Economic evaluations of patient-navigation programs in cancer care.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 14-14
Author(s):  
Chloe Gerves-Pinquie ◽  
Anne Girault ◽  
Claude Sicotte ◽  
Etienne Minvielle
Keyword(s):  
Randomized Controlled Trials ◽  
Economic Impact ◽  
Societal Perspective ◽  
Cancer Care ◽  
Patient Navigation ◽  
Productivity Loss ◽  
Indirect Costs ◽  
Economic Evaluations ◽  
Controlled Trials ◽  
Randomized Controlled

14 Background: Lack of coordination is challenging our health care systems. This is especially true in cancer care, which is based on multiple treatment alternatives and several types of patient-professional interactions. One recommendation is to develop patient navigation programs based on telemedicine in order to avoid costs that are due to under-coordination among providers and/or between patients and providers. The objective of our study was to identify the evidence on the economic impact of such programs in oncology, and to develop a methodological framework to conduct economic evaluations. Methods: We conducted a literature review, exploring articles indexed in Medline (2005-2015), and focusing on economic evaluations of navigation programs in oncology, with particular attention to the use of telemedicine. Results: Of the 14 studies included, nine were randomized controlled trials. Four studies adopted a societal perspective. Every study computed the direct costs of the program. Six studies included indirect costs in the total costs associated with the program, mainly based on patient productivity loss and travel cost. Only two papers included indirect costs associated with informal care. Two studies showed that patient navigation programs were less costly than standard care. Most of the total cost of patient navigation is attributable to direct medical costs (i.e. patient admission, diagnostic follow-up and medical intervention). Conclusions: More evidence is needed regarding the economic impact of navigation programs in oncology. This review provides some guidance for the design of economic evaluations. If these programs are funded through public resources, a societal perspective should be adopted since it covers the direct, indirect and intangible costs of the program. Furthermore, a key strategy will be to identify the most common situations of under-coordination occurring alongside the usual care pathway and measure avoidable costs. This advocates for an extended use of economic evaluations based on randomized controlled trials.

scholarly journals Economic impact of pharmacists' interventions in asthma management: a systematic review

2021 ◽  
Vol 12 (3) ◽  
pp. 587
Author(s):  
Gabriel R. FREITAS ◽  
Juliana U. SANTOS ◽  
Juliana S. FRANÇA ◽  
Rodrigo S. PINTO ◽  
Brayan V. SEIXAS
Keyword(s):  
Cohort Studies ◽  
Randomized Controlled Trials ◽  
Economic Impact ◽  
Pharmaceutical Care ◽  
Randomized Clinical Trials ◽  
Asthma Management ◽  
Risk Of Bias ◽  
Economic Evaluations ◽  
Controlled Trials ◽  
Randomized Controlled

Objective: The purpose of this study was to review in a systematically way the studies that investigated the economic impact of clinical pharmacist services delivered to asthma individuals. Methods: A systematic survey was conducted in the PubMed, Scopus, Lilacs and Cochrane databases aiming to grade the economic evaluations published until January 2020. English, Spanish, Portuguese or French language articles were included if they evaluated a pharmaceutical intervention aiming asthma patients and also reported economic data about these interventions. There was no limitation regarding the study design or type of economic analysis. Two independent authors assessed and selected the studies, extracted the data, and measured risk of bias. Risk of bias was measured through the Cochrane’s risk of bias tool for randomized controlled trials and the Newcastle-Ottawa quality assessment scale for cohort studies. Results: 2,832 references were identified through the search strategy, but only seven studies met the inclusion criteria to be selected into the final analysis. Out of these seven articles, four consisted of cohort studies, and three consisted of randomized controlled trials. Instructional programs and patient counseling were the most usual components of pharmaceutical care interventions. Six articles showed statistically significant positive economic outcomes of pharmaceutical care interventions in asthma management. Moreover, pharmaceutical interventions were found to decrease hospitalizations, emergency visits, symptoms, and increase adherence to pharmacotherapy. Conclusions: Studies included showed acceptable and satisfactory cost-saving ratios, demonstrating the potential benefit of inserting the pharmacist into the multidisciplinary team. Nevertheless, long-term studies and randomized clinical trials are needed to establish solid evidence in order to expand the results found in this review to broader and different contexts.  

scholarly journals Clinical Application of Chinese Herbal Injection for Cancer Care: Evidence-Mapping of the Systematic Reviews, Meta-analyses, and Randomized Controlled Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Ming Yang ◽  
Si-jia Zhu ◽  
Chen Shen ◽  
Rui Zhai ◽  
Duo-duo Li ◽  
...  
Keyword(s):  
Health Insurance ◽  
Randomized Controlled Trials ◽  
Clinical Application ◽  
Systematic Reviews ◽  
Cancer Care ◽  
Controlled Trials ◽  
Evidence Mapping ◽  
Randomized Controlled ◽  
Chinese Herbal ◽  
Meta Analyses

Background and objective: Cancer is a life-threatening disease worldwide and current standard therapy cannot fulfill all clinical needs. Chinese herbal injections have been widely used for cancer in Chinese and Western hospitals in China. This study aimed to apply evidence mapping in order to provide an overview of the clinical application of Chinese herbal injections in cancer care based on randomized controlled trials, systematic reviews, and meta-analyses.Methods and results: Seven databases were systematically searched for eligible randomized controlled trials, systematic reviews, and meta-analyses for ten Chinese herbal injections used in cancer treatment and covered in the Chinese national essential health insurance program. Excel 2016 and RStudio were used to integrate and process the data.In total 366 randomized controlled trials and 48 systematic reviews and meta-analyses were included in the evidence mapping of herbal medicines including; Compound Kushen, Shenqi Fuzheng, Aidi, Kangai, Kanglaite, Xiaoaiping, Cinobufacin, Brucea javanica oil emulsion, Polyporus polysaccharide injection, and Astragalus polysaccharide for injection. Health insurance restricts the scope of clinical application for these herbal injections. The numbers of studies published increased, especially around 2013–2015. The most studied cancer types were lung cancer (118, 32.2%), colorectal cancer (39, 10.7%), and gastric cancer (39, 10.7%), and the most used injections were Compound Kushen (78, 21.3%), Shenqi Fuzheng (76, 20.8%), and Aidi (63, 17.2%). The most consistently reported benefits were observed for Compound Kushen, Shenqi Fuzheng, Aidi, and Kangai for tumor response, quality of life, myelosuppression, and enhancing immunity.Conclusion: The current evidence mapping provides an overview of the outcomes and effects of Chinese herbal injections used in cancer care, and offers information on their clinical application which warrants further evidence-based research in order to inform clinical and policy decision-making.

Supportive care interventions for people with cancer assisted by digital technology: A systematic review (Preprint)

2020 ◽  
Author(s):  
Michael Marthick ◽  
Deborah McGregor ◽  
Jennier A. Alison ◽  
Birinder Cheema ◽  
Haryana Dhillon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Supportive Care ◽  
Randomized Controlled Trials ◽  
Outcome Measures ◽  
Cancer Care ◽  
Digital Health ◽  
Health Interventions ◽  
Controlled Trials ◽  
Supportive Cancer Care ◽  
Randomized Controlled

BACKGROUND While relatively new, digital health interventions are demonstrating rapid growth due to their ability to facilitate access and overcome issues of location, time, health status, and most recently, the impact of a major pandemic. With the increased uptake of digital technologies, digital health has the potential to improve the provision of supportive cancer care. OBJECTIVE The purpose of this systematic review was to evaluate digital health interventions in supportive cancer care. METHODS Published literature between 2000 and 2020 was systematically searched in Medline, PubMed, Embase, PsycINFO, Cochrane Central Register of Controlled Trials and Scopus. Eligible publications were randomized controlled trials (RCTs) of clinician led digital health interventions to support adult cancer patients. Included interventions were determined by applying a digital health conceptual model. Studies were appraised for quality using the revised Cochrane risk of bias tool. RESULTS Twenty randomized controlled trials met the inclusion criteria for analysis. Interventions varied by duration, frequency, degree of technology use and applied outcome measures. Interventions targeting a single tumour stream, predominantly breast cancer, and studies involving the implementation of remote symptom monitoring dominated results. In most studies the digital intervention resulted in significant positive outcomes in patient reported symptoms, levels of fatigue and pain, health-related quality of life, functional capacity, and/or depression levels compared to control. CONCLUSIONS Digital health interventions are helpful and effective for the supportive care of patients with cancer. There is a need for higher quality research. Future endeavours could focus on use of valid, standardised outcome measures, maintenance of methodological rigour, and strategies to improve patient and health professional engagement in the design and delivery of supportive digital health interventions. CLINICALTRIAL

scholarly journals Traditional Chinese Medicine in Cancer Care: An Overview of 5834 Randomized Controlled Trials Published in Chinese

2021 ◽  
Vol 20 ◽  
pp. 153473542110316
Author(s):  
Chun-Li Lu ◽  
Xun Li ◽  
Hong-Mei Zhou ◽  
Chi Zhang ◽  
Ya-Yue Yang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Randomized Controlled Trials ◽  
Cancer Care ◽  
Conventional Treatment ◽  
Symptom Improvement ◽  
Controlled Trials ◽  
Randomized Controlled

Background: Traditional Chinese medicine (TCM) is widely integrated into cancer care in China. An overview in 2011 identified 2384 randomized and non-randomized controlled trials (RCTs, non-RCTs) on TCM for cancer published in the Chinese literature. This article summarizes updated evidence of RCTs on TCM for cancer care. Methods: We searched 4 main Chinese databases: China National Knowledge Infrastructure, Chinese Scientific Journal Database, SinoMed, and Wanfang. RCTs on TCM used in cancer care were analyzed in this bibliometric study. Results: Of 5834 RCTs (477 157 cancer patients), only 62 RCTs were indexed in MEDLINE. The top 3 cancers treated were lung, stomach, and breast cancer. About 4752 RCTs (81.45%) tested TCM combined with conventional treatment, and 1082 RCTs (18.55%) used TCM alone for treating symptoms and side-effects. Herbal medicine was the most frequently used TCM modality (5087 RCTs; 87.20%). The most frequently reported outcome was symptom improvement (3712 RCTs; 63.63%) followed by quality of life (2725 RCTs; 46.71%), and biomarkers (2384 RCTs; 40.86%). The majority of RCTs (4051; 69.44%) concluded there were beneficial effects using either TCM alone or TCM plus conventional treatment compared with conventional treatment. Conclusion: Substantial randomized trials demonstrated different types/stages of cancer were treated by various TCM modalities, alone or in combination with conventional medicine. Further evaluation on the effects and safety of TCM modalities focusing on outcomes such as quality of life is required.

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