. The Ghanaian flora provides such a ready source for new therapeutic interventions for the local population. Several researches have provided evidence of the anti-parasitic activity of Ghanaian medicinal plants. This chapter provides a review with special focus on medicinal plants collected from Ghana with anthelmintic and anti-schistosomal activity. Evidence of pharmacological activities of crude extracts, fractions and bioactive phytoconstituents as well as possible mechanisms of action where investigated are discussed.
8
Shan, Harinee, and Anand Mahendran. "A Cloud Robotic Solution to Assist Medical Application." In Advances in Edge Computing: Massive Parallel Processing and Applications. IOS Press, 2020. http://dx.doi.org/10.3233/apc200012.
Full textAbstract:
Health care in India has been ranked 112th position out of 190 countries by WHO (World Health Organization). The health care in this country falls behind due to high cost for treatment and medication. The Conventional robots used in the field of medical need high memory and computation power for decision making and task execution. Which in turn leads to a high budget in the construction of robots. To overcome this problem and to provide a solution for upgrading healthcare, we propose a new architecture which makes use of Commercial off-the-shelf (COTS) for cloud robotics. Then, the key forces behind the progress of cloud robotics are analyzed. This chapter mainly deals with the patient who needs first aid at times of emergency (based on the data from COTS product) and how the cloud robot stands by to help the patient. COTS help in tracking the health of individuals and these reports are stored either in the devices or on storage spaces. And the use of these products reduces the cost of the proposed model. As the data are stored in the cloud or on the device the robots do not require memory space for storing these data. Henceforth the memory requirement for the robot can be reduced which in turn the cost spent on the memory of the robot and its size.
9
Sultanow, Eldar, and Alina M. Chircu. "Improving Healthcare with Data-Driven Track-and-Trace Systems." In Big Data, 1229–46. IGI Global, 2016. http://dx.doi.org/10.4018/978-1-4666-9840-6.ch055.
Full textAbstract:
This chapter illustrates the potential of data-driven track-and-trace technology for improving healthcare through efficient management of internal operations and better delivery of services to patients. Track-and-trace can help healthcare organizations meet government regulations, reduce cost, provide value-added services, and monitor and protect patients, equipment, and materials. Two real-world examples of commercially available track-and-trace systems based on RFID and sensors are discussed: a system for counterfeiting prevention and quality assurance in pharmaceutical supply chains and a monitoring system. The system-generated data (such as location, temperature, movement, etc.) about tracked entities (such as medication, patients, or staff) is “big data” (i.e. data with high volume, variety, velocity, and veracity). The chapter discusses the challenges related to data capture, storage, retrieval, and ultimately analysis in support of organizational objectives (such as lowering costs, increasing security, improving patient outcomes, etc.).
10
Sultanow, Eldar, and Alina M. Chircu. "Improving Healthcare with Data-Driven Track-and-Trace Systems." In Strategic Data-Based Wisdom in the Big Data Era, 65–82. IGI Global, 2015. http://dx.doi.org/10.4018/978-1-4666-8122-4.ch004.
Full textAbstract:
This chapter illustrates the potential of data-driven track-and-trace technology for improving healthcare through efficient management of internal operations and better delivery of services to patients. Track-and-trace can help healthcare organizations meet government regulations, reduce cost, provide value-added services, and monitor and protect patients, equipment, and materials. Two real-world examples of commercially available track-and-trace systems based on RFID and sensors are discussed: a system for counterfeiting prevention and quality assurance in pharmaceutical supply chains and a monitoring system. The system-generated data (such as location, temperature, movement, etc.) about tracked entities (such as medication, patients, or staff) is “big data” (i.e. data with high volume, variety, velocity, and veracity). The chapter discusses the challenges related to data capture, storage, retrieval, and ultimately analysis in support of organizational objectives (such as lowering costs, increasing security, improving patient outcomes, etc.).
Conference papers on the topic "High cost medications"
1
"Knowledge and practice of analgesics use among Albaq’a refugees camp, Jordan. : A cross sectional study." In International Conference on Public Health and Humanitarian Action. International Federation of Medical Students' Associations - Jordan, 2022. http://dx.doi.org/10.56950/ehgb9785.
Full textAbstract:
Background : Due to the rising healthcare costs around the world, self-medication has become an important option in the management of common conditions. However, the benefits of such selfmedication practices depend upon them being used responsibly. Studies about the prevalence of analgesics use and related factors are limited in Jordan, particularly among refugees which is one of the vulnerable sectors of the population. Objective: The objective of this study was to evaluate the knowledge and practices of Palestinian refugees in the Al-Baqa’a camp in Jordan regarding the use of analgesics to address any common misuse or misknowledge. Method: A cross-sectional study design was conducted from 20 October to 10 November 2021. A researcher-developed questionnaire to assess knowledge and practices were used as a tool for studying both interviewer-administered and self-administered survey among 253 adult Palestine refugees at Al Baqa’a refugee camp. Statistical analysis was performed using SPSS version 26 for descriptive and inferential statistics. Results: A high percentage of the respondents 78.3% reported that they use analgesics as selfmedication. Of these participants, 37.9% reported having a chronic disease, 34.4 % never suffer from pain in the last month, and 33.6% reported that they do not have health insurance. the most commonly used class of drugs was NSAIDs with a frequency of 193 fowled by paracetamol with a frequency of 90. While the most common condition for which the refugees use self-medication is the cost with 168 frequency, In the assessment of participant’s knowledge; analgesics are used to treat minor illnesses by 70%. 94% reported that analgesics can’t be used after their expiry date while 34% reported that analgesics do not have side effects. Final statics will have presented at the conference. Conclusion: Self-medication is widely practiced in Albaq’a refugees camp, although they are familiar with the most important information regarding the risks associated with the use of analgesics. Keywords: over-the-counter , non-steroidal anti-inflammatory drugs
2
Zhu, Linda, Nathaniel S. Miller, Charlotte Tang, Sriram Pendyala, Quinn Hanses, and Lacie Gladding. "Reliability Check of an Assessment System for Parkinson’s Disease Tremor Monitoring With Portable Devices." In ASME 2021 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2021. http://dx.doi.org/10.1115/imece2021-71144.
Full textAbstract:
Abstract Tremor, or an involuntary and oscillatory movement of a body part, is a cardinal symptom of Parkinson’s disease (PD) that can significantly impact activities of daily living in people with PD (PwPD). Although tremor can be mitigated with anti-PD medications, medication effectiveness is mixed for PwPD. Therefore, daily monitoring and assessment of tremor are of interest to PwPD, clinicians, and researchers. While several sensors and wearable devices have been developed and introduced to the consumer market, high costs limit their accessibility. The current research is two-fold. First, an assessment system based on multiple algorithms is developed for evaluating the reliability of measurements of PD symptoms: hand tremor and finger/hand movement speed. Second, an Android mobile application was designed and developed to capture finger-tapping frequencies and measurements of several PD symptoms like hand tremor. A healthy young adult participant produced a self-generated tremor for this study. The participant held the portable device and conducted self-measurements by following in-app instructions. Resting tremor was measured while the participant rested his upper extremity on the arm of a chair, postural tremor was measured while he maintained a position against gravity, and kinetic tremor was measured during a movement task. Data collection took approximately fifteen minutes. The linear and rotational motions, respectively, were collected by accelerometers and gyroscopes embedded within the mobile device. The results were captured and delivered to a cloud database. An assessment system with multiple algorithms provided a final evaluation of the participant’s tremor. The process included three parts. First, calculation of root-mean-square (RMS) values at all linear and rotational directions was conducted to provide tremor strength. Second, fast Fourier transform (FFT) extracted the peak frequency at each direction. The powers of peaks were compared and the highest peak was defined as the dominant frequency and that frequency’s corresponding direction of motion. Third, hand and motion correlation analysis was used to find any coherence of tremor on 3-D motions. To test the reliability of motion measurement, the same motion input was applied to multiple devices simultaneously. The outputs of different types of mobile devices were evaluated, while considering various factors and models of mobile devices in the market (i.e., device size, weight, operating system, sampling frequency, and accuracy during the measurement). Multiple trials were conducted to test the reliability of the assessment system and the performance of the mobile app. Additionally, the mobile application supports finger tapping tests that measure hand movement speed, which is commonly impaired in PwPD. Both tremor and movement speed measurements can be used to evaluate disease progression over time and could support focused medication adjustments based on symptom data.
3
Marshall, Lauren, Isabel Löwstedt, Paul Gatenholm, and Joel Berry. "Prevascularized, Co-Culture Model for Breast Cancer Drug Development." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80409.
Full textAbstract:
The objective of this study was to create 3D engineered tissue models to accelerate identification of safe and efficacious breast cancer drug therapies. It is expected that this platform will dramatically reduce the time and costs associated with development and regulatory approval of anti-cancer therapies, currently a multi-billion dollar endeavor [1]. Existing two-dimensional (2D) in vitro and in vivo animal studies required for identification of effective cancer therapies account for much of the high costs of anti-cancer medications and health insurance premiums borne by patients, many of whom cannot afford it. An emerging paradigm in pharmaceutical drug development is the use of three-dimensional (3D) cell/biomaterial models that will accurately screen novel therapeutic compounds, repurpose existing compounds and terminate ineffective ones. In particular, identification of effective chemotherapies for breast cancer are anticipated to occur more quickly in 3D in vitro models than 2D in vitro environments and in vivo animal models, neither of which accurately mimic natural human tumor environments [2]. Moreover, these 3D models can be multi-cellular and designed with extracellular matrix (ECM) function and mechanical properties similar to that of natural in vivo cancer environments [3].
Reports on the topic "High cost medications"
1
Busso, Matías, María P. González, and Carlos Scartascini. On the Demand for Telemedicine: Evidence from the Covid-19 Pandemic. Inter-American Development Bank, April 2021. http://dx.doi.org/10.18235/0003225.
Full textAbstract:
Telemedicine can expand access to health care at relatively low cost. Historically, however, demand for telemedicine has remained low. Using administrative records and a difference-in-differences methodology, we estimate the change in demand for telemedicine experienced after the onset of the COVID-19 epidemic and the imposition of mobility restrictions. We find a 233 percent increase in the number of telemedicine calls and a 342 percent increase in calls resulting in a medication being prescribed. The effects were mostly driven by older individuals with pre-existing conditions who used the service for internal medicine consultations. The demand for telemedicine remains high even after mobility restrictions were relaxed, which is consistent with telemedicine being an experience good. These results are a proof of concept for policymakers willing to expand access to healthcare using advances in technology.
2
Pu, Fenglan, Tianli Li, Yingqiao Wang, Chunmei Tang, Chen Shen, and Jianping Liu. Cordyceps preparations for preventing contrast-induced nephropathy: A protocol of systematic review of randomized controlled trials. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, June 2022. http://dx.doi.org/10.37766/inplasy2022.6.0098.
Full textAbstract:
Review question / Objective: To systematically evaluate the efficacy and safety of cordyceps preparations as a complementary preventive therapy for Contrast-induced nephropathy (CIN). Condition being studied: At present, contrast agents are widely used in diagnostic and interventional radiology examinations worldwide. However, they can affect kidney function and cause a risk of renal impairment. Contrast-induced nephropathy (CIN) is defined as a rise in serum creatinine (SCr) levels by ≥ 25% of baseline or 44 µmol/l from the pre-contrast value within 72 h of intravascular administration of a contrast agent in the absence of an alternative etiology. The incidence of CIN varies widely among studies depending on study population and baseline risk factors, as for high-risk groups such as pre-existing renal insufficiency, diabetes, advanced age, or receiving nephrotoxic agents, the incidence is up to 30–50%. To date, CIN has been the third most common cause of hospital-acquired renal failure, after impaired renal perfusion and nephrotoxic medications, which can lead to longer hospital stay, increased costs and higher mortality.
3
Tipton, Kelley, Brian F. Leas, Nikhil K. Mull, Shazia M. Siddique, S. Ryan Greysen, Meghan B. Lane-Fall, and Amy Y. Tsou. Interventions To Decrease Hospital Length of Stay. Agency for Healthcare Research and Quality (AHRQ), September 2021. http://dx.doi.org/10.23970/ahrqepctb40.
Full textAbstract:
Background. Timely discharge of hospitalized patients can prevent patient harm, improve patient satisfaction and quality of life, and reduce costs. Numerous strategies have been tested to improve the efficiency and safety of patient recovery and discharge, but hospitals continue to face challenges. Purpose. This Technical Brief aimed to identify and synthesize current knowledge and emerging concepts regarding systematic strategies that hospitals and health systems can implement to reduce length of stay (LOS), with emphasis on medically complex or vulnerable patients at high risk for prolonged LOS due to clinical, social, or economic barriers to timely discharge. Methods. We conducted a structured search for published and unpublished studies and conducted interviews with Key Informants representing vulnerable patients, hospitals, health systems, and clinicians. The interviews provided guidance on our research protocol, search strategy, and analysis. Due to the large and diverse evidence base, we limited our evaluation to systematic reviews of interventions to decrease hospital LOS for patients at potentially higher risk for delayed discharge; primary research studies were not included, and searches were restricted to reviews published since 2010. We cataloged the characteristics of relevant interventions and assessed evidence of their effectiveness. Findings. Our searches yielded 4,364 potential studies. After screening, we included 19 systematic reviews reported in 20 articles. The reviews described eight strategies for reducing LOS: discharge planning; geriatric assessment or consultation; medication management; clinical pathways; inter- or multidisciplinary care; case management; hospitalist services; and telehealth. All reviews included adult patients, and two reviews also included children. Interventions were frequently designed for older (often frail) patients or patients with chronic illness. One review included pregnant women at high risk for premature delivery. No reviews focused on factors linking patient vulnerability with social determinants of health. The reviews reported few details about hospital setting, context, or resources associated with the interventions studied. Evidence for effectiveness of interventions was generally not robust and often inconsistent—for example, we identified six reviews of discharge planning; three found no effect on LOS, two found LOS decreased, and one reported an increase. Many reviews also reported patient readmission rates and mortality but with similarly inconsistent results. Conclusions. A broad range of strategies have been employed to reduce LOS, but rigorous systematic reviews have not consistently demonstrated effectiveness within medically complex, high-risk, and vulnerable populations. Health system leaders, researchers, and policymakers must collaborate to address these needs.