Introduction Data suggest that ED is still an underdiagnosed and undertreated condition. In addition, it seems that men with ED are unsatisfied about their relationship with their physician and with the available drugs. Aim The study aims to identify health-related characteristics and unmet needs of patients suffering from erectile dysfunction (ED) in big 5 European Union (EU) nations (France, Germany, Italy, Spain, and UK). Methods Data were collected from the 2011 5EU National Health and Wellness-Survey on a population of 28,511 adult men (mean age: 47.18; SD 16.07) and was focused on men (5,184) who self-reported ED in the past 6 months. In addition, the quality of life (QoL) and work productivity/activity were explored. Main Outcome Measures Health-related QoL (HRQoL) and work productivity were measured with SF-12v2 and WPAI validated psychometric tools. Results One in every 20 young men (age 18–39) across 5EU experienced ED in the past 6 months. About half of men (2,702/5,184; [52%]) with ED across all ages did not discuss their condition with their physician. Interestingly, among those men who did discuss their condition with their physician, 68% (1,668/2,465) do not currently use medication. These findings were more evident in the age group of 18–39 years. Only 48% (2,465/5,184) had a closer relationship with their physician, suggesting that this quality of relationship may be unsatisfactory. Compared with controls, ED patients have a significantly higher intrapsychic and relational psychopathological comorbid burden and relevant decreasing in HRQoL, with a significantly higher impairment on work productivity/activity. Conclusion Data suggest that there is a need for a new therapeutic paradigm in ED treatment which images the achievement of a new alliance between physician and patient. Hence, alternative drug delivery strategies may reduce the psychological and social impact of this disease.
Purpose: With more than 50% of the individuals on chronic conditions not taking medicines as prescribed, it is essential for health care providers to understand the reasons, so that adherence-related conversations can be initiated and focused appropriately. Measuring medication non-adherence is complex, because patients are often on multiple medications and take them via various modes of administration such as orally, by injection, or topically, and at various frequencies such as daily or weekly. The Medication Adherence Reasons Scale (MAR-Scale) is a twenty-item, self-reported, comprehensive scale developed to measure two aspects of medication non-adherence: the extent or frequency of non-adherence and reasons for non-adherence. The objective of this study was to identify the top reasons, in 17 distinct chronic disease conditions, reported by patients for being non-adherent across various modes and frequencies of the corresponding medications. Internal reliability of the MAR-Scale was also assessed in each condition. Patients and methods: Results were derived from Kantar Health’s US 2017 National Health and Wellness Survey (NHWS), a self-administered, annual, Internet-based cross-sectional survey of 75,000 adults (≥18 years). The survey sample was drawn from an Internet panel and was stratified according to age, gender, and ethnicity in order to represent the US adult population based on the US Census Bureau. Respondents to the 2017 NHWS who self-reported taking prescription medication(s) to treat one of the 17 conditions were invited to complete the MAR-Scale in a follow-up online survey, reporting on reasons for non-adherence in the past 7 days (daily medications) or four weeks (weekly), with non-adherence defined as any reported non-adherence in the corresponding timeframe for medicines taken orally, by injection, and topically. Results: MAR-Scale data were obtained from 15,672 respondents in one or more conditions, modes, and frequencies. MAR-Scale reliability ranged from Cronbach’s alpha of 0.861 in multiple sclerosis to 0.973 in psoriasis. For daily orals, non-adherence ranged from 25.2% in diabetes to 63.7% in eczema. The most common reasons across conditions were “simply missed it,” “side effects,” and “concern about long-term effects.” Conclusion: The MAR-Scale demonstrates acceptable reliability in multiple chronic disease conditions and across modes and frequencies of administration.
psoriasis were as follows: 13% were currently taking a biologic, 42% would consider taking a biologic, 17% had previously taken a biologic, and 24% would not consider taking a biologic. Hierarchical and non-hierarchical cluster analyses were applied to the moment-to-moment affect traces that identified four unique patient clusters (# 1-4). MDA was used to identify the five most impactful time periods within the focus group audio segments. Cluster composition profiles were identified based upon demographic information and patient responses to behavioral and attitudinal questions. CONCLUSIONS: Understanding complex patient perspectives on coping with disease is essential for delivering appropriate treatments over the lifelong course of psoriasis. This novel methodology begins to bridge this knowledge gap in understanding the patient-centered view of psoriasis. Furthermore, it improves the likelihood of recommending treatments in alignment with the patient's needs to improve health-related quality-of-life, productivity, and well-being. OBJECTIVES:Currently in Brazil's public healthcare, patients with psoriasis who fail the available treatment options (phototherapy, methotrexate, acitretin and cyclosporin) due to any cause, are experiencing a medical unmet need. This study is aimed to assess comorbidity, quality of life (QoL), work/productivity loss (WPL), and medical resource utilization in patients diagnosed with psoriasis (PdwP) in Brazil. METHODS: A total of 12,000 individuals' (age 18ϩ) self-reported data were collected from 2011 National Health and Wellness Survey (NHWS) in Brazil, a crosssectional representative sample of the adult population. QoL was measured by the physical component score (PCS) and mental component score (MCS) of the Short Form-12 (SF-12). WPL was measured by the validated Work Productivity and Activity Impairment instrument. Medical resource utilization was measured by health care provider utilization, emergency room visits and hospitalization in the past 6 months. RESULTS: Of the 12,000 respondents, 205 (1.3%) were patients diagnosed with psoriasis (PdwP) (53.0% women). Mean age was 40.2. Higher percentage of co-morbidities was found among PdwP compared to patients not diagnosed with psoriasis (PndP): headache (71% vs. 54%), sleep difficulties (50% vs.24%), anxiety (50% vs.33%), insomnia (46% vs.22%), pain (42% vs.23%), skin allergies (40% vs.17%), migraine (40%vs.20%), Heartburn (38% vs.23%) hay fever (37% vs.15%), nasal allergies (33% vs.21%), depression (33% vs.16%), rhinitis (32%vs.11%), high blood pressure (29% vs.16%), gingivitis (22%vs.6%), nail fungus (20%vs.7% ), dry eye (20% vs.5%), anemia (19% vs.6%), diabetes type 1 or 2 (19% vs.4%). PdwP had a lower mean PCS (45.8 vs. 49.7) and MCS (42.3 vs.47.0), more visiting health practitioners (87.0% vs.76.0%), emergency room visits (36.0%vs.22.0%), and hospitalizations for a medical condition (21.0% vs.10.0%) over the past 6 months compared to the PndP group. Furthermore, PdwP reported higher presenteeism (30.4% vs.14.8%), work producti...
Introduction: While it is generally believed that people living with more severe obesity experience greater negative impacts on health-related quality of life (HRQoL), their experience may be impacted by other factors such as age, gender, and type 2 diabetes mellitus (T2DM). Methods: The 36-Item Short Form Health Survey physical component score and mental component score, Work Productivity and Activity Impairment, and Patient Activation Measure ® data from the 2018 National Health and Wellness Survey were analyzed in adults by body mass index (BMI) categories (normal weight: ≥18.5-<25kg/m 2 , overweight: ≥25-<30kg/m 2 , class 1 obesity: ≥30-<35kg/m 2 , class 2 obesity: ≥35-<40kg/m 2 , class 3 obesity: ≥40kg/m 2 , combined class 2/3 obesity: ≥35kg/m 2). Findings were further stratified across age groups (young: 18-35y, middle-aged: 36-64y, older: ≥65y), by gender, and by T2DM status. Results: Overall, as BMI increased people had greater negative effects on HRQoL, felt less involved with and in control of their healthcare, and had greater work productivity and activity impairments. The largest declines were generally observed between class 2 and 3 obesity categories. Young adults with obesity were more likely to feel less engaged with their health care than middle-aged/older adults with obesity. The effects of obesity on HRQoL and patient activation were generally consistent by gender. People with T2DM and obesity tended to have greater declines in physical functioning and more work and activity impairments than people with obesity without T2DM. The proportion of people trying to lose weight increased with increasing BMI category, and people with T2DM were less likely to exercise and more likely to diet than those without T2DM. Conclusion: Increasing levels of obesity tended to have a greater negative impact on HRQoL, patient activation, work productivity, and weight loss behaviors, but some differences in effects by age, gender, and T2DM status were observed.
S105OBJECTIVES: Community pharmacy is a major link in the asthma therapy chain. However, community pharmacists have insufficient knowledge about asthma and asthma medications for counselling patients effectively in Vietnam. The study aimed to investigate improvement in knowledge and practice of community pharmacists in asthma counselling after attending a short training course. METHODS: 300 pharmacists consented to participate in a study using simulated patients. A knowledge questionnaire about asthma medications and a standardized inhaler checklist were designed to test before and after training. Pharmacists were invited to attend a short training course (3h) focused on counselling asthma patients (asthma control, distinguish relievers and controllers, side effects, medication adherence, inhaler technique teaching). After the training, 10 simulated patients trained with a standardized asthma case were sent to the community pharmacy to test the pharmacist's knowledge and practice. RESULTS: After the training, number of correct answer and score of asthma knowledge of pharmacists increased remarkably (p< 0.001). While there was no pharmacist performed correctly both metered-dose inhaler (MDI) and dry powder inhaler (DPI) in pre-training, > 50% performed correctly in post-training (p< 0.001). Regarding tested by simulated patients, knowledge and practice of pharmacists in the training group improved significantly. 94.3% of pharmacists in training group could distinguish relievers and controllers compared with under 50% in no-training group (p< 0.001). Percentage of pharmacists counselling correctly about controller adherence in training group was statistically higher than no-training group (91.8% vs 63.6%). Pharmacists attended training also performed better in counselling asthma patients about side effects of asthma medications (p< 0.001). When teaching patients in pharmacy, inhaler technique score of training group was significantly higher than the no-training group (6.1 vs 4.3, p< 0.001). CONCLUSIONS: A short training course was effective in providing community pharmacists with necessary knowledge about asthma and medications to improve quality of counselling asthma patients in community pharmacy
objeCtives: To describe the effectiveness and side effects of oseltamivir for treatment of influenza through meta-analysis of published meta-analysis. Methods: Meta-analysis of meta-analyses published from 2009 in general and/or at risk population in all age groups was carried out. Studies that assessed the treatment of cases confirmed or diagnosed with Influenza-Like Illness (ILI) with oseltamivir at any doses in comparison with doing nothing, placebo or other medication, was included. Treatment with medicinal plants were excluded. The electronic databases PubMed and Cochrane Collaboration were consulted and reliability of meta-analysis was evaluated with the SURE methodology by independent pairs. The studies qualified as fatal flaws were excluded. For the combination of the outcomes we selected the outcomes comparable in age and risk group with the random effects model. Results: The search strategy captured 16 meta-analyses, and three studies were meta-analyzed. The outcomes selected were pneumonia in children and adults. In children, the reduction of pneumonia associate to influenza was 0.78 (0.52 -1.17); I2 = 57.4%; and Number Needed to Treat (NNT) to avoid a case of pneumonia was 254.4. In adults the reduction of pneumonia associate to influenza was 0.66 (0.34 -1.29); I2 = 86.5%; and the NNT was 214. ConClusions: This analysis showed effectiveness of oseltamivir in preventing influenza-associated pneumonia, but the combined estimates include the null value in the confidence intervals.
Limited data exist on the prevalence of asthma in Europe in recent years. This study estimated the prevalence of diagnosed asthma, the proportion of patients with diagnosed asthma receiving treatment, and the severity distribution of asthma in five European countries in 2018. METHODS: Data from the population-based, cross-sectional, online, patient-reported National Health and Wellness Survey (NHWS) among adults ($18 years of age) conducted in France, Germany, Italy, Spain and the United Kingdom (UK) were used in this study. The NHWS sample is representative of the adult population of the five European countries and is drawn from an internet panel stratified by age and gender in each country. In this survey, the case definition of asthma included survey respondents who reported experiencing asthma symptoms in the past 12 months and who confirmed receiving a physician diagnosis of asthma. Respondents with asthma were asked whether they were receiving any prescription treatments for asthma at the time of the survey and were also asked to rate the severity of their asthma (mild, moderate, or severe).
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