A Systematic Review of Zero-markup Policy for Essential Drugs Effect on Medical Treatment

Abstract Objective. This systematic review is conducted to synthesize recent empirical evidence of Zero-markup Policy for Essential Drugs Effect on Medical Treatment in China. Methods. We searched the PubMed, Embase, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for all related studies published from inception to 30 April 2019 without restriction on language. In addition, grey literatures were captured through other sources, such as OpenGrey and Open Access Theses and Dissertations (OATD), to avoid selection bias. Methodological quality were evaluated using the PRISMA statement the Newcastle Ottawa Scale Collaboration tool. Results. Thirty-four full texts were initially searched, but only nine studies met our inclusion criteria. Most of studies indicated the significant reduction for both the total expense and drug expense per visit. Additionally, outpatient and inpatient services indicated increasing trends in annual patient-visits. Conclusions. In conclusion, the available limited, relative low-quality evidence does not support the long-term association between zero-markup policy for essential drugs and reduced medical expenditure. Further longitudinal studies that provide data for hospitals over a wider range of regions would make the economic effects more discursive.

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Antimicrobial Resistance Following Prolonged Use of Hand Hygiene Products: A Systematic Review

Pharmacy ◽

10.3390/pharmacy10010009 ◽

2022 ◽

Vol 10 (1) ◽

pp. 9

Author(s):

Gouri Rani Banik ◽

Bandar Durayb ◽

Catherine King ◽

Harunor Rashid

Keyword(s):

Systematic Review ◽

Antimicrobial Resistance ◽

Hand Hygiene ◽

Bibliographic Databases ◽

Health Care Settings ◽

Country Study ◽

Newcastle Ottawa Scale ◽

Study Setting ◽

Ottawa Scale

Background: This systematic review aimed to establish whether antimicrobial resistance (AMR) occurs following prolonged use of antimicrobial hand hygiene (HH) products, and, if so, in what magnitude. Methods: Key bibliographic databases were searched to locate items on HH use and AMR development from database inception to December 2020. Records were screened and full texts of all potentially eligible articles were retrieved and checked for inclusion. The following data from the included studies were abstracted: type of HH product used, including the name of antimicrobial agent, study setting, country, study year, duration of use and development of AMR including the organisms involved. Quality assessment was done using the Newcastle-Ottawa Scale (NOS). Results: Of 339 full-text articles assessed for eligibility, only four heterogeneous United States (US) studies conducted in the period between 1986 and 2015 were found eligible, and included. One hospital-based study showed evidence of AMR following long term use of HH products, two studies conducted in household settings showed no evidence of AMR, and another experimental study showed partial evidence of AMR. The overall certainty of the evidence was moderate. Conclusion: Prolonged use of HH products may cause AMR in health care settings, but perhaps not in other settings.

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Systematic Review of the Effect of a Zero-Markup Policy for Essential Drugs on Healthcare Costs and Utilization in China, 2015–2021

Frontiers in Medicine ◽

10.3389/fmed.2021.618046 ◽

2021 ◽

Vol 8 ◽

Author(s):

Wen-Yi Liu ◽

Chia-Hsien Hsu ◽

Ting-Jun Liu ◽

Pei-En Chen ◽

Boyuan Zheng ◽

...

Keyword(s):

Systematic Review ◽

Healthcare Costs ◽

Medical Services ◽

Essential Drugs ◽

Medical Spending ◽

Financial Perspective ◽

Newcastle Ottawa Scale ◽

The Government ◽

Meta Analyses ◽

Ottawa Scale

Objective: This systematic review aimed to discuss the effects of a zero-markup policy for essential drugs (ZPED) on healthcare costs and utilization in China in the years 2015–2021.Methods: We searched the PubMed, Embase, Scopus, and CINAHL databases for all associated studies carried out from January 1, 2015, to May 31, 2021, without any limitations regarding the language the studies were written in. To prevent selection bias, gray documents were tackled by other means. The methodological approaches were assessed by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Newcastle-Ottawa Scale (NOS) collaboration tool.Results: Forty studies were selected at first and then 15 studies that met the inclusion criterion. Most of the studies showed a considerable decrease in total medical spending and drug spending in both outpatient and inpatient services. After the implementation of ZPED, studies showed that the medical services increased and total hospital income sustained, despite a decrease in drug revenue. Minimal or no government subsidy is required from a financial perspective.Conclusions: Although, the government could implement ZEPD with lower medical cost and drug cost to patients, and sustained income for health facilities, we have limited understanding of whether the increase in medical services was induced by the provider or was a response to unmet needs in the population. Further, studies using rigorous and advanced methods to study health policy, patient behaviors, provider behaviors, and government decisions are warranted.

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The Carcinogenic Effects of Formaldehyde Occupational Exposure: A Systematic Review

Cancers ◽

10.3390/cancers14010165 ◽

2021 ◽

Vol 14 (1) ◽

pp. 165

Author(s):

Carmela Protano ◽

Giuseppe Buomprisco ◽

Vittoria Cammalleri ◽

Roberta Noemi Pocino ◽

Daniela Marotta ◽

...

Keyword(s):

Systematic Review ◽

Occupational Exposure ◽

Nasopharyngeal Cancer ◽

Work Activities ◽

Prisma Statement ◽

Newcastle Ottawa Scale ◽

Central Nervous Systems ◽

Carcinogenic Effects ◽

Representative Samples ◽

Ottawa Scale

Background: Formaldehyde, classified as a carcinogen in 2004, as of today is widely used in many work activities. From its classification, further studies were performed to evaluate its carcinogenicity. The aim of the systematic review is to update the evidence on occupational exposure to formaldehyde and cancer onset. Methods: The review, in accordance with the PRISMA statement, includes articles in English reporting original results of studies conducted on workers exposed to formaldehyde, considering all types of cancer, published from 1 January 2000 to 30 July 2021 and selected from the Pubmed and Scopus databases. The studies’ quality was assessed by the Newcastle–Ottawa Scale. Results: A total of 21 articles were included, conducted in different European, American, and Asian countries. The most investigated occupational areas are those characterized by a deliberate use of formaldehyde. Some studies evaluated all types of cancer, whereas others focused on specific sites such as thyroid and respiratory, lymphohematopoietic, or central nervous systems. The results showed weak associations with lung cancer, nasopharyngeal cancer, leukemia, and non-Hodgkin’s lymphoma. Conclusions: The results demonstrate the need for further original studies carried out on representative samples of workers exposed to measured levels of FA. These studies should be designed to reduce the bias due to co-exposure to other carcinogens.

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Long-Term Nightshift Work and Breast Cancer Risk: An Updated Systematic Review and Meta-Analysis with Special Attention to Menopausal Status and to Recent Nightshift Work

Cancers ◽

10.3390/cancers13235952 ◽

2021 ◽

Vol 13 (23) ◽

pp. 5952

Author(s):

Christine Schwarz ◽

Ana María Pedraza-Flechas ◽

Roberto Pastor-Barriuso ◽

Virginia Lope ◽

Nerea Fernández de Larrea ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Menopausal Status ◽

Case Control ◽

Risk Exposure ◽

Newcastle Ottawa Scale ◽

Meta Analyses ◽

Nested Case Control ◽

Ottawa Scale

This systematic review discusses long-term NSW and female BC risk, with special attention to differences between pre- and postmenopausal BC, to test the association with recent NSW. The review follows PRISMA guidelines (Prospero registry: CRD42018102515). We searched PubMed, Embase, and WOS for case–control, nested case–control, and cohort studies addressing long-term NSW (≥15 years) as risk exposure and female BC as outcome until 31 December 2020. Risk of bias was evaluated with the Newcastle–Ottawa scale. Eighteen studies were finally included (eight cohorts; five nested case–control; five case–control). We performed meta-analyses on long-term NSW and BC risk; overall and by menopausal status; a subanalysis on recent long-term NSW, based on studies involving predominantly women below retirement age; and a dose–response meta-analysis on NSW duration. The pooled estimate for long-term NSW and BC was 1.13 (95%CI = 1.01–1.27; 18 studies, I2 = 56.8%, p = 0.002). BC risk increased 4.7% per 10 years of NSW (95%CI = 0.94–1.09; 16 studies, I2 = 33.4%, p = 0.008). The pooled estimate for premenopausal BC was 1.27 (95%CI = 0.96–1.68; six studies, I2 = 32.0%, p = 0.196) and for postmenopausal BC 1.05 (95%CI = 0.90–1.24,I2 = 52.4%; seven studies, p = 0.050). For recent long-term exposure, the pooled estimate was 1.23 (95%CI = 1.06–1.42; 15 studies; I2 = 48.4%, p = 0.018). Our results indicate that long-term NSW increases the risk for BC and that menopausal status and time since exposure might be relevant.

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Safety of Systemic Medications Among Older Adults With Psoriasis and Atopic Dermatitis: A Systematic Review of Observational Studies

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475421993770 ◽

2021 ◽

pp. 120347542199377

Author(s):

Evan Tang ◽

Talha Maqbool ◽

Megan Lam ◽

Gaelen P. Adam ◽

Mina Tadrous ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Atopic Dermatitis ◽

Observational Studies ◽

Relative Effect ◽

Emergency Department Visits ◽

Major Cardiovascular Events ◽

Quantitative Synthesis ◽

Newcastle Ottawa Scale ◽

Ottawa Scale

Background Psoriasis and atopic dermatitis are common among older adults (≥65 years old), but clinical trials often exclude that population. Objective To synthesize evidence from observational studies on the safety of systemic therapies (conventional or biologic) for psoriasis and atopic dermatitis among older adults in a systematic review. Methods We searched MEDLINE and EMBASE (inception to October 31, 2019) and included observational studies reporting adverse events among older people treated with systemic therapy for psoriasis or atopic dermatitis. Outcomes were death, hospitalization, emergency department visits, infections, major cardiovascular events, renal toxicity, hepatotoxicity, and cytopenias. We assessed study quality using the Newcastle-Ottawa Scale. Results We included 22 studies on treatment for psoriasis and 2 for atopic dermatitis. Most studies were small and non-comparative and 20 of 24 were low quality. Studies comparing safety between medications or medication classes or between older and younger adults did not show apparent differences but had wide confidence intervals around relative effect estimates. Heterogeneity of study design and reporting precluded quantitative synthesis. Conclusions There is scant evidence on the safety of conventional systemic and biologic medications for older adults with psoriasis or atopic dermatitis; older adults and their clinicians should be aware of this evidence gap.

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The promise of Telemedicine in Pakistan: A Systematic Review (Preprint)

10.2196/preprints.27961 ◽

2021 ◽

Author(s):

Syed Sarosh Mahdi ◽

Franceso Amenta ◽

Raheel Allana ◽

Gopi Battineni 3rd ◽

Tamsal Khalid ◽

...

Keyword(s):

Systematic Review ◽

Rural Areas ◽

Urban Region ◽

Middle Income ◽

Web Based ◽

Study Characteristics ◽

Implementation Costs ◽

Newcastle Ottawa Scale ◽

Good Support ◽

Ottawa Scale

BACKGROUND Telemedicine is a medical practice of assisting remote patients and it has great potential in developing countries like Pakistan. Telemedicine solves the logistical barriers, deliver good support to weak health systems and unite worldwide networks of healthcare personals. Because of high implementation costs, yet it is not possible to adopt telehealth systems for low and middle-income nations. OBJECTIVE In this systematic review, we aim to present an update revision of region-based telemedical services in Pakistan. METHODS Libraries such as PubMed (Medline), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus (EMBASE) and Google Scholar were used for document search. Newcastle Ottawa Scale (NOS) is adopted to conduct study quality. Majority of the studies (n-8) included in the review were of high quality as assessed through the Newcastle Ottawa scale. Selected study characteristics further analyzed based on different parameters such as publication year, sample size, study design, methods, motivation and outcomes. RESULTS Search produced 955 articles and 11 items were ultimately selected to conduct the review. These studies further characterized as region-based telemedicine implementation. Out of 11, eight studies were conducted in the urban region and three studies were conducted in the rural areas of Pakistan. Majority of studies produced evidence on telehealth interventions by smartphone services like SMS, apps and web-based telemedicine. CONCLUSIONS Telehealth interventions like mHealth, eHealth, telemedicine, and telepharmacy are starting to evaluate for the last two decades but certainly needs to become an integral part of Pakistan's current health infrastructure.

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Sleep in youth with autism spectrum disorders: systematic review and meta-analysis of subjective and objective studies

Evidence-Based Mental Health ◽

10.1136/ebmental-2018-300037 ◽

2018 ◽

Vol 21 (4) ◽

pp. 146-154 ◽

Cited By ~ 23

Author(s):

Amparo Díaz-Román ◽

Junhua Zhang ◽

Richard Delorme ◽

Anita Beggiato ◽

Samuele Cortese

Keyword(s):

Systematic Review ◽

Autism Spectrum Disorders ◽

Evidence Synthesis ◽

Meta Analysis ◽

Autism Spectrum ◽

Newcastle Ottawa Scale ◽

Spectrum Disorders ◽

Sleep Alterations ◽

The Impact ◽

Ottawa Scale

BackgroundSleep problems are common and impairing in individuals with autism spectrum disorders (ASD). Evidence synthesis including both subjective (ie, measured with questionnaires) and objective (ie, quantified with neurophysiological tools) sleep alterations in youth with ASD is currently lacking.ObjectiveWe conducted a systematic review and meta-analysis of subjective and objective studies sleep studies in youth with ASD.MethodsWe searched the following electronic databases with no language, date or type of document restriction up to 23 May 2018: PubMed, PsycInfo, Embase+Embase Classic, Ovid Medline and Web of Knowledge. Random-effects models were used. Heterogeneity was assessed with Cochran’s Q and I2 statistics. Publication (small studies) bias was assessed with final plots and the Egger’s test. Study quality was evaluated with the Newcastle Ottawa Scale. Analyses were conducted using Review Manager and Comprehensive Meta-Analysis.FindingsFrom a pool of 3359 non-duplicate potentially relevant references, 47 datasets were included in the meta-analyses. Subjective and objective sleep outcome measures were extracted from 37 and 15 studies, respectively. Only five studies were based on comorbidity free, medication-naïve participants. Compared with typically developing controls, youth with ASD significantly differed in 10/14 subjective parameters and in 7/14 objective sleep parameters. The average quality score in the Newcastle-Ottawa Scale was 5.9/9.Discussion and clinical implicationsA number of subjective and, to a less extent, objective sleep alterations might characterise youth with ASD, but future studies should assess the impact of pharmacological treatment and psychiatric comorbidities.

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Reduction of ileocolic intussusception under sedation or anaesthesia: a systematic review of complications

Archives of Disease in Childhood ◽

10.1136/archdischild-2021-322706 ◽

2021 ◽

pp. archdischild-2021-322706

Author(s):

Moran Gal ◽

Shirly Gamsu ◽

Ron Jacob ◽

Daniel M Cohen ◽

Itai Shavit

Keyword(s):

Systematic Review ◽

Intestinal Perforation ◽

English Language ◽

Data Extraction ◽

Current Data ◽

Pulmonary Aspiration ◽

Ileocolic Intussusception ◽

Newcastle Ottawa Scale ◽

Permanent Neurological Deficit ◽

Ottawa Scale

BackgroundDespite the increased use of sedation in children undergoing stressful procedures, reduction of ileocolic intussusception (RII) is usually performed on awake children without any form of sedation.ObjectiveTo evaluate the incidence of severe complications of RII under sedation or anaesthesia.DesignA systematic review including English language original articles of any date.PatientsChildren undergoing RII (pneumatic or hydrostatic) under sedation or anaesthesia.Data sourcesOvid Embase, Scopus, PubMed, the Cochrane Database of Systematic Reviews and the internet search engine Google Scholar.Data extractionThree authors independently reviewed each article for eligibility. The Newcastle-Ottawa Scale was used to assess the quality of included studies.Main outcome measuresThe primary outcome was the incidence of intestinal perforation during RII. The secondary outcomes were the incidence of sentinel adverse events defined as death, cardiopulmonary resuscitation, permanent neurological deficit and pulmonary aspiration syndrome.ResultsThe search yielded 368 articles. Nine studies with 1391 cases were included in the analysis. Of the nine studies, six had a score of ≤6 stars in the Newcastle-Ottawa Scale assessment, indicating low-to-moderate quality. Propofol-based sedation was used in 849 (59.2%) cases; 5 (0.6%) had intestinal perforation. Intestinal perforation was not reported in patients who were sedated with other sedatives. One patient had pulmonary aspiration syndrome.ConclusionsAlthough caution remains warranted, current data suggest that the incidence of severe complications due to RII under sedation or anaesthesia is low. Due to the lack of prospective data, it is difficult to ascertain the exact incidence of severe complications.

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Does the Animal Model Influence in Vertical Alveolar Distraction? A Systematic Review of the Literature

Animals ◽

10.3390/ani10122347 ◽

2020 ◽

Vol 10 (12) ◽

pp. 2347

Author(s):

Mario García-González ◽

Fernando Muñoz ◽

Antonio González-Cantalapiedra ◽

Mónica López-Peña ◽

Nikola Saulacic

Keyword(s):

Systematic Review ◽

Animal Model ◽

Quality Score ◽

Inclusion Criteria ◽

Animal Trials ◽

Mongrel Dog ◽

Medium Quality ◽

Newcastle Ottawa Scale ◽

High Quality Score ◽

Ottawa Scale

This study is aimed at synthesizing all available evidence on vertical alveolar osteogenesis distraction (VAOD) in animal trials to determine whether the animal model used and its handling influence or not, and find which is the most appropriate animal model for this specific technique. This systematic review has been carried out following the PRISMA statements. Bibliographic sources have been consulted manually by two reviewers. Risk of bias was assessed using a version of the Newcastle-Ottawa-Scale (NOS). The selection criteria established by expert researchers were applied in order to decide which studies should be included in the review. Twenty-six studies met the inclusion criteria and were included in the review. Twenty-four of them had a high quality (score between 7 and 9), two medium quality (score between 4 and 6), and none low quality (score between 1 and 3). The highest possible score was 9 (using the NOS). Six studies complied with all NOS criteria. The animal model has been seen to influence the results, leading to failure in some cases. The most used animal model on VAOD, with fewer complications, was the Mongrel dog. The use of the pig and minipig is not recommended, due to the difficulties in handling and complications encountered.

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Depression, anthropometric parameters, and body image in adults: a systematic review

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.65.5.731 ◽

2019 ◽

Vol 65 (5) ◽

pp. 731-738 ◽

Cited By ~ 5

Author(s):

Daniela Silva ◽

Lara Ferriani ◽

Maria Carmen Viana

Keyword(s):

Systematic Review ◽

Body Image ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Employed Women ◽

Language Restriction ◽

Newcastle Ottawa Scale ◽

The Relationship ◽

Ottawa Scale

SUMMARY OBJECTIVE: To evaluate the association between depression, anthropometric parameters and body image in adults through a systematic review of the literature. METHOD: Medline, Lilacs and PsycInfo databases were searched by two independent reviewers up to August 2018, without language restriction, including cross-sectional, case-control, and cohort studies in adults (18-65 years), of both genders. The quality of the studies was assessed using the Newcastle-Ottawa Scale instrument. The PRISMA standards were adopted for the conduct of this review, whose protocol is registered in PROSPERO, number CRD42018105248. RESULTS: The search resulted in 1,770 articles; however, a total of 5 articles were included in this review, whose designs were transversal. Quality scores ranged from 8 to 9 points. The association between depression, anthropometric parameters, and body image was found in all included studies, regardless of the different statistical methods employed. Women perceived their body larger than it really was by idealizing a lean body, whereas in men the perception of being underweight or dissatisfaction was observed by idealizing a larger body, both conditions were associated with the presence of depression or depressive symptoms and body mass index in the same time. CONCLUSION: Depression, anthropometric parameters and body image were associated. It is necessary to conduct other studies, especially longitudinal studies to elucidate the relationship among depression, weight, body image, and other associated factors.

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