Persons with mental disorders switching from Medicaid to Medicare drug coverage may have drug access problems

2010 ◽  
Keyword(s):  
Mental Disorders ◽  
Drug Coverage ◽  
Drug Access ◽  
Access Problems

scholarly journals Understanding the Battle for Universal Pharmacare in Canada Comment on "Universal Pharmacare in Canada"

2020 ◽  
Author(s):  
Marc-André Gagnon
Keyword(s):  
Prescription Drugs ◽  
Access To Medicines ◽  
Academic Community ◽  
Drug Coverage ◽  
Value For Money ◽  
Drug Access ◽  
Canadian Population ◽  
Overwhelming Evidence ◽  
Appropriate Prescribing ◽  
Catastrophic Coverage

Drug coverage in Canada is a patchwork; an inequitable inefficient and unsustainable patchwork with no coherence or purpose. Some people think that we can solve the problem by adding more patches, but the core of the problem is that it is a patchwork. For the working population, access to medicines is still organized as privileges offered by employers to their employees. Universal pharmacare would not only provide better access to needed prescription drugs, but also eliminate waste, ensure value-for-money and help improve drug safety and appropriate prescribing. Opponents fear that a universal pharmacare plan would ration drugs, and impede drug access for some patients. However, these claims misunderstand the reality of drug coverage, pricing and access. Opponents propose, instead, to "fill the gap" of current drug coverage by implementing catastrophic coverage, which would serve commercial interests without maximizing health outcomes for the Canadian population. In spite of overwhelming evidence and consensus in the academic community in favour of universal pharmacare, the battle is far from over.

scholarly journals Extent of Drug Coverage across Generic Drug Discount Programs offered by Community Pharmacies: A look at five Chronic Conditions

2012 ◽  
Vol 3 (2) ◽  
Author(s):  
Harshali K. Patel ◽  
Peter O. Akinwunmi ◽  
Sujit S. Sansgiry
Keyword(s):  
Mental Disorders ◽  
Generic Drug ◽  
Chronic Conditions ◽  
Generic Drugs ◽  
Drug Coverage ◽  
Descriptive Statistics ◽  
Sales Volume ◽  
Innovative Strategies ◽  
Respiratory Conditions ◽  
Improve Access

Background: Chronic conditions are expensive to treat because of the ongoing prescription cost burden. Generic drug discount programs (GDDPs) that offer generics at discounted price may prove beneficial to reduce pharmacy costs for the same. Objective: The objective of this study was to assess the extent to which GDDPs provide drug coverage for five common chronic conditions. Methods: A content analyses of preexisting information was conducted. Extent of coverage based on top 200 generic drugs prescribed during 2008 for the treatment of chronic conditions such as hypertension, mental disorders, arthritis, pulmonary/respiratory conditions, and diabetes were identified. Commonly prescribed medications for these diseases were identified using published peer reviewed clinical guidelines. List of drugs covered under a GDDP for stores, Wal-Mart, Walgreens, CVS, Kroger, HEB, Target, and Randalls were obtained and compared to assess drug coverage by retail dollar sales and sales volume. Descriptive statistics and frequency/percentage of coverage were reported using SAS 9.2. Results: GDDPs covered the highest number of drugs for hypertension (21-27 across different GDDPs) and the least (3-5 across different GDDPs) for pulmonary/respiratory conditions. Arthritis (5-11), mental disorders (6-11) and diabetes (5-7) had similar coverage. When compared to the top 200 drugs by retail dollars spent during 2008, hypertension (68%-87%) and diabetes (63%-88%) had the highest coverage followed by respiratory conditions (30%-50%), arthritis (22%-48%), and mental disorders (21%-38%). Similar result was obtained when GDDP coverage was compared with the top 200 generic drugs by sales volume, where diabetes (63-88%) and hypertension (57%-74%) had the highest coverage and mental disorders remained the lowest (23%-37%). Conclusion/Implications: Drug coverage in GDDPs varied by pharmacies across the five common chronic conditions evaluated which may limit accessibility of these programs for uninformed consumers. Drug coverage was higher for diabetes and hypertension compared to mental disorders, arthritis, and pulmonary/respiratory conditions. Innovative strategies such as a national GDDP formulary list or internet-based technological tools to help consumers identify comparative drug coverage may be useful to improve access to these medications.   Type: Student Project

Reductionist thinking and animal models in neuropsychiatric research

2019 ◽  
Vol 42 ◽  
Author(s):  
Nicole M. Baran
Keyword(s):  
Animal Models ◽  
Mental Disorders ◽  
Environmental Factors ◽  
Neuropsychiatric Disorders ◽  
Model Organisms ◽  
Developmental Genetic ◽  
Term Study ◽  
Genetic And Environmental Factors ◽  
Mechanisms Of Plasticity

AbstractReductionist thinking in neuroscience is manifest in the widespread use of animal models of neuropsychiatric disorders. Broader investigations of diverse behaviors in non-model organisms and longer-term study of the mechanisms of plasticity will yield fundamental insights into the neurobiological, developmental, genetic, and environmental factors contributing to the “massively multifactorial system networks” which go awry in mental disorders.

Assessing Mental and Behavioral Disorder Impairment: Overview of Sixth Edition Approaches

2008 ◽  
Vol 13 (6) ◽  
pp. 1-7
Author(s):  
Norma Leclair ◽  
Steve Leclair ◽  
Robert Barth
Keyword(s):  
Mental Disorders ◽  
Behavioral Disorders ◽  
Psychotic Disorders ◽  
Behavioral Disorder ◽  
Behavioral Impairment ◽  
Central Nervous System Damage ◽  
Brain Functioning ◽  
Sixth Edition ◽  
Diagnostic And Statistical Manual ◽  
Mental And Behavioral Disorders

Abstract Chapter 14, Mental and Behavioral Disorders, in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, defines a process for assessing permanent impairment, including providing numeric ratings, for persons with specific mental and behavioral disorders. These mental disorders are limited to mood disorders, anxiety disorders, and psychotic disorders, and this chapter focuses on the evaluation of brain functioning and its effects on behavior in the absence of evident traumatic or disease-related objective central nervous system damage. This article poses and answers questions about the sixth edition. For example, this is the first since the second edition (1984) that provides a numeric impairment rating, and this edition establishes a standard, uniform template to translate human trauma or disease into a percentage of whole person impairment. Persons who conduct independent mental and behavioral evaluation using this chapter should be trained in psychiatry or psychology; other users should be experienced in psychiatric or psychological evaluations and should have expertise in the diagnosis and treatment of mental and behavioral disorders. The critical first step in determining a mental or behavioral impairment rating is to document the existence of a definitive diagnosis based on the current edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. The article also enumerates the psychiatric disorders that are considered ratable in the sixth edition, addresses use of the sixth edition during independent medical evaluations, and answers additional questions.

When Mental Disorders Suspected, Tools Abound

2006 ◽  
Vol 40 (10) ◽  
pp. 24-25
Author(s):  
KERRI WACHTER
Keyword(s):  
Mental Disorders

Malfunctional Reorganization in the Developing Limbo-Prefrontal System in Animals: Implications for Human Psychoses?

2001 ◽  
Vol 12 (1) ◽  
pp. 8-14
Author(s):  
Gertraud Teuchert-Noodt ◽  
Ralf R. Dawirs
Keyword(s):  
Prefrontal Cortex ◽  
Mental Disorders ◽  
Dentate Gyrus ◽  
Cognitive Functions ◽  
Experimental Approach ◽  
Regulatory Mechanisms ◽  
Hippocampal Dentate Gyrus ◽  
Non Invasive ◽  
Invasive Method ◽  
Activity Dependent

Abstract: Neuroplasticity research in connection with mental disorders has recently bridged the gap between basic neurobiology and applied neuropsychology. A non-invasive method in the gerbil (Meriones unguiculus) - the restricted versus enriched breading and the systemically applied single methamphetamine dose - offers an experimental approach to investigate psychoses. Acts of intervening affirm an activity dependent malfunctional reorganization in the prefrontal cortex and in the hippocampal dentate gyrus and reveal the dopamine position as being critical for the disruption of interactions between the areas concerned. From the extent of plasticity effects the probability and risk of psycho-cognitive development may be derived. Advance may be expected from insights into regulatory mechanisms of neurogenesis in the hippocampal dentate gyrus which is obviously to meet the necessary requirements to promote psycho-cognitive functions/malfunctions via the limbo-prefrontal circuit.

Multidisciplinary management of vascular access for haemodialysis: from the preparation of the initial access to the treatment of stenosis and thrombosis

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 188-198 ◽  
Author(s):  
Reinhold ◽  
Haage ◽  
Hollenbeck ◽  
Mickley ◽  
Ranft
Keyword(s):  
Vascular Access ◽  
Central Venous ◽  
Advantages And Disadvantages ◽  
Multidisciplinary Study ◽  
First Results ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Access Problems ◽  
Arteriovenous Grafts ◽  
The Individual

In February 2008 a multidisciplinary study group was established in Germany to improve the treatment of patients with potential vascular access problems. As one of the first results of their work interdisciplinary recommendations for the management of vascular access were provided, from the creation of the initial access to the treatment of complications. As a rule the wrist arteriovenous fistula (AVF) is the access of choice due to its lower complication rate when compared to other types of access. The AVF should be created 3 months prior to the expected start of haemodialysis to allow for sufficient maturation. Second and third choice accesses are arteriovenous grafts (AVG) and central venous catheters (CVC). Ultrasound is a reliable tool for vessel selection before access creation, and also for the diagnosis of complications in AVF and grafts. Access stenosis and thrombosis can be treated surgically and interventionally. The comparison of both methods reveals advantages and disadvantages for each. The therapeutic decision should be based on the individual patients’ constitution, and also on the availability and experience of the involved specialists.

Angststörungen – von der ICD-10 zur ICD-11

2020 ◽  
pp. 1-5
Author(s):  
Timo D. Vloet ◽  
Marcel Romanos
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

Lexical Access Problems Lead to Disfluencies in Speech

2010 ◽  
Vol 57 (3) ◽  
pp. 169-177 ◽  
Author(s):  
Robert J. Hartsuiker ◽  
Lies Notebaert
Keyword(s):  
Lexical Access ◽  
Picture Naming ◽  
Language Production ◽  
Line Drawings ◽  
Name Agreement ◽  
Access Problems ◽  
Agreement Condition

A picture naming experiment in Dutch tested whether disfluencies in speech can arise from difficulties in lexical access. Speakers described networks consisting of line drawings and paths connecting these drawings, and we manipulated picture name agreement. Consistent with our hypothesis, there were more pauses and more self-corrections in the low name agreement condition than the high name agreement condition, but there was no effect on repetitions. We also considered determiner frequency. There were more self-corrections and more repetitions when the picture name required the less frequent (neuter-gender) determiner “het” than the more frequent (common-gender) determiner “de”. These data suggest that difficulties in distinct stages of language production result in distinct patterns of disfluencies.

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