AboutOpen Pub Date : 2024-07-17 DOI: 10.33393/ao.2024.3096

L. Degli Esposti, Alessandro Tabarroni, Valentina Perrone, Luisa Gervasio, Alberto Pinelli, Grazia Sances

{"title":"An Activity-Based Costing model applied to the management process of patients with migraine at IRCCS Mondino Foundation","authors":"L. Degli Esposti, Alessandro Tabarroni, Valentina Perrone, Luisa Gervasio, Alberto Pinelli, Grazia Sances","doi":"10.33393/ao.2024.3096","DOIUrl":"https://doi.org/10.33393/ao.2024.3096","url":null,"abstract":"Background and aim: The ageing of the general population, with the increase in chronic diseases, poses the need for using technological innovation to face the growing healthcare needs. The present analysis applied the Activity-Based Costing tool in migraine patients followed at the IRCCS Mondino of Pavia to formalize and quantify the costs of the whole patient’s management process and to estimate the overall economic burden of migraine from the perspective of the National Health Service (NHS).\u0000Methods: A two-stage analysis was conducted. The first stage aimed at drawing patient’s pathway, defining all the possible activities and actors involved in the healthcare delivery and treatment for migraine at the IRCCS during year 2022. The second phase was the development of a model to estimate the costs of the entire process by pricing the individual activities.\u0000Results: The described model yielded an estimated total annual cost for the overall management of migraine of € 1,222,392, corresponding to a direct cost for a therapy of approximately 6 months per single patient of € 814. The most impactive items on the estimated annual expenditures were hospitalizations, followed by diagnostic examinations after follow-up visits and drugs dispensed by Hospital Pharmacy for home-administration (monoclonal antibodies).\u0000Conclusions: This analysis allowed detailing the single activities and resources used in migraine patient’s pathway and then estimating the direct costs sustained by the NHS. The model could be translated to other diseases for optimizing the diagnostic/therapeutic and economic management of assisted patients and improving healthcare resource allocation.","PeriodicalId":511117,"journal":{"name":"AboutOpen","volume":" 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Training needs and educational sources of European musculoskeletal specialists: learning outcomes of the IBSA International Academy – MSK Modules 欧洲肌肉骨骼专家的培训需求和教育来源：IBSA 国际学院--MSK 模块的学习成果

AboutOpen Pub Date : 2024-07-01 DOI: 10.33393/ao.2024.3150

Stefano Guerrasio, Ivan Saenz, Michele Fasola, Giuliana Villa

{"title":"Training needs and educational sources of European musculoskeletal specialists: learning outcomes of the IBSA International Academy – MSK Modules","authors":"Stefano Guerrasio, Ivan Saenz, Michele Fasola, Giuliana Villa","doi":"10.33393/ao.2024.3150","DOIUrl":"https://doi.org/10.33393/ao.2024.3150","url":null,"abstract":"Background: Building a meaningful training program for musculoskeletal (MSK) specialists is a major undertaking to improve the clinicians’ skills and ultimately patients’ outcome. The purpose of this study was to gather direct information from attendants of a training program called IBSA International Academy – MSK Modules on the perceived benefit of such initiative.\u0000Methods: The IBSA International Academy has been developed during 2021 by IBSA’s Global Medical Affairs department with the involvement and support of an international faculty composed by experts in the field that has become the scientific Board of the Academy. More than 100 specialists from several European countries attended one or more modules focused on ultrasound (US) and US-guided infiltration and were asked to answer (a) a short survey just after the modules were completed and (b) a more detailed survey several weeks after their return to daily practice.\u0000Results: A total of 114 specialists from 12 European countries attended the academy. The post-module evaluation form was completed by 94 (82.4%) and the follow-up survey by 30 (26.3%) participants. Response rate was highest for specialists from Nordic countries (50.0%) and lowest from Balkan countries (11.1%). The overall feedback of the participants to the academy was overwhelmingly positive both immediately and medium–long term after return to daily practice. About 57% of responders indicated mastering US and 30% indicated a better understanding of the anatomy as a key learning outcome of the academy. The added value of networking between peers and of direct contact with the experts in the faculty was mentioned by 77% and 53% respectively.","PeriodicalId":511117,"journal":{"name":"AboutOpen","volume":"51 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using the Nephrology Referral Form in Italian primary care to improve the care pathway of patients with anemia or other complications related to chronic kidney disease: survey findings 在意大利初级保健中使用肾脏病转诊表改善贫血或其他慢性肾脏病并发症患者的护理路径：调查结果

AboutOpen Pub Date : 2024-05-15 DOI: 10.33393/ao.2024.3066

Giuseppe Pompilio, Francesca Pia Chiara Leone, M. Gullì, Davide Integlia

{"title":"Using the Nephrology Referral Form in Italian primary care to improve the care pathway of patients with anemia or other complications related to chronic kidney disease: survey findings","authors":"Giuseppe Pompilio, Francesca Pia Chiara Leone, M. Gullì, Davide Integlia","doi":"10.33393/ao.2024.3066","DOIUrl":"https://doi.org/10.33393/ao.2024.3066","url":null,"abstract":"Introduction: Anemia is a potentially reversible condition in early chronic kidney disease (CKD) that requires timely intervention. General practitioners (GPs) play a crucial role in recognizing CKD. A new Nephrology Referral Form (NRF) was developed and tested in the Italian setting.\u0000Methods: This mixed-methods survey, conducted between 2021 and 2022, introduced the NRF through focus group discussions involving a scientific committee. The NRF was tested in a 6-month trial involving 24 GPs each from Lazio and Puglia regions. GPs provided feedback on the use of the NRF in clinical practice through a questionnaire sent via Microsoft Form. The data were analyzed descriptively.\u0000Results: After 6 months, 41.67% of the GPs were using the NRF at least once a week. Diabetes mellitus and hypertension were common triggers for NRF assessments. GPs overwhelmingly agreed (96%) on the NRF’s utility in identifying CKD cases, with 92% citing its effectiveness in diagnosing well-defined cases. The NRF facilitated specialist referrals, with 83% of GPs reporting increased referrals compared to the prior 6 months. Feedback underscored the NRF’s positive impact, suggesting improvements such as additional referral centers, regional/national networks, enhanced GP training, and increased collaboration.\u0000Conclusion: GPs regularly used the NRF to identify and diagnose cases of CKD, streamlining the referral process and increasing referrals to specialists. Feedback emphasized the NRF’s positive impact and highlighted its potential as a valuable tool for enhancing early CKD detection, interventions, and fostering multidisciplinary management in primary care for better patient outcomes.","PeriodicalId":511117,"journal":{"name":"AboutOpen","volume":"22 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140974488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Economic evaluation of two therapeutic sequences in the first-line treatment of moderate to severe active ulcerative rectocolitis in Italy 意大利对中度至重度活动性溃疡性直肠结肠炎一线治疗中两种治疗序列的经济评估

AboutOpen Pub Date : 2024-03-02 DOI: 10.33393/ao.2024.2893

P. Armeni, Elena Compagnucci, G. Fiorino, Vincenzo Lolli, Grazia Mazzone, A. Orlando, M. Principi, Roberto Ravasio, Fernando Rizzello, E. Savarino, Francesca Tombari

{"title":"Economic evaluation of two therapeutic sequences in the first-line treatment of moderate to severe active ulcerative rectocolitis in Italy","authors":"P. Armeni, Elena Compagnucci, G. Fiorino, Vincenzo Lolli, Grazia Mazzone, A. Orlando, M. Principi, Roberto Ravasio, Fernando Rizzello, E. Savarino, Francesca Tombari","doi":"10.33393/ao.2024.2893","DOIUrl":"https://doi.org/10.33393/ao.2024.2893","url":null,"abstract":"Background: Vedolizumab (VDZ) and infliximab are used to treat moderate to severe ulcerative colitis (UC). The choice of the drug to use at first-line is often based on a combination of clinical and economic factors. The cost of treatment pathway is rarely considered. Therefore, this cost-consequence analysis (CCA) investigated the overall costs of treatment pathway for vedolizumab followed by infliximab (VDZ → IFX) compared to infliximab followed by vedolizumab (IFX → VDZ).\u0000Methods: We used a published cost-consequence model (CCM), based on a targeted literature search reporting the time-on-treatment data for vedolizumab or infliximab in UC in first and second-line of treatment. CCM time horizon was defined by the length of treatment sequences. Considering the Italian hospital perspective, the CCA evaluated the biologic drugs acquisition costs, drug administration costs, hospitalization costs, switch costs, colectomy costs and third-line treatment costs. Third-line options included colectomy, tofacitinib, ustekinumab or dose escalation of second-line biologic.\u0000Results: Over the 5.2-year time horizon (duration of the longer VDZ → IFX pathway), the mean cost per patient of VDZ → IFX pathway was slightly lower than the mean cost per patient of IFX → VDZ pathway (€ 86,339 vs 89,636). The CCM predicted that using VDZ as first-line treatment delayed the time to costly third-line therapies compared to first-line using IFX (VDZ-first-line median time-on-treatment 3.6-years and IFX-second-line 1.6-years; IFX-first-line 1.4-years and VDZ-second-line 2.3-years and third-line 1.5-years).\u0000Conclusion: The CCA showed that a biologic treatment pathway that begins with first-line vedolizumab is not more expensive than one beginning with first-line infliximab and delayed the time to costly third-line.","PeriodicalId":511117,"journal":{"name":"AboutOpen","volume":"27 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140267444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fournier’s gangrene wounds successfully healed with High pbserum enzymes: a case report 使用高浓度 pbserum 酶成功治愈 Fournier 坏疽伤口：病例报告

AboutOpen Pub Date : 2024-02-26 DOI: 10.33393/ao.2024.2736

Eugenia Paris, Jorge López Berroa

{"title":"Fournier’s gangrene wounds successfully healed with High pbserum enzymes: a case report","authors":"Eugenia Paris, Jorge López Berroa","doi":"10.33393/ao.2024.2736","DOIUrl":"https://doi.org/10.33393/ao.2024.2736","url":null,"abstract":"Fournier’s gangrene is an aggressive form of infective necrotizing fasciitis in the perianal and genital area. In this article we discuss the case of a 75-year-old male patient diagnosed with Fournier’s gangrene with the entire perianal region affected. Surgical washings were performed and debridement with multiple flaps were required for reconstruction. Complications in the suture wounds, cavities, and a seroma were observed after 5 weeks, and they were treated with dressings. Treatment with High pbserum recombinant enzymes was initiated after 3 weeks, to accelerate the closure of the wounds. The granulation tissue was irrigated by drip irrigation once every 3 weeks, ensuring good tissue impregnation. We observed that the epithelialization of the affected areas was achieved after the first week, and in 1 month, most of the wounds healed properly without signs of infection. High pbserum is an enzyme cocktail, composed of higher collagenase concentration, lipase, and liase. This study shows how High pbserum improves and accelerates wound healing in a patient with Fournier’s gangrene. Further investigations are needed to conclude treatment recommendations.","PeriodicalId":511117,"journal":{"name":"AboutOpen","volume":"125 S178","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140429077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Follow-up of breast cancer: why is it necessary to start a Consensus in 2024? 乳腺癌的随访：为什么有必要在 2024 年启动 "共识"？

AboutOpen Pub Date : 2024-02-23 DOI: 10.33393/ao.2024.2634

Stefania Gori, A. Zambelli, Catia Angiolini, Antonella Ferro, F. De Rose, A. Fabi, Giuseppe Azzarello, Giuseppe Bogina, Maurizio Cancian, Matteo Valerio, M. Cinquini, Fabrizio Nicolis, Giovanni Pappagallo

{"title":"Follow-up of breast cancer: why is it necessary to start a Consensus in 2024?","authors":"Stefania Gori, A. Zambelli, Catia Angiolini, Antonella Ferro, F. De Rose, A. Fabi, Giuseppe Azzarello, Giuseppe Bogina, Maurizio Cancian, Matteo Valerio, M. Cinquini, Fabrizio Nicolis, Giovanni Pappagallo","doi":"10.33393/ao.2024.2634","DOIUrl":"https://doi.org/10.33393/ao.2024.2634","url":null,"abstract":"In Italy, breast cancer is the most frequently diagnosed cancer in women, with 55,900 new cases in 2023 (over 90% in the early stages). Due to the screening, early diagnosis and adjuvant treatment, these patients have a 5-years survival rate of 87% after the diagnosis.\u0000There are 834,154 women in Italy with a previous diagnosis of breast cancer: most of these women require a follow-up.\u0000The AIOM, ESMO and ASCO Guidelines recommend for early breast cancer (EBC) a clinical follow-up with only physical examination (and eliciting of symptoms) and an annual X-ray mammography, on the basis of the results of two randomized trials published in 1994 that showed no benefit in overall survival with intensive follow-up.\u0000However, an Italian survey reported the application by 80% of oncologists of an intensive follow-up based on the individual patient’s risk of recurrence. In fact, the oncologists believe that an early diagnosis of locoregional or distant recurrence may allow an early start of very effective therapies.\u0000In this lack of up-to-date scientific data, many questions about follow-up remain unanswered and the few ongoing studies will provide results in several years.\u0000Non-compliance with guideline recommendations leads to increased costs for the healthcare system. Furthermore, management varies widely from centre to centre with regard to guideline recommendations, resulting in inequalities between patients. For these reasons, the follow-up of breast cancer should be reconsidered.\u0000In the absence of recent scientific evidence, a multidisciplinary group of breast cancer experts has initiated a Consensus on the follow-up of EBC according to the mini-Delphi methodology. The project will be completed by the end of 2024.","PeriodicalId":511117,"journal":{"name":"AboutOpen","volume":"33 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140435433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Environmental sustainability in ophthalmology 眼科的环境可持续性

AboutOpen Pub Date : 2024-02-21 DOI: 10.33393/ao.2024.2690

Vittorio Capuano

引用次数: 0

A case of exaggerated placental site treated with hysteroscopy 一例通过宫腔镜治疗的夸大胎盘部位病例

AboutOpen Pub Date : 2024-01-11 DOI: 10.33393/ao.2024.2611

S. Calzolari, Chiara Comito, Karin Louise Andresson, Giovanna Giarrè, Gianluigi Taddei, Valeria Dubini

引用次数: 0

AboutOpen最新文献