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Economic Evaluation and Cost-Effectiveness of Health Care Interventions
Published in Emmanuel Lesaffre, Gianluca Baio, Bruno Boulanger, Bayesian Methods in Pharmaceutical Research, 2020
Nicky J Welton, Mark Strong, Christopher Jackson, Gianluca Baio
In the guideline for acute depression in adults with bipolar disorder (NICE, 2014), the economic model took the form of a decision tree. A simplified version of the decision tree is displayed in Figure 15.2. Under each treatment decision option, a patient may either discontinue treatment or continue on treatment. For patients who continue on treatment, they may either respond or not, and those that respond may achieve a partial response or a full response. Responders may subsequently relapse, with a probability that depends on whether they had achieved a partial or full response. Patients that relapse may either enter a manic or depressive episode. If patients discontinue treatment or fail to respond, then their subsequent costs and benefits are the same as if they used no pharmacological treatment. The actual model used in the guideline (NICE, 2014) had the added complication that patients who discontinue or fail to respond are given the option of a second-line treatment, where the costs and consequences of the second-line treatment are as for the first-line treatments. The time-horizon of the model was 18 weeks, to capture treatment of the acute depression phase of bipolar disorders, after which long-term pharmacological maintenance treatment would be initiated. The parameters θ comprise the probabilities of following each path in the tree, and the costs and health effects associated with each outcome, as described in Section 15.4.4.
Neurofeedback in Combination with Psychotherapy
Published in Hanno W. Kirk, Restoring the Brain, 2020
Moreover, pharmacological treatment methods lack specificity for target areas in the brain and can lead to unwanted side effects and/or unpleasant outcomes, such as dry mouth, headache, nausea, constipation, and sexual dysfunction, adversely affecting the patients’ quality of life.9
Sleep and pregnancy complications
Published in Moshe Hod, Vincenzo Berghella, Mary E. D'Alton, Gian Carlo Di Renzo, Eduard Gratacós, Vassilios Fanos, New Technologies and Perinatal Medicine, 2019
A consensus statement on the management of RLS during pregnancy was recently published (35). Treatment is usually based on symptom severity: for mild cases, simple reassurance may be sufficient. For moderate intensity symptoms, treatment guidelines recommend considering nonmedication treatment as primary. These include avoidance of alcohol and tobacco use, relaxing exercises like yoga, pneumatic compressions, massage, and treatment of obstructive sleep apnea. For severe symptoms causing significant distress and impairment and that occur at least twice a week, pharmacological treatment should be considered with the use of the lower effective dose and for the shortest duration. Treatment should be reassessed periodically and at delivery.
Characterisation of medication side effects in patients with mostly resistant depression in a real-world setting
Published in The World Journal of Biological Psychiatry, 2023
Fabio Panariello, Siegfried Kasper, Joseph Zohar, Daniel Souery, Stuart Montgomery, Panagiotis Ferentinos, Dan Rujescu, Julien Mendlewicz, Diana De Ronchi, Alessandro Serretti, Chiara Fabbri
Side effects negatively impact on dose titration to optimal dosages, with the consequence of interfering with the probability of symptoms remission and the prevention of relapse and recurrence (Kelly et al. 2008). In addition, the onset and the severity of side effects compromise patients’ quality of life and daily activities, representing one of the most relevant causes of drug non-adherence and discontinuation (Lingam and Scott 2002). In MDD outpatients on pharmacological treatment, 53% reported that they stopped the treatment within the first 6 months and of these, 23% attributed the choice to side effects disrupting daily functioning and quality of life (Demyttenaere et al. 2001). In other cases, side effects lead to poor adherence to the treatment, i.e. irregular intake of the prescribed drug(s) or dose. There is considerable evidence that this is linked to treatment ‘pseudo-resistance’ in MDD (Voineskos et al. 2020).
Symptoms associated with ADHD/treatment-related adverse side effects and their impact on quality of life and work productivity in adults with ADHD
Published in Current Medical Research and Opinion, 2023
Jeff Schein, Martin Cloutier, Marjolaine Gauthier-Loiselle, Rebecca Bungay, Annie Guerin, Ann Childress
As per the study eligibility criteria, all participants were receiving a pharmacological treatment at the time of data collection, with 93.7% receiving stimulants, 17.9% receiving non-stimulants, and 38.6% receiving combination therapy, including 11.6% who were receiving both stimulants and non-stimulants; 56.9% of participants were treated with their current ADHD medication for more than 24 months (Table 2). Most participants (73.2%) reported at least sometimes skipping or missing a planned dose of their current pharmacological treatment, with 19.7% reporting skipping or missing a planned dose at least half of the time. Of those skipping or missing a planned dose, the main reported reasons were problems with obtaining prescription (54.4%), forgot to take it (51.4%), timing of dosing conflicts with daily routine and/or other activities (25.0%), and experienced or to avoid potentially experiencing undesirable effects (19.9%).
Azelaic acid loaded chitosan and HPMC based hydrogels for treatment of acne: formulation, characterization, in vitro-ex vivo evaluation
Published in Pharmaceutical Development and Technology, 2022
Muhammet Davut Arpa, İkbal Merve Seçen, Ümit Can Erim, Ayşegül Hoş, Neslihan Üstündağ Okur
Pharmacological treatment of acne includes active ingredients such as tetracyclines, erythromycin, clindamycin, azithromycin, benzoyl peroxide, fusidic acid, azelaic acid, isotretinoin, adapalene, nadifloxacin, spironolactone and salicylic acid. (Shalita et al. 1995; Sommer et al. 1997; Elman and Lebzelter 2004; Taub 2007; Kobayashi et al. 2011; Leyden and del Rosso 2011; Austin and Fleischer 2017; Patel and Prabhu 2020; Ilic et al. 2021). Pharmacological treatment is carried out either systemically or topically in the form of either monotherapy or combined therapy, depending on the type and course of the disease (Kim and Ochsendorf 2016). Topical therapy is considered as the first choice for mild and moderate acne, especially when the side effects of drugs used systemically are considered extensively (Kahraman et al. 2016).