EXERCISE: AN IMPORTANT KEY TO PREVENT PHYSICAL AND COGNITIVE FRAILTY

2015 ◽  
pp. 1-3
Author(s):  
M.C. DULAC ◽  
M. AUBERTIN-LEHEUDRE
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Health Care Systems ◽  
Cost Effective ◽  
Older Individuals ◽  
Cognitive Frailty ◽  
Western Population ◽  
Effective Interventions ◽  
Care Systems ◽  
Aging People

The life expectancy of older individuals continues to increase with persons aged 70 years and more representing the fastest growing proportion of the western population (1). At the same time, this extended life should involve the preservation of autonomy through the maintenance of physical and cognitive function. However, with normal aging, people will develop frailty. Thus, identifying cost-effective interventions, which prevent frailty, is one of the most important challenges of health care systems. The difficulty in developing specific interventions to prevent or delay frailty is due to the complexity of the phenomenon, which involves many different physiological, cognitive, and psychological systems. Because no single manifestation of frailty can encompass the whole of the symptoms or signs present, consensual exercise training guidelines remain paradoxically difficult. Therefore, the aim of this review is to address an overview of the literature regarding the effect of exercise/physical activity in the prevention of physical and cognitive frailty.

scholarly journals Identification and management of prediabetes: results of the Latin America Strategic Prediabetes Meeting

2017 ◽  
Vol 41 ◽  
pp. 1 ◽  
Author(s):  
Patricio López-Jaramillo ◽  
Ramfis E. Nieto-Martínez ◽  
Gestne Aure-Fariñez ◽  
Carlos O. Mendivil ◽  
Rodolfo A. Lahsen ◽  
...  
Keyword(s):  
Latin America ◽  
Health Care Systems ◽  
Public Health Problem ◽  
Preventive Treatment ◽  
Cost Effective ◽  
Lifestyle Changes ◽  
Diagnosis And Treatment ◽  
Effective Interventions ◽  
The Status ◽  
Care Systems

To understand the status of prediabetes diagnosis and treatment in Latin America and to evaluate the use of metformin for diabetes prevention in this context. A panel of 15 diabetes experts from seven countries in Latin America met on 14 – 15 August 2014 in Lima, Peru, to review the available literature, discuss the role of prediabetes in type 2 diabetes mellitus and cardiovascular disease, analyze collected information, and make conclusions for prediabetes diagnosis and treatment in Latin America. Prediabetes diagnosis, screening, and treatment, including lifestyle changes, pharmacological treatment, and cost-effectiveness were discussed. Five resulting statements were issued for Latin America: prediabetes is a clinical and public health problem; health care systems do not currently diagnose/treat prediabetes; use of prediabetes risk detection tools are needed region-wide; treatment includes lifestyle changes, multidisciplinary education, and metformin; and registries of patient records and further studies should be supported. The expert panel concluded that in Latin America, preventive treatment through lifestyle changes and metformin are cost-effective interventions. It is important to improve prediabetes identification and management at the primary care level.

scholarly journals A 2019. évi ARIA kezelési irányelvek magyar adaptációja és a hazai alkalmazás lehetőségei allergiás rhinitisben

2020 ◽  
Vol 161 (49) ◽  
pp. 2059-2071
Author(s):  
Helga Kraxner ◽  
Andor Hirschberg ◽  
Kristóf Nékám
Keyword(s):  
Health Care ◽  
Allergic Rhinitis ◽  
Mobile Health ◽  
Health Care Systems ◽  
Cost Effective ◽  
Allergic Diseases ◽  
The European Union ◽  
Sentinel Network ◽  
Intranasal Corticosteroids ◽  
Care Systems

Összefoglaló. Az allergiás betegségekben szenvedő emberek száma világszerte, köztük Magyarországon is növekszik. Az egészségügyi ellátórendszerek azon dolgoznak, hogy minél hatékonyabban tudják felhasználni a rendelkezésre álló forrásokat. Az Allergic Rhinitis and its Impact on Asthma (ARIA) szervezet célja az allergiás náthában szenvedő betegek ellátásának javítása, szakmai ajánlások készítése, aktualizálása. Ennek egyik módja integrált betegellátási utak kidolgozása. Célunk ezek hazai elérhetővé tétele, az ajánlások széles körű elterjesztése az Európai Unió (EU) többi tagállamához hasonlóan Magyarországon is. Az ARIA más nemzetközi innovatív szervezetek bevonásával olyan integrált betegellátási utakat fejlesztett ki, amelyek allergiás nátha, esetleg társbetegsége, az asztma esetén támogatják a kezelést. Ezeket újgenerációs irányelvek kidolgozása útján alkották, amelyekhez felhasználták a mobiltechnológiából és pollenkamra-vizsgálatokból származó valós evidenciákat is. A gyógyszeres terápia optimalizálásához a vizuális analóg skálán alapuló, úgynevezett Mobil Légúti Figyelő Hálózat algoritmusát digitalizálták, és valós evidenciák felhasználásával tovább finomították. Allergén immunterápiára az ARIA a világon elsőként dolgozott ki integrált betegellátási utakat 2019-ben. A kezelési irányelvekhez való adherenciaszint alacsony, a betegek a tüneteik erőssége alapján módosítják a kezelést. A flutikazon-propionát–azelasztin kombináció hatása erősebb az intranasalis kortikoszteroidokénál, míg az utóbbi hatásosabb az oralis H1-antihisztaminoknál. A mobiltelefonokban tárolt elektronikus napló vagy más ’mobile health’ (mHealth) eszközök használata segíti a betegek kiválasztását allergén immunterápiára. Az ARIA által javasolt algoritmus megfelelőnek mutatkozott az allergiás rhinitis kezelésére, ezért ezek az irányelvek bekerülnek integrált betegellátási utakba, és részét fogják képezni az EU Egészségügyi és Élelmiszer-biztonsági Főigazgatósága digitalizált, személyközpontú gondozási anyagainak. Az allergén immunterápia hatékony az inhalatív allergének által okozott allergiás betegségekben, alkalmazását azonban korlátozni kell gondosan válogatott betegekre. Orv Hetil. 2020; 161(49): 2059–2071. Summary. The number of allergic patients is increasing all over the world, also in Hungary. Delivering effective and cost-effective health care is essential for all health care systems. ARIA (Allergic Rhinitis and its Impact on Asthma) aims to improve the care of patients who suffer from allergic rhinitis by setting up guidelines and updating them. Development of ICPs (integrated care pathways) can play an essential role in attaining this goal. Our aim is to make ICP-s developed by ARIA available also in Hungary, as is already the case in other countries of the European Union (EU). Together with other international initiatives, ARIA has worked out digitally-enabled ICPs to support care in allergic rhinitis and comorbid asthma. ICPs are based on new-generation guidelines using RWE (real-world evidence) from chamber studies and mobile technology. The MASK (Mobile Airways Sentinel NetworK) algorithm – based on visual analogue scale – was digitalized to support pharmacotherapy, and was refined by using RWE. ARIA was the first to develop ICPs for allergen immunotherapy (AIT) in 2019. Based on MASK data, patients did not follow guidelines and their adherence to treatment was poor. Patients would modify their treatments, depending on the disease control. The effect of fluticasone propionate–azelastine combination is superior to intranasal corticosteroids which are superior to oral H1-antihistamines. Electronic diaries obtained from cell phones and other ’mobile health’ (mHealth) devices help select patients for AIT. The ARIA algorithm for AR was found appropriate and no change is necessary. These guidelines will inform ICPs and will be included in the DG Santé digitally-enabled, person-centred care system. AIT is an effective treatment for allergic diseases caused by inhaled allergens. Its use should, however, be restricted to carefully selected patients. Orv Hetil. 2020; 161(49): 2059–2071.

Emergency Telehealth Services in the Correctional Setting

2021 ◽  
pp. 210-221
Author(s):  
Newton E. Kendig ◽  
David G. Ellis ◽  
Renoj Varughese ◽  
Obinna M. Ome Irondi
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Emergency Services ◽  
Point Of Care ◽  
Health Care Systems ◽  
Cost Effective ◽  
Correctional Setting ◽  
Correctional Health Care ◽  
Correctional Health ◽  
Care Systems

Millions of patients receive their primary health care in U.S. jails and prisons each year. Correctional health care systems frequently lack round-the-clock onsite physician services, and access to local hospital-based emergency services may be limited. Increasingly, correctional health care systems are relying on telehealth capabilities to improve their access to subspecialty services. Emergency telehealth services, however, are largely underutilized. Available reports suggest that emergency telehealth services can reduce outside medical trips and prove cost-effective in certain settings. Successful emergency telehealth programs emphasize the importance of a thorough diagnostic evaluation, effective communication with local correctional health care providers, and strategic use of point-of-care testing. This chapter provides practical recommendations for the telehealth evaluation and management of commonly occurring medical emergencies in the correctional setting.

Organizing a diabetes service

2011 ◽  
pp. 2005-2011
Author(s):  
Stephen C. L. Gough
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Cost Effective ◽  
Health Care Need ◽  
Delivery Of Care ◽  
Strategic Approach ◽  
Effective Manner ◽  
Care Systems ◽  
The Individual ◽  
The Uk

The increasing worldwide incidence and prevalence of diabetes is placing substantial pressures on health care systems and economies. As a consequence individuals involved in the care of people with diabetes are looking at services currently being provided and examining ways in which care can be organized in the most cost-effective manner. Whilst the degree to which diabetes care is delivered differs from country to country, similar fundamental questions are being asked by those involved in the delivery of care, including: What are we currently providing? What do we need to provide? What are we able to provide? Although the answers to these questions are quite different not just between countries but often within specific localities within a country, the ultimate aim is the same: to provide the best possible care to as many people with diabetes as possible. The global diversity of diabetes health care need is enormous and while the solutions will be equally diverse, the approach to the development of a diabetes service will, for many organizations, be similar. The main focus of this chapter is based upon the model or the strategic approach developed in the UK, but many of the individual component parts are present in most health care settings.

scholarly journals Subcategorizing the Expected Value of Perfect Implementation to Identify When and Where to Invest in Implementation Initiatives

2020 ◽  
Vol 40 (3) ◽  
pp. 327-338
Author(s):  
Kasper Johannesen ◽  
Magnus Janzon ◽  
Tomas Jernberg ◽  
Martin Henriksson
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Expected Value ◽  
Net Benefit ◽  
Relative Value ◽  
Care Systems ◽  
The Absolute

Purpose. Clinical practice variations and low implementation of effective and cost-effective health care technologies are a key challenge for health care systems and may lead to suboptimal treatment and health loss for patients. The purpose of this work was to subcategorize the expected value of perfect implementation (EVPIM) to enable estimation of the absolute and relative value of eliminating slow, low, and delayed implementation. Methods. Building on the EVPIM framework, this work defines EVPIM subcategories to estimate the expected value of eliminating slow, low, or delayed implementation. The work also shows how information on regional implementation patterns can be used to estimate the value of eliminating regional implementation variation. The application of this subcategorization is illustrated by a case study of the implementation of an antiplatelet therapy for the secondary prevention after myocardial infarction in Sweden. Incremental net benefit (INB) estimates are based on published cost-effectiveness assessments and a threshold of SEK 250,000 (£22,300) per quality-adjusted life year (QALY). Results. In the case study, slow, low, and delayed implementation was estimated to represent 22%, 34%, and 44% of the total population EVPIM (2941 QALYs or SEK 735 million), respectively. The value of eliminating implementation variation across health care regions was estimated to 39% of total EVPIM (1138 QALYs). Conclusion. Subcategorizing EVPIM estimates the absolute and relative value of eliminating different parts of suboptimal implementation. By doing so, this approach could help decision makers to identify which parts of suboptimal implementation are contributing most to total EVPIM and provide the basis for assessing the cost and benefit of implementation activities that may address these in future implementation of health care interventions.

scholarly journals The Hospitalization Costs of Diabetes and Hypertension Complications in Zimbabwe: Estimations and Correlations

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Mutsa P. Mutowo ◽  
Paula K. Lorgelly ◽  
Michael Laxy ◽  
Andre M. N. Renzaho ◽  
John C. Mangwiro ◽  
...  
Keyword(s):  
Linear Models ◽  
Wound Care ◽  
Health Care Systems ◽  
Secondary Data ◽  
Cost Effective ◽  
Effective Interventions ◽  
Hospitalization Costs ◽  
Patients With Diabetes ◽  
Care Systems ◽  
Mean Cost

Objective. Treating complications associated with diabetes and hypertension imposes significant costs on health care systems. This study estimated the hospitalization costs for inpatients in a public hospital in Zimbabwe.Methods. The study was retrospective and utilized secondary data from medical records. Total hospitalization costs were estimated using generalized linear models.Results. The median cost and interquartile range (IQR) for patients with diabetes, $994 (385–1553) mean $1319 (95% CI: 981–1657), was higher than patients with hypertension, $759 (494–1147) mean $914 (95% CI: 825–1003). Female patients aged below 65 years with diabetes had the highest estimated mean costs ($1467 (95% CI: 1177–1828)). Wound care had the highest estimated mean cost of all procedures, $2884 (95% CI: 2004–4149) for patients with diabetes and $2239 (95% CI: 1589–3156) for patients with hypertension. Age below 65 years, medical procedures (amputation, wound care, dialysis, and physiotherapy), the presence of two or more comorbidities, and being prescribed two or more drugs were associated with significantly higher hospitalization costs.Conclusion. Our estimated costs could be used to evaluate and improve current inpatient treatment and management of patients with diabetes and hypertension and determine the most cost-effective interventions to prevent complications and comorbidities.

Pharmacy preparedness during phases of pandemic COVID in Odisha, India

2021 ◽  
Vol 1 (2) ◽  
pp. 008-014
Author(s):  
Sonali Kar ◽  
Ankita Banerjee ◽  
Priyanka Lakshmi ◽  
Ansuman Kar ◽  
Varsha Shrivastava ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Cost Effective ◽  
Severe Form ◽  
Middle Level ◽  
Mitigation Strategies ◽  
Public Health Care ◽  
Small Scale ◽  
Care Systems ◽  
The Government

The COVID 19 pandemic is one of the worst pandemics that struck the world, after the Spanish flu in 1918 and stalled the entire public health care system. Initially in the absence of definite drugs, the primary mitigation priority was prevention. Its web like spread put pressure on the accessory health care systems too and the most affected were perhaps the Pharmacy. In India the pharmacy are an integral part of health services, with desperate demand for an array of supplies and drugs, affecting the Pharmacies and their functioning tremendously, they too have contributed immensely in the mitigation strategies of the government. The study assesses the pharmacies in terms of their preparedness to cope with the demands and enhancement of role of the pharmacists to provide cost effective and consumer friendly services.Online services were good and satisfactory and were offered by only the big scale pharmacy (67%) ;Pharmacists from small scale set ups were yet to be vaccinated (33.3%), preparedness was optimum in terms masks and sanitization of premises, but IEC materials were missing in the small shops(44.4%); supplies were good and surplus but small scale ones sometimes sold the cost effective one’s; adjuvant drugs were in excess but drugs for moderate to severe form of COVID were limited to facility based pharmacyonly. Non COVID medications,in order to prioritize COVID drugs,went missing.Stock charts were displayed by big and middle level shops. Study suggests the pharmacy role in managing a pandemic is upnteem and periodic checks and regulations should be revised as per needs of the time.

scholarly journals Structured Q1 headache services as the solution to the ill-health burden of headache: 1. Rationale and description

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Timothy J. Steiner ◽  
Rigmor Jensen ◽  
Zaza Katsarava ◽  
Lars Jacob Stovner ◽  
Derya Uluduz ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Systems ◽  
Tertiary Care ◽  
Cost Effective ◽  
High Demand ◽  
Patient Journey ◽  
Global Campaign ◽  
Care Systems ◽  
Economic Analyses

AbstractIn countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the “patient journey”) with perplexing obstacles.High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary.The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded.It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.

scholarly journals A NEED OF BETTER PHARMACOVIGILANCE SYSTEM IN INDIA

2016 ◽  
Vol 10 (1) ◽  
pp. 22
Author(s):  
Prajakta Pradeep Masurkar
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Adverse Drug Reaction Reporting ◽  
Health Care Systems ◽  
Herbal Medicines ◽  
Cost Effective ◽  
Pharmacovigilance System ◽  
Regulatory Body ◽  
Education Association ◽  
Care Systems

ABSTRACTIndia is one of the top producers of generics globally and is currently being recognized as the “pharmacy of the world” for the generic drug products.Thus, there is a need that it has best health-care systems in place to regulate and provide better quality drugs by monitoring the possible riskassociated with the use of drugs. Being the generic hub, physicians, pharmacists, etc., should be erudite to provide an alternative cost-effective genericmedicine, which is one of the education-related aspects of pharmacovigilance. We need a more systematic approach to surveillance of drug-relatedproblems, which is at the heart of pharmacovigilance. The health-care system requires new processes to understand the risk-benefit ratio of drugs.The challenges in implementation of better pharmacovigilance in country due to nonavailability of trained staff in pharmacovigilance, lack of trainingof health-care professionals on drug safety, and adverse drug reaction reporting which comprises adverse interactions of medicines with chemicals,other medicines, and food are often neglected leading to under-reporting by health-care professionals as well as patients, lack of expertise, etc., shouldbe overcome by Indian regulatory body via practical oriented knowledge-based system. The web market monitoring, global electronic database,education, association of stakeholders and regulation of herbal medicines standards and allied medicinal systems are vital restructurings needed tobe introduced for a better pharmacovigilance system in India.Keywords: Pharmacovigilance, India.

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