Pharmacoeconomic features of the use of drugs used in the treatment of allergic rhinitis

2021 ◽  
pp. 9-16
Author(s):  
Afanasyeva T.G. ◽  
Lavrova N.N. ◽  
Tumentseva V.R.
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Nasal Mucosa ◽  
Generic Drugs ◽  
Cost Minimization ◽  
Nasal Congestion ◽  
World Health ◽  
Cost Minimization Analysis ◽  
Wide Range

Rhinitis is an inflammation of the nasal mucosa; today, according to the World Health Organization, the prevalence of the disease is 40% of the world's population. Allergic rhinitis is the most common type of chronic rhinitis, affecting 10–20% of the world's population, and the severity of the disease is associated with a significant deterioration in the quality of life, sleep and performance. Allergic rhinitis is an inflammatory disease of the nasal mucosa caused by exposure to an allergen, causing IgE-mediated inflammation. Clinically, the disease is characterized by the following main symptoms: rhinorrhea, sneezing, itching and nasal congestion. Despite the general symptoms of allergic rhinitis, its impact on the quality of life of patients and the significant cost of treatment, including pharmacotherapy, many patients do not adhere to drug treatment regimens due to their insufficient effectiveness in eliminating the emerging symptoms. Pharmacoeconomic research identifies, measures and compares the costs and effects of drug use. This framework includes research methods related to cost minimization, cost-effectiveness, decision analysis, cost of illness, and patient quality of life. This article will consider one of the four main methods for assessing pharmacoeconomics - cost minimization analysis. A cost-minimization analysis is a pharmacoeconomic assessment by comparing the costs of two or more drug alternatives regardless of outcome. Since the pharmaceutical market is represented by a wide range of original, reference and generic drugs for the treatment of allergic rhinitis, an important aspect of our research is the selection of effective and economically acceptable therapy for outpatients.

An Instant, Safe, Antihistamine, Anti-Inflammatory and Decongestant Polymeric Nasal Barrier to Prevent and To Treat Allergic Rhinitis in Children

2021 ◽  
Vol 7 (5) ◽  
pp. 01-09
Author(s):  
Ravi Shrivastava
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Side Effects ◽  
Symptom Score ◽  
Inflammatory Cytokines ◽  
Nasal Mucosa ◽  
Eosinophil Count ◽  
Allergen Exposure ◽  
Glycerol Solution

Introduction: Allergic rhinitis (AR) in children is a common chronic pathology with a strong impact on patient quality of life. The main physiopathology affects the nasal cavity as a multi-factorial disease involving nasal mucosa damage, nasal inflammation with high concentrations of histamine, pro-inflammatory cytokines such as histamine, TNF-α, IL-4, IL-5, IL-6, IL-10, IL-13, and IgE antibodies on the nasal mucosa. Systemic entry of these proteins through damaged nasal mucosa maintains continued inflammatory and allergen cascades. Therefore, an ideal treatment should be multitarget in order to stop allergen exposure, inflammation, and nasal mucosa barrier degradation, but such treatments are nearly impossible to conceive. We envisaged an osmotic and protective nasal barrier film, not only capable of protecting the nasal mucosa from allergen exposure but also of trapping and neutralizing selected cytokines and cleaning the nasal surface continuously without using any harmful substance for children. Materials and Methods: We associated highly osmotic glycerol solution with specific plant polymers to conceive an osmotic but stable film. As plant polymers (tannins) can bind with selective proteins, a range of glycerol binding non-cytotoxic polymers were screened using the sandwich ELISA method to select those having binding affinity for allergen induced nasal proinflammatory cytokines. After verifying cytotoxicity and irritant potential, a 15-day observational clinical study was performed with approval from the ethics committee on 30 children aged between 4-13, suffering from allergic rhinitis. The test product (TP) was supplied in 15-ml nasal sprays and applied 2-3 times per day for a period of 15 days. Saline solution served as control (CP). The scores of nasal and ocular symptoms, effect on quality of life, eosinophil count in nasal smears, and need for antihistamine treatment was evaluated at the start, at 30 minutes and on days 2, 3 and 15 of treatment. Results: A few specific polymers were able to bind with selected cytokines and histamine at adequate filmogen concentrations. The osmotic film was stable, non-irritant and was able to clean the nasal mucosa continuously for 4-6h after each application. Clinical observations of Total Nasal Symptom Score (TNSS) grouping the scores of nasal congestion, runny nose, sneezing, and itching, revealed a strong decrease right after the 1st treatment in both groups but the reduction was much stronger and faster with the TP. The mean TNSS score reduction was 44.74% in CP vs 83.53% in the TP group after 7 days of treatment (p<0.001). Total Ocular Symptom Score (TOSS) was decreased by 21.13% and 51.41% in CP v/s 35.12 and 99.59% in TP group on days 2 and 7, respectively. Nasal smear eosinophil count was equally strongly reduced in the TP v/s CP group. No treatment-related side effects were recorded in any of the groups. Conclusion: Protecting the nasal mucosa against allergens, neutralizing inflammatory cytokines, and keeping the nasal surface clean with an osmotic polymeric film, constitute a major breakthrough for the treatment of allergic rhinitis in children. This simple but scientific and logical approach should avoid exposing children to chemicals and to their long-term side effects.

Investigation of the Impact of Myelodysplasia (MDS) From the Patients' Perspective

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5049-5049 ◽  
Author(s):  
Stephen P McKenna ◽  
James Twiss ◽  
Jeanette N Wilburn ◽  
Sigrid Rebecca Crawford ◽  
Kevin Loth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Research Funding ◽  
Sleep Problems ◽  
World Health ◽  
Activity Limitations ◽  
Wide Range ◽  
Fundamental Needs ◽  
The Impact ◽  
Patients Perspective

Abstract Abstract 5049 Introduction: Little research is currently available on the impact of MDS from the patients' perspective. Where research has been conducted it has predominantly used generic cancer outcome measures. Such measures do not provide an accurate assessment of MDS patients as they miss important aspects of the condition. A qualitative study was conducted with MDS patients to investigate how their lives are affected by the condition. Methods: Qualitative, unstructured interviews were conducted with patients. Verbatim transcripts of the interviews were analysed thematically to assess the impact of MDS in terms of symptoms experienced, activity limitations and quality of life (QoL). Emergent themes were identified, clustered and harmonised. Investigation of issues related to impairments and activity limitations were guided by the World Health Organizations (WHO) classification of outcomes related to health and injury. Investigation of QoL issues was guided by the needs-based model of QoL (Hunt SM, McKenna SP. The QLDS: A scale for the measurement of quality of life in depression. (1992). Health Policy 22; 307–319). This model identifies several core fundamental needs that are important to an individual's QoL and adjustment to society. Illness affects QoL by preventing the satisfaction of these needs. Results: The sample included 30 participants (male 17 (56.7%); mean (SD) age 65.5 (11.3) years with low to intermediate-1 risk MDS. Illness information for the sample is shown in Table 1. The analyses identified several symptoms. The most frequently reported symptoms were; fatigue (97%), breathlessness (60%), increased infections (60%), sleep problems (53%), cognitive problems (50%), temperature fluctuations (47%), increased bruising (40%) and bleeding (10%), pain (30%), depression (23%) and anxiety (10%). Several common functions were affected by MDS, including; standing, walking, bending, lifting, carrying and rising from sitting. Various more complex functions were also affected such as the ability to socialise, shop and do jobs around the house. A total 33 QoL issues were identified. Nine fundamental needs were affected by MDS; subsistence, safety and security, affection, understanding, participation, leisure, self-actualisation, identity and independence. Conclusions: The study was successful in developing outcome models describing how MDS affects symptoms, activity limitations and QoL. Many symptoms were experienced including several in addition to those directly associated with anaemia. Functioning was also frequently affected. A wide range of QoL issues were identified with several fundamental needs impaired to some extent. Following this study a large bank of potential items has been created that will aid the development of MDS-specific outcome scales assessing symptoms, activity limitations and QoL. Disclosures: McKenna: Celgene Ltd: Consultancy, Research Funding. Twiss:Celgege Ltd: Consultancy, Research Funding. Wilburn:Celegene Ltd: Consultancy, Research Funding. Crawford:Celegene: Consultancy, Research Funding. Loth:Celgene Ltd: Employment.

scholarly journals Subcutaneous Immunotherapy Improves the Symptomatology of Allergic Rhinitis

2015 ◽  
Vol 20 (01) ◽  
pp. 006-012 ◽  
Author(s):  
Edmir Lourenço ◽  
Eduardo Caldeira ◽  
César Carvalho ◽  
Marcelo Cunha ◽  
Marcus Carvalho ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Nasal Congestion ◽  
Average Score ◽  
Subcutaneous Immunotherapy ◽  
Therapeutic Tool ◽  
Pathological Conditions ◽  
In The Beginning ◽  
Subcutaneous Specific Immunotherapy

Introduction The relevance of allergic rhinitis is unquestionable. This condition affects people's quality of life and its incidence has increased over the last years. Objective Thus, this study aims to analyze the effectiveness of subcutaneous injectable immunotherapy in cases of nasal itching, sneeze, rhinorrhea and nasal congestion in allergic rhinitis patients. Methods In the present study, the same researcher analyzed the records of 281 patients. Furthermore, the researchers identified allergens through puncture cutaneous tests using standardized extracts containing acari, fungi, pet hair, flower pollen, and feathers. Then, the patients underwent treatment with subcutaneous specific immunotherapy, using four vaccine vials for desensitization, associated with environmental hygiene. The authors analyzed conditions of nasal itching, sneeze, rhinorrhea, and nasal congestion throughout the treatment, and assigned them with a score ranging from zero (0), meaning absence of these symptoms to three (3), for severe cases. The symptoms were statistically compared in the beginning, during, and after treatment. Results In this study, authors analyzed the cases distribution according to age and the evolution of symptomatology according to the scores, comparing all phases of treatment. The average score for the entire population studied was 2.08 before treatment and 0.44 at the end. These results represent an overall improvement of ∼79% in symptomatology of allergic rhinitis in the studied population. Conclusion The subcutaneous immunotherapy as treatment of allergic rhinitis led to a reduction in all symptoms studied, improving the quality of life of patients, proving itself as an important therapeutic tool for these pathological conditions.

Recent Trends in Management of Allergic Rhinitis

2016 ◽  
Vol 9 (3) ◽  
pp. 130-136 ◽  
Author(s):  
Rajalaxmi Panigrahi ◽  
Sudhir K Acharya
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Adverse Effects ◽  
Immunoglobulin E ◽  
Nasal Congestion ◽  
Symptomatic Relief ◽  
Dust Mite ◽  
Recent Trends ◽  
Ige Mediated

ABSTRACT Allergic rhinitis is an inflammatory, immunoglobulin E (IgE)- mediated disease, characterized by nasal congestion, rhinorrhea, and sneezing with or without nasal itching. It can significantly interfere with patient's quality of life. The goals of treatment are to provide the patient with symptomatic relief and improve the quality of life with minimal adverse effects. Prevention has been a large focus in the treatment of allergic rhinitis, but few interventions have proven effective. Although dust mite allergies are more common. How to cite this article Panigrahi R, Acharya SK. Recent Trends in Management of Allergic Rhinitis. Clin Rhinol An Int J 2016;9(3):130-136.

Montelukast Effectively Treats the Nighttime Impact of Seasonal Allergic Rhinitis

2005 ◽  
Vol 19 (6) ◽  
pp. 591-598 ◽  
Author(s):  
Eli O. Meltzer ◽  
George Philip ◽  
Steven F. Weinstein ◽  
Craig F. LaForce ◽  
Marie-Pierre Malice ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Seasonal Allergic Rhinitis ◽  
Nasal Congestion ◽  
Positive Control ◽  
Global Evaluation ◽  
Life Questionnaire ◽  
Double Blind ◽  
Significant Burden

Background Nighttime problems constitute a significant burden on the quality of life of patients with seasonal allergic rhinitis (SAR). The aim of this study was to evaluate the effectiveness of montelukast on nighttime AR symptoms. Methods In seven multicenter, double-blind, parallel-group trials, nighttime problems were assessed as the nighttime symptoms score (NSS), an average of three individual symptom scores: difficulty going to sleep, nighttime awakening, and nasal congestion on awakening (each rated 0 = none to 3 = severe). Patients (aged 15–82 years) were randomized to receive montelukast, 10 mg (n = 1751), placebo (n = 1557), or the positive control loratadine, 10 mg (n = 1616). Results In a combined analysis, changes from baseline (mean ± SE) in NSS were -0.28 ± 0.01, -0.16 ± 0.01, and —0.24 ± 0.01 for the montelukast, placebo, and loratadine groups, respectively. Difference versus placebo in least-squares mean change from baseline were —0.11 (95% confidence interval, -0.14, -0.08; p ≤ 0.001) for montelukast and -0.09 (-0.12, -0.06; p ≤ 0.001) for loratadine. Strong baseline correlations (R > 0.70; p < 0.001) of NSS and two of its individual symptoms with the sleep domain of the validated Rhinoconjunctivitis Quality of Life Questionnaire support the validity and importance of measuring nighttime morbidity in SAR. Furthermore, a clinically important benefit of montelukast on the nighttime impact of SAR was shown using an analysis anchored on the Patient's Global Evaluation. Conclusion These data underscore the importance of nighttime problems in patients with SAR and the need to treat nighttime symptoms. In these studies, montelukast significantly improved the NSS, a clinically relevant and valid measure in patients with SAR.

Desloratadine relieves nasal congestion and improves quality-of-life in persistent allergic rhinitis

Allergy ◽  
2009 ◽  
Vol 64 (11) ◽  
pp. 1663-1670 ◽  
Author(s):  
K. Holmberg ◽  
A.-B. Tonnel ◽  
I. Dreyfus ◽  
P. Olsson ◽  
J. Cougnard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Nasal Congestion ◽  
Persistent Allergic Rhinitis

scholarly journals Profiles of subjective health among people living alone: a latent class analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tytti P. Pasanen ◽  
Nina Tamminen ◽  
Tuija Martelin ◽  
Katariina Mankinen ◽  
Pia Solin
Keyword(s):  
Quality Of Life ◽  
Latent Class Analysis ◽  
Latent Class ◽  
Subjective Health ◽  
Living Alone ◽  
World Health ◽  
Class Analysis ◽  
Wide Range ◽  
Health Profiles

Abstract Background Living alone has increased globally and especially in Finland where 45% of all households are single occupancy. Epidemiological research has found that living alone a risk factor for a wide range of adversities related to quality of life but the rapidly-changing demographics of people living alone calls for a more detailed investigation of their subjective health status. Methods Using a cross-sectional survey sent for a random sample of Finnish residents in single-person households (n = 884), we explored with latent class analysis whether the respondents form different health profiles based on the three health dimensions defined by the World Health Organization: physical, social, and mental well-being. The identified groups were then compared in terms of demographic characteristics with the χ2 test and quality of life using linear regression models. Sensitivity analyses were run using more refined, manual 3-step BCH method. Results Four distinct health profiles were found: Languishing (4%), Managing (35%), Healthy (30%), and Flourishing (31%). The groups differed in most socio-demographic aspects such as marital and employment status, but not in terms of geographic location or gender (apart from group Languishing that contained more men). Controlling for these socio-demographic differences, all groups showed different average levels of perceived quality of life to the expected direction. Conclusions Our findings suggest that people living alone are indeed a very heterogeneous group in terms of subjective health. Instead of seeing living alone as a mere risk for low quality of life, concept of living alone should be understood more broadly both in public discussion and scientific research.

Satisfaction of psychotic patients with care and its value to predict outcomes

2018 ◽  
Vol 47 ◽  
pp. 60-66 ◽  
Author(s):  
J.M. Vermeulen ◽  
N.F. Schirmbeck ◽  
M.J. van Tricht ◽  
L. de Haan
Keyword(s):  
Quality Of Life ◽  
Predictive Value ◽  
World Health ◽  
Psychotic Symptoms ◽  
Satisfaction With Care ◽  
Symptom Scale ◽  
World Health Organization Quality ◽  
Wide Range ◽  
Health Organization

AbstractBackgroundA key indicator of quality of treatment from the patient's perspective is expressed by satisfaction with care. Our aim was to (i) explore satisfaction and its relation to clinical outcome measures; and (ii) explore the predictive value of satisfaction for the course of outcomes over three years.MethodsData of 654 patients with a non-affective psychosis included in a naturalistic longitudinal cohort study were analyzed. We included 506 males and 148 females with a mean age of 30.47 (SD 7.24) from The Netherlands. Satisfaction was measured with the self-rating Client Satisfaction Questionnaire-8. A wide range of interviewer-rated (e.g., Positive and Negative Symptom Scale) and self-rated (e.g., World Health Organization Quality of Life); outcomes of low, intermediate and high satisfied patients were compared using ANOVA, Chi2 or Kruskal–Wallis tests. The predictive value of satisfaction level on clinical outcomes after three years was tested using regression models.ResultsSatisfaction levels were low (19.4%), intermediate (48.9%) or high (31.7%). High satisfied patients showed significantly better interviewer-rated outcomes, e.g., less severe psychotic symptoms, and self-rated outcomes, e.g., better quality of life, compared to patients with intermediate or low satisfaction. Higher levels of satisfaction with care at baseline predicted a reduction of positive symptoms three years later (B=–.09, P-value=.013).ConclusionsSatisfaction of patients with psychosis is a valuable monitoring measure since high satisfied patients show more favorable outcomes ranging from psychopathological symptoms to quality of life. Further research into explanations of lower levels of satisfaction is commendable in order to improve outcomes.

scholarly journals Perubahan kualitas hidup, eosinofil mukosa hidung, dan interleukin-5 serum pasien rinitis alergi pasca terapi

2015 ◽  
Vol 45 (2) ◽  
pp. 121
Author(s):  
Arinda Putri Pitarini ◽  
Nina Irawati ◽  
Niken Lestari Poerbonegoro ◽  
Dewi Wulandari ◽  
Saptawati Badarsono
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Eosinophil Count ◽  
Immunoglobulin E ◽  
Nasal Congestion ◽  
Inflammatory Cells ◽  
Clinical Practices ◽  
Interleukin 5 ◽  
Comprehensive Management

 Latar belakang: Rinitis alergi adalah suatu penyakit inflamasi pada hidung yang dimediasi oleh imunoglobulin-E, yang terjadi setelah mukosa hidung terpajan alergen. Sel dan mediator inflamasi yang berperan penting adalah eosinofil, histamin, dan sitokin produk Th2. Penyakit ini ditandai dengan gejala rinorea, bersin berulang, hidung tersumbat dan/atau hidung gatal. Selain dari gejala yang mengganggu, rinitis alergi berdampak buruk terhadap kualitas hidup penderita. Tatalaksana komprehensif, meliputi penghindaran alergen, farmakoterapi, imunoterapi dan edukasi, ditujukan untuk menghilangkan gejala dan memperbaiki kualitas hidup pasien. Tujuan: Mengetahui perubahan kualitas hidup, jumlah eosinofil mukosa hidung, dan kadar IL-5 serum pada pasien rinitis alergi setelah mendapat terapi farmaka sesuai panduan. Metode: Penelitian ini merupakan studi pre-eksperimental analitik dengan pengambilan data sebelum dan sesudah pemberian farmakoterapi. Hasil: Sebanyak 31 dari 33 subjek mengalami perubahan kualitas hidup yang bermakna (MID>0,7). Seluruh pasien, 33 subjek memperlihatkan perubahan yang responsif dari jumlah eosinofil mukosa hidung. Sebanyak 30 subjek dinyatakan responsif dan terdapat penurunan kadar IL-5. Tidak ada hubungan yang bermakna antara perubahan kualitas hidup dan kadar IL-5. Kesimpulan: Perubahan kualitas hidup, jumlah eosinofil mukosa hidung, dan kadar IL-5 serum dapat digunakan sebagai penanda objektif keberhasilan terapi rinitis alergi yang dapat dipakai dalam praktik klinis sehari-hari maupun kepentingan riset. Kata kunci: rinitis alergi, kualitas hidup, eosinofil, interleukin-5ABSTRACT Background: Allergic rhinitis defined as an inflammatory disease of the nose mediated by immunoglobulin-E, induced after nasal mucosa exposure to allergen. Important inflammatory cells and mediators are eosinophils, histamine, and Th2-related cytokines. Symptoms include rhinorrhea, repeated sneezing, nasal congestion and/or nasal itching. Aside from its bothersome symptoms, allergic rhinitis decreases patient’s quality of life (QOL). Comprehensive management consist of allergen avoidance, medication, immunotherapy, and education, aimed to diminish symptoms and improve the patient’s quality of life. Purpose: To evaluate changes in quality of life, nasal mucosal eosinophil count, and level of interleukin-5 in allergic rhinitis after medicamentous treatment. Methods: This was an analytic pre-experimental study with data taken before and after medicamentous treatment. Results: Thirty-one of 33 subjects showed significant changes of QOL (MID>0,7). All samples, 33 subjects, experienced responsive changes in nasal mucosal eosinophil count. Thirty subjects were responsive, which showed decrease of IL-5 level. There was no significant relation between changes of QOL and changes of IL-5 level. Conclusion: Changes in quality of life, nasal mucosal eosinophil count, and IL-5 level are objective markers of treatment efficacy in Allergic Rhinitis, which can be used in clinical practices and researches. Keywords: allergic rhinitis, quality of life, eosinophil, interleukin-5, intranasal steroid, antihistamine

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