Review shows back-to-work interventions help for back pain, but authors demand more research into mental health and cardio-respiratory problems

2019 ◽  
Vol 27 (4) ◽  
pp. 4-6
Keyword(s):  
Mental Health ◽  
Back Pain ◽  
Cost Effectiveness ◽  
Academic Research ◽  
Health Conditions ◽  
Content Type ◽  
Respiratory Problems ◽  
Effective Interventions ◽  
Academic Review ◽  
The Cost

Purpose An academic review assessed the evidence for various interventions in helping people with disabilities and health conditions return to work. Design/methodology/approach The authors sifted through academic research, searching for answers to the following two questions: 1. “What is the available evidence on effective interventions in terms of employment outcomes and cost effectiveness?” 2. “Are there gaps in evidence with regard to the effectiveness of interventions for certain conditions?” Findings There is some evidence that interventions for workers with disabilities and health conditions can produce better outcomes at work, but there are huge gaps in the research data. Most studies focus on lower back pain and more research is needed into cardio-respiratory conditions and mental health. There is also a lack of research into the cost-effectiveness of various interventions. Originality/value This study highlights not only the effectiveness of some approaches but also the gaps in the research which need to be plugged to better inform policies.

scholarly journals Do return to work interventions for workers with disabilities and health conditions achieve employment outcomes and are they cost effective? A systematic narrative review

2018 ◽  
Vol 40 (6) ◽  
pp. 999-1014 ◽  
Author(s):  
Pauline Dibben ◽  
Geoffrey Wood ◽  
Rachel O’Hara
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Return To Work ◽  
Cost Effective ◽  
Employment Outcomes ◽  
Health Conditions ◽  
Content Type ◽  
Musculoskeletal Conditions ◽  
Mental Health Conditions ◽  
Lower Back

Purpose The purpose of this paper is to evaluate existing evidence on whether return to work interventions achieve employment outcomes and are cost effective in order to better inform those needing accommodations at work, as well as their line managers and trade union representatives, occupational health specialists and HR managers. Design/methodology/approach The paper uses a systematic narrative review to evaluate the evidence on the employment outcomes and cost effectiveness of return to work initiatives. Findings Evidence on interventions for musculoskeletal conditions such as lower back pain indicates that certain forms of intervention such as vocational rehabilitation and workplace-based rehabilitation facilitate outcomes such as employment, reduced sick leave and effective return to work. However, there is very little evidence on whether these interventions are cost effective. More generally there are glaring gaps in evidence on cardio-respiratory (heart and breathing) and mental health conditions with regard to both employment outcomes and the cost of interventions. Research limitations/implications This systematic review has critical and timely implications for both knowledge development and practice. While highlighting methodological limitations in the existing research base, it also presents avenues for further research on return work strategies and the factors inhibiting and facilitating their adoption and effective operation. Originality/value Although there is much existent literature on the return to work process, far less attention has been paid to the employment outcomes and cost effectiveness of interventions. This paper highlights the interventions for musculoskeletal conditions such as lower back conditions that may result in positive employment outcomes, with implications for practice. However, it also highlights gaps in evidence on the employment outcomes and cost effectiveness of interventions for cardio-respiratory (heart and breathing) and mental health conditions.

The cost-effectiveness of insulin analogs and regular insulin for diabetes control: a case study in Iran

2020 ◽  
Vol 33 (4/5) ◽  
pp. 323-331
Author(s):  
Mohsen pakdaman ◽  
Raheleh akbari ◽  
Hamid reza Dehghan ◽  
Asra Asgharzadeh ◽  
Mahdieh Namayandeh
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Regular Insulin ◽  
Diabetes Control ◽  
Diabetic Patients ◽  
Insulin Analogs ◽  
Content Type ◽  
Patients With Diabetes ◽  
The Government ◽  
The Cost

PurposeFor years, traditional techniques have been used for diabetes treatment. There are two major types of insulin: insulin analogs and regular insulin. Insulin analogs are similar to regular insulin and lead to changes in pharmacokinetic and pharmacodynamic properties. The purpose of the present research was to determine the cost-effectiveness of insulin analogs versus regular insulin for diabetes control in Yazd Diabetes Center in 2017.Design/methodology/approachIn this descriptive–analytical research, the cost-effectiveness index was used to compare insulin analogs and regular insulin (pen/vial) for treatment of diabetes. Data were analyzed in the TreeAge Software and a decision tree was constructed. A 10% discount rate was used for ICER sensitivity analysis. Cost-effectiveness was examined from a provider's perspective.FindingsQALY was calculated to be 0.2 for diabetic patients using insulin analogs and 0.05 for those using regular insulin. The average cost was $3.228 for analog users and $1.826 for regular insulin users. An ICER of $0.093506/QALY was obtained. The present findings suggest that insulin analogs are more cost-effective than regular insulin.Originality/valueThis study was conducted using a cost-effectiveness analysis to evaluate insulin analogs versus regular insulin in controlling diabetes. The results of study are helpful to the government to allocate more resources to apply the cost-effective method of the treatment and to protect patients with diabetes from the high cost of treatment.

scholarly journals Community interventions for people with complex emotional needs that meet the criteria for ‘personality disorder’ diagnoses: a systematic review of economic evaluations

2020 ◽  
Author(s):  
Joe Botham ◽  
Amy Clark ◽  
Thomas Steare ◽  
Ruth Stuart ◽  
Sian Oram ◽  
...  
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Personality Disorder ◽  
Economic Evaluations ◽  
Economic Evidence ◽  
Emotional Needs ◽  
Community Based Interventions ◽  
Community Based ◽  
Single Intervention ◽  
The Cost

AbstractBackgroundDiagnoses of “personality disorder” are prevalent among people using community secondary mental health services. Whilst the effectiveness of a range of community-based treatments have been considered, as the NHS budget is finite, it is also important to consider the cost-effectiveness of those interventions.AimsTo assess the cost-effectiveness of primary or secondary care community-based interventions for people with complex emotional needs that meet criteria for a diagnosis of “personality disorder” to inform healthcare policy making.MethodSystematic review (PRESPORO #: CRD42020134068) of five databases, supplemented by reference list screening and citation tracking of included papers. We included economic evaluations of interventions for adults with complex emotional needs associated with a diagnosis of ‘personality disorder’ in community mental health settings published between before 18 September 2019. Study quality was assessed using the CHEERS statement. Narrative synthesis was used to summarise study findings.ResultsEighteen studies were included. The studies mainly evaluated psychotherapeutic interventions. Studies were also identified which evaluated altering the setting in which care was delivered and joint crisis plans. No strong economic evidence to support a single intervention or model of community-based care was identified.ConclusionThere is no robust economic evidence to support a single intervention or model of community-based care for people with complex emotional needs. The review identified the strongest evidence for Dialectical Behavioural Therapy with all three identified studies indicating the intervention is likely to be cost-effective in community settings compared to treatment as usual. Further research is needed to provide robust evidence on the cost-effectiveness of community-based interventions upon which decision makers can confidently base guidelines or allocate resources.

scholarly journals Update of Markov Model on the Cost-effectiveness of Nonpharmacologic Interventions for Chronic Low Back Pain Compared to Usual Care

Spine ◽  
2020 ◽  
Vol 45 (19) ◽  
pp. 1383-1385
Author(s):  
Patricia M. Herman ◽  
Ryan K. McBain ◽  
Nicholas Broten ◽  
Ian D. Coulter
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cost Effectiveness ◽  
Markov Model ◽  
Usual Care ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
The Cost

scholarly journals Cost-effectiveness evaluation for pricing medicines and devices: A new value-based price adjustment system in Japan

2020 ◽  
Vol 36 (3) ◽  
pp. 270-276
Author(s):  
Takeru Shiroiwa
Keyword(s):  
Cost Effectiveness ◽  
Evaluation System ◽  
Price Adjustment ◽  
Effectiveness Evaluation ◽  
Government Documents ◽  
Academic Review ◽  
Adjustment System ◽  
The Cost ◽  
Trial Implementation ◽  
New System

ObjectivesIn Japan, a new cost-effectiveness evaluation system for medicine and medical device pricing was employed in April 2019 after a trial implementation. This study describes the discussions held from April 2016 to March 2019 concerning the newly introduced system.MethodsUsing published government documents, discussions with stakeholders, and the minutes of the Chuikyo committee meetings, the following issues are addressed: (i) the results of the trial implementation and (ii) an overview of the newly introduced system.ResultsDuring the trial implementation, thirteen products were evaluated and their prices adjusted. The process of the new system—which was to be implemented in FY 2019—takes about 15–18 months to complete after listing of the target products by the National Health Insurance. The target products are selected principally based on sales volume, degree of innovation (premium), and disclosure of rationale for price setting. First, a manufacturer submits the cost-effectiveness data, which is then reviewed by the Center for Outcomes Research and Economic Evaluation for Health (C2H) in collaboration with academics. The results of the cost-effectiveness evaluation are not considered during the decision-making process concerning the product's listing. The price adjustment system is similar to value-based pricing (VBP); hence, the new system can be considered as VBP adjustment.ConclusionCost-effectiveness evaluation can help promote both technological innovation and sustainability of the healthcare system. We need to create a greater capacity for enhancing this academic review system.

PTSD, panic disorder and alcohol use disorder as a triple threat for violence among male jail detainees

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Alexa J. Barrett ◽  
Stephanie L. Taylor ◽  
Albert M. Kopak ◽  
Norman G. Hoffmann
Keyword(s):  
Mental Health ◽  
Alcohol Use ◽  
Panic Disorder ◽  
Alcohol Use Disorder ◽  
Health Conditions ◽  
Post Traumatic Stress ◽  
Content Type ◽  
Mental Health Conditions ◽  
Jail Detainees ◽  
Violent Offenses

Purpose Despite ranking among the most prevalent mental health conditions and their likely contributions to violent offending, post-traumatic stress disorder (PTSD), panic disorder (PD) and alcohol use disorder (AUD) have not been examined closely among adult males detained in rural jails. The purpose of this paper is to assess the prevalence of co-occurring PTSD, PD and AUD within this population and identify their associations with violent offenses. Design/methodology/approach The sample consists of 349 males recently booked into local jails. The Comprehensive Addictions and Psychological Evaluation – 5 was administered to assess mental health conditions. Bivariate statistics and multivariate logistic regression were used to examine associations between PTSD, PD, AUD and violent offenses. Findings A disproportionate number of participants met criteria for PTSD, PD and AUD. Co-occurrence was prevalent among detainees booked for violent offenses with 25% reporting symptoms of all three disorders. PD emerged as the strongest single condition associated with violence, while the combination of PTSD, PD and AUD significantly increased the likelihood of violent offenses. Practical implications A better understanding of the relationship between mental health conditions and violent offenses is essential for efficacious assessment and treatment. Appropriately informed mental health care for jail detainees can increase public safety and guide practices for addressing these conditions within criminal justice populations. Originality/value There is limited research on mental health within the rural jail detainee population. To the authors’ knowledge, this is the first study to examine the association between PTSD, PD, AUD and violent offenses drawn from local detention centers.

scholarly journals The Cost-Effectiveness of Duloxetine in Chronic Low Back Pain: A US Private Payer Perspective—Author Response to Letter to the Editor

2013 ◽  
Vol 16 (8) ◽  
pp. 1173-1174
Author(s):  
Ronald C. Wielage ◽  
Megha Bansal ◽  
J. Scott Andrews ◽  
Madelaine M. Wohlreich ◽  
Robert W. Klein ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cost Effectiveness ◽  
Chronic Low Back Pain ◽  
Author Response ◽  
Low Back ◽  
Letter To The Editor ◽  
Payer Perspective ◽  
The Cost ◽  
Private Payer
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