To characterize and study the impact of moderate-to-severe atopic dermatitis (AD) on the adult treated population in Portugal. Methods: Crosssectional study conducted in Portuguese community pharmacies. Eligible participants were recruited by pharmacists based on their AD medication, between February and March 2018. A self-administered questionnaire was used to collected data on patients' demographics, medical care, level of embarrassment and absenteeism related to AD. The analysis was based on descriptive statistics and multiple regression models. These were used to study the predictors of embarrassment and systemic treatment. Results: A total of 622 eligible patients were recruited in 57 pharmacies. Mean patients' age was 46.8 years, 55.1% were women and 66.2% were employed. Many (43.1%) reported having felt little embarrassment in the previous week due to AD but 40.2% felt a lot or very much embarrassed. AD was most frequently treated by combined topic and systemic therapy (56.4%), 58.5% were followed by a dermatologist, and 52.8% were followed in a public setting. Only 4.1% of patients had been hospitalized in the previous 12 months. About 18% of patients missed work due to AD, and among those the mean number of days absent in the previous 6 months was 4.8. The results from the regression model showed that being followed by a dermatologist, consulting more than one specialist and having a prior hospitalization were predictors of a higher level of embarrassment. Patients followed by a dermatologist and patients hospitalized in the last 12 months had higher odds of being treated with systemic therapy. Conclusions: Results show that AD impacts patients' life. Most patients reported some level of embarrassment and some reported that AD had an impact on their work life. The study also gives some insights on the predictors of AD medication and the level of embarrassment experienced by patients.
Objectives: Develop the BDP through a technically sound and broadly consultative process. Methods: The process of developing the BDP was started with the drafting of a technical note discussing the rationale, contents and proposed approach for its development. This was followed by a broad consultation of stakeholders representing PhilHealth members, providers, the Department of Health, members from the academe and research community, and development partners. Results: There was consensus that the introduction of benefits under UHC will use criteria such as legal mandates, burden of disease, advances in technology, value for money and fund viability, among others. Appropriate decision rules will have to be developed to make use of these criteria in decision-making. In addition, the stakeholders agreed on a formal and explicit process in benefit development. Making the process explicit improves transparency in the benefit development process where interests of various stakeholders can be managed and operational considerations can be flagged. Both members and providers expressed strong preference to be involved in the benefit development process at its various stages. The role of the Health Technology Assessment Council (HTAC) also needs to be defined as new benefits can only be introduced if there is positive recommendation. Conclusions: PhilHealth is expected to complete its BDP soon. Other countries in similar stages of implementing UHC may want to study how an explicit benefit development process can be developed and implemented.
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