Global & Regional Health Technology Assessment最新文献

{"title":"Usefulness of dalbavancin in early discharge and nonhospitalization. It's time to throw your heart over the obstacle?","authors":"Massimo Crapis, Sergio Venturini, Astrid Callegari, Giovanni Del Fabro, Igor Bramuzzo, Laura De Santi, Elisa Pontoni, Maurizio Tonizzo, Barbara Basso","doi":"10.33393/grhta.2024.3071","DOIUrl":"10.33393/grhta.2024.3071","url":null,"abstract":"<p><strong>Introduction: </strong>Dalbavancin is a semisynthetic lipoglycopeptide long-acting antibiotic approved for the treatment of acute bacterial skin and skin structure infections (ABSSSIs). Its features can be useful in the current healthcare scenario characterized by the shortage of available hospital beds.</p><p><strong>Materials methods and results: </strong>We implemented several actions in order to optimize the use of dalbavancin allowing an improvement strategy both from the healthcare system and the patient's perspective in two hospital settings. In the Emergency Department we hospitalized only patients who met the clinical criteria and not the logistic criteria (i.e., the need for antibiotic therapy infusion). During the years 2017-2023, this strategy was applied in 40 cases, thus avoiding 40 hospitalizations for a total saving of 280 days of hospitalization.In the Internal Medicine ward and surgery department when there was no longer any need for hospitalization, we discharged the patient as early as possible. During the years 2017-2023, this strategy was applied in 189 cases, saving at least 1,134 days of hospitalization. The outcome of the treated patients was favorable in 228 out of 229 patients (99.5%).</p><p><strong>Conclusions: </strong>Our experience using dalbavancin in ABSSSI has been very satisfactory overall. The efficacy was close to 100%. Minor adverse events of slight severity occurred rarely. At the same time, this strategy allowed a more efficient allocation of hospital beds. Dalbavancin presents an ideal pharmacodynamic/pharmacokinetic profile for the management of ABSSSI especially in settings where shortage of hospital beds is critical.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 2","pages":"18-21"},"PeriodicalIF":0.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, organizational, and pharmacoeconomic perspectives of dalbavancin vs standard of care in the infectious disease network.","authors":"Daniela Segala, Marco Barbieri, Mariachiara Di Nuzzo, Melissa Benazzi, Aurora Bonazza, Letizia Romanini, Brunella Quarta, Kristian Scolz, Anna Marra, Diana Campioni, Rosario Cultrera","doi":"10.33393/grhta.2024.3094","DOIUrl":"10.33393/grhta.2024.3094","url":null,"abstract":"<p><strong>Introduction: </strong>The therapeutic approach to the patient with acute bacterial skin and skin structure infection (ABSSSI) and complicated infections often involves the early transition from intravenous to oral therapy (early switch) or early discharge. Our study aimed to evaluate sustainable and innovative care models that can be transferred to community healthcare and the economic impact of dalbavancin therapy vs Standard of Care (SoC) therapy for the treatment of ABSSSI and other Gram-positive infections including those by multidrug-resistant organisms. We also described the organization of an infectious disease network that allows optimizing the treatment of ABSSSI and other complex infections with dalbavancin.</p><p><strong>Materials and methods: </strong>We retrospectively studied all patients treated with dalbavancin in the University Hospital \"S. Anna\" of Ferrara, Italy, between November 2016 and December 2022. The clinical information of each patient was collected from the hospital's SAP database and used to evaluate the impact of dalbavancin in early discharge with reduction of length of stay promoting dehospitalization and in improving adherence to antibiotic therapy.</p><p><strong>Results: </strong>A total of 287 patients (165 males and 122 females) were included in the study of which 62 were treated with dalbavancin. In 13/62 patients dalbavancin was administered in a single dose at the completion of therapy to facilitate early discharge. Assuming a 12-day hospitalization required for the treatment of ABSSSI or to complete the treatment of osteomyelitis or spondilodiscitis, the treatment with dalbavancin results in a cost reduction of more than €3,200 per single patient compared to SoC (dancomycin, linezolid or vancomycin).</p><p><strong>Conclusions: </strong>Dalbavancin has proven to be a valid therapeutic aid in the organization of a territorial infectious disease network given its prolonged action, which allows the dehospitalization with management of even patients with complex infections in outpatient parenteral antimicrobial therapy.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 2","pages":"5-12"},"PeriodicalIF":0.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Place in therapy of dalbavancin to treat Gram-positive infections in antimicrobial resistance era: an overview.","authors":"Rosario Cultrera","doi":"10.33393/grhta.2024.3108","DOIUrl":"10.33393/grhta.2024.3108","url":null,"abstract":"","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 2","pages":"1-4"},"PeriodicalIF":0.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Models of care and relevance of territorial management in assisting persons with epilepsy.","authors":"Oriano Mecarelli","doi":"10.33393/grhta.2024.2889","DOIUrl":"10.33393/grhta.2024.2889","url":null,"abstract":"<p><p>Epilepsy is a widespread social disease that affects people of all ages and often involves both diagnostic and therapeutic difficulties. Beyond seizure control, it is necessary to ensure people with epilepsy a good quality of life and respect for human rights, seeking to increase self-management capacity and break down stigma. People with epilepsy should have privileged access to specialized epilepsy centers, where multidisciplinary care is possible. These centers, organized by different levels of complexity, should be uniformly distributed throughout the country and networked together. The scientific community and health care organizations must therefore design all necessary strategies so that knowledge about epilepsy improves among the general population and the most effective pathways of care are effectively implemented.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 1","pages":"2-7"},"PeriodicalIF":0.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the hospital pharmacist to guarantee access and continuity of care for the management of epilepsy.","authors":"Marcello Pani","doi":"10.33393/grhta.2024.2970","DOIUrl":"10.33393/grhta.2024.2970","url":null,"abstract":"<p><p>In this article the pivotal role of hospital pharmacists in the multidisciplinary management of epilepsy is discussed. Hospital pharmacists are members of national and local ethics committees, oversee clinical trials, and ensure adherence to regulations for patient access to novel therapeutic treatments. They actively contribute to regulatory processes and the definition of prescribing centers. In the post-launch phase, hospital pharmacists are a key member in the multidisciplinary team, they are involved in decisions relating to the local introduction of drugs, in the management of the drug within the hospital structure and with the direct distribution, and to ensure proper and timely treatment. The pharmacovigilance network, including hospital and community pharmacists, monitors and prevents adverse effects related to epilepsy medications and enhances a collaborative approach with specialists to promote prescription appropriateness, targeting therapy for better patient outcomes. Finally, the potential benefits of deprescribing are briefly discussed, underscoring the importance of a multidisciplinary approach involving doctors and clinical pharmacists to gather comprehensive data and enhance patient care in epilepsy management.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 1","pages":"8-10"},"PeriodicalIF":0.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital pharmacists and their role in the management of epilepsy.","authors":"Marcello Pani","doi":"10.33393/grhta.2024.2890","DOIUrl":"https://doi.org/10.33393/grhta.2024.2890","url":null,"abstract":"","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 1","pages":"1"},"PeriodicalIF":0.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical pharmacy and telemedicine: an opportunity to improve epilepsy management.","authors":"Rossella Moscogiuri","doi":"10.33393/grhta.2024.3095","DOIUrl":"10.33393/grhta.2024.3095","url":null,"abstract":"<p><p>Clinical pharmacy, as defined by the European Society of Clinical Pharmacy, is a comprehensive professional practice encompassing all pharmacist profiles regardless of the setting. It focuses on promoting optimal drug utilization for patient-centric clinical outcomes. Telemedicine leverages information and communication technologies for remote healthcare delivery, bridging geographical gaps. The integration of clinical pharmacy and telemedicine is crucial in modern healthcare paradigms, especially for patients with chronic illnesses. In 2021, marketing authorization was granted for cenobamate as adjunctive treatment for focal-onset seizures with or without secondary generalization in adults with epilepsy who have not been adequately controlled despite a history of treatment with at least two antiepileptic medicinal products. This review emphasizes the synergistic role of clinical pharmacists and neurologists in utilizing telemedicine for patient counselling, drug information dissemination, adverse drug reaction surveillance, and personalized medication management within the context of epilepsy care. This integration could enhance patient safety, therapeutic outcomes and address socio-economic challenges faced by chronic patients.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 1","pages":"11-14"},"PeriodicalIF":0.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valutazione dell’innovatività e negoziazione di prezzi e rimborso dei farmaci: raccomandazioni da un panel di esperti.","authors":"Claudio Jommi, Francesca Patarnello, Cosetta Bianchi, Giuliano Buzzetti","doi":"10.33393/grhta.2024.3107","DOIUrl":"10.33393/grhta.2024.3107","url":null,"abstract":"","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 ","pages":"169-174"},"PeriodicalIF":0.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the administrative burden faced by hematologists: a comprehensive study in Italy.","authors":"Davide Petruzzelli, Marco Vignetti, Stefania Trasarti, Paolo Sportoletti, Silvia Della Torre, Roberto Cairoli, Francesca Pia Chiara Leone, Giuseppe Pompilio, Marco Gullì, Eva Brown Hajdukova, Davide Integlia","doi":"10.33393/grhta.2024.3042","DOIUrl":"10.33393/grhta.2024.3042","url":null,"abstract":"<p><strong>Background: </strong>Administrative burdens have been identified as a major issue impacting patient care, professional practice, and the overall efficiency of healthcare systems. The aim of this study is to assess the administrative burden faced by Italian hematologists.</p><p><strong>Methods: </strong>A cross-sectional survey that included both closed-ended quantitative questions and open-ended free text answer options was administered to 1,570 hematologists working with malignancies and members of Italian GIMEMA Foundation - Franco Mandelli ONLUS and the Italian Linfomi Foundation (FIL). The survey was conducted online from May 24 to June 30, 2023. Descriptive statistics were computed for the quantitative data to clearly summarize the responses and descriptive analysis of free text responses was carried out.</p><p><strong>Results: </strong>Surveyed hematologists spend an average of 47.07% of their time on administrative tasks, with 63.22% (n = 110) of respondents reporting spending at least half of their time on these activities. More than half (57.47%, n = 100) reported that \"Patient care\" is the medical task most affected by a lack of time. Additionally, 55.17% (n = 96) reported experiencing burnout in the past 6 months, with filling out \"Forms\" being identified as the top contributing administrative task by 27.59% (n = 48) of respondents, followed by \"Scheduling\" (24.71%, n = 43) and \"Managing IT system failures\" (21.84%, n = 38). Nearly half of the surveyed hematologists (45.40%, n  =  = 79) identified patient care as the top priority requiring more time.</p><p><strong>Conclusions: </strong>The study confirms that the administrative workload of hematologists has a significant impact on patient care, communication, and burnout risk, reducing the time available for patient care, leading to exhaustion and concern about clinical errors.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 ","pages":"161-168"},"PeriodicalIF":0.4,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11228512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cabozantinib use in second or subsequent line of treatment in renal cell carcinoma: an analysis of Italian administrative databases.","authors":"Cristian Lolli, Antonio Verde, Luca Degli Esposti, Valentina Acciai, Alessia Brigido, Emanuela Proietti, Sarah Scagliarini","doi":"10.33393/grhta.2024.2892","DOIUrl":"10.33393/grhta.2024.2892","url":null,"abstract":"<p><strong>Background: </strong>Cabozantinib use in everyday clinical practice for advanced or metastatic renal cell carcinoma (RCC) is relatively recent, and real-world data on treatment persistence, adherence and sequencing are still limited.</p><p><strong>Methods: </strong>We conducted an analysis based on an integrated administrative database, covering around 6.9 million health-assisted Italian individuals, to explore the use of cabozantinib for RCC. Patients with at least one prescription for cabozantinib during 2017-2020 were searched. These were characterized during all available period (i.e. from 2010 onwards) before the index date and were observed after inclusion.</p><p><strong>Results: </strong>A total of 113 patients treated with cabozantinib in second or subsequent line were included, and their demographic, clinical and treatment characteristics were described. About half of these RCC patients were aged >65 years (47.8%). Sixty patients (53.1%) were highly adherent to cabozantinib therapy, and the median cabozantinib treatment duration of use was 8.7 months (95% confidence interval: 5.8-11.1). During the first year of follow-up, the average total cost per patient was €32,508.</p><p><strong>Conclusions: </strong>We described second or subsequent line cabozantinib treatment for RCC in a real-world setting and the economic burden of disease in Italy, taking advantage of large, integrated administrative databases.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 ","pages":"154-160"},"PeriodicalIF":0.4,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11228513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}