scholarly journals The Challenge of Sustainability of High-Cost Oncological Drugs: A Budgeting Model in an Italian Cancer Center

2021 ◽  
Vol 18 (24) ◽  
pp. 13413
Author(s):  
Carla Masini ◽  
Davide Gallegati ◽  
Nicola Gentili ◽  
Ilaria Massa ◽  
Raffaella Ciucci ◽  
...  
Keyword(s):  
Pharmaceutical Expenditure ◽  
Drug Expenditure ◽  
Regional Governance ◽  
Cancer Center ◽  
Percentage Increase ◽  
Determining Factors ◽  
Governance Tools ◽  
Mean Cost ◽  
Per Capita Consumption

In Italy, drug expenditure governance is achieved by setting caps based on the percentage increase in hospital spending compared to the previous year. This method is ineffective in identifying issues and opportunities as it does not consider an analysis of the number of treated cases and per capita consumption in local and regional settings. The IRCCS (Scientific hospitalization and treatment institute) Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori” in Meldola, has developed and adopted an effective management model designed to oversee pharmaceutical expenditure, guarantee prescription appropriateness and quality of care to patients. The budget setting follows a structured process which evaluates determining factors of the expenditure such as expected patients calculated according to the epidemiology and to national and regional indications of appropriateness, mean cost per patient calculated on the average period of demonstrated efficacy of the drug and use of drugs with the best cost-effectiveness ratio. Strict monitoring and integrated purchasing processes allow for immediate corrective actions on expenditures, as well as a continuous dialogue with the region in order to guarantee consistent funding of IRST activities. The model, presented in this article is efficient and implements concepts beyond the conventional “silos” approach and national and regional governance tools, in terms of patient centricity.

Assessing the impact of chemotherapy-induced nausea and vomiting on patients’ quality of life: An Arabic version of the Functional Living Index-Emesis

2021 ◽  
pp. 107815522199844
Author(s):  
Abdullah M Alhammad ◽  
Nora Alkhudair ◽  
Rawan Alzaidi ◽  
Latifa S Almosabhi ◽  
Mohammad H Aljawadi
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Arabic Language ◽  
Nausea And Vomiting ◽  
Cancer Center ◽  
Arabic Version ◽  
Patient Reported ◽  
Arabic Speaking ◽  
The Impact

Introduction Chemotherapy-induced nausea and vomiting is a serious complication of cancer treatment that compromises patients’ quality of life and treatment adherence, which necessitates regular assessment. Therefore, there is a need to assess patient-reported nausea and vomiting using a validated scale among Arabic speaking cancer patient population. The objective of this study was to translate and validate the Functional Living Index-Emesis (FLIE) instrument in Arabic, a patient-reported outcome measure designed to assess the influence of chemotherapy-induced nausea and vomiting on patients’ quality of life. Methods Linguistic validation of an Arabic-language version was performed. The instrument was administered to cancer patients undergoing chemotherapy in a tertiary hospital's cancer center in Saudi Arabia. Results One-hundred cancer patients who received chemotherapy were enrolled. The participants’ mean age was 53.3 ± 14.9 years, and 50% were female. Half of the participants had a history of nausea and vomiting with previous chemotherapy. The Cronbach coefficient alpha for the FLIE was 0.9606 and 0.9736 for nausea and vomiting domains, respectively, which indicated an excellent reliability for the Arabic FLIE. The mean FLIE score was 110.9 ± 23.5, indicating no or minimal impact on daily life (NIDL). Conclusions The Arabic FLIE is a valid and reliable tool among the Arabic-speaking cancer population. Thus, the Arabic version of the FLIE will be a useful tool to assess the quality of life among Arabic speaking patients receiving chemotherapy. Additionally, the translated instrument will be a useful tool for future research studies to explore new antiemetic treatments among cancer patients.

scholarly journals Outcomes of Peer Review for Radiotherapy Treatment Plans With Palliative Intent

2018 ◽  
Vol 14 (12) ◽  
pp. e794-e800
Author(s):  
Dina Thompson ◽  
Kimberly Cox ◽  
James Loudon ◽  
Ivan Yeung ◽  
Woodrow Wells
Keyword(s):  
Peer Review ◽  
Treatment Plan ◽  
Palliative Radiotherapy ◽  
Cancer Center ◽  
Palliative Intent ◽  
Treatment Plans ◽  
Important Quality ◽  
Radiation Medicine ◽  
Radiotherapy Treatment

Purpose: Peer review of a proposed treatment plan is increasingly recognized as an important quality activity in radiation medicine. Although peer review has been emphasized in the curative setting, applying peer review for treatment plans that have palliative intent is receiving increased attention. This study reports peer review outcomes for a regional cancer center that applied routine interprofessional peer review as a standard practice for palliative radiotherapy. Methods and Materials: Peer review outcomes for palliative radiotherapy plans were recorded prospectively for patients who began radiotherapy between October 1, 2015, and September 30, 2017. Recommended and implemented changes were recorded. The content of detailed discussions was recorded to gain insight into the complexities of palliative treatment plans considered during peer review. Results: Peer review outcomes were reviewed for 1,413 treatment plans with palliative intent. The proportions of detailed discussions and changes recommended were found to be 139 (9.8%) and 29 (2.1%), respectively. The content of detailed discussions and changes recommended was categorized. Major changes represented 75.9% of recommended changes, of which 84.2% were implemented clinically. Conclusion: Many complexities exist that are specific to palliative radiotherapy. Interprofessional peer review provides a forum for these complexities to be openly discussed and is an important activity to optimize the quality of care for patients with treatment plans that have palliative intent.

scholarly journals Fears, beliefs, and quality of life of patients with cancer vs the general population during the coronavirus disease 2019 (COVID-19) pandemic in Lombardy

2021 ◽  
pp. 030089162110228
Author(s):  
Carla Ida Ripamonti ◽  
Giacomo Massa ◽  
Daniela Insolvibile ◽  
Mauro Guglielmo ◽  
Guido Miccinesi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Perceived Risk ◽  
Well Being ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Psychological Consequences ◽  
Patients With Cancer ◽  
Fear Of Cancer

Aim: To understand how patients with cancer reacted to the coronavirus disease 2019 (COVID-19) pandemic and whether their quality of life (QoL) was affected. Methods: In June 2020, 111 patients with cancer treated in the supportive care unit of a Comprehensive Cancer Center in Milan and 201 healthy controls from the general population were enrolled and assessed both quantitatively and qualitatively for fears and COVID-19–related beliefs as well as for QoL. Results: Fear of COVID-19 was significantly lower among patients (41% vs 57.6%; p = 0.007), as was fear of cancer (61.5% vs 85.6%; p < 0.001) and other diseases. The perceived risk of getting COVID-19 was lower among patients (25.2% vs 52.7%; p < 0.001), as was the belief of having been exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (18.1% vs 40.8%; p < 0.001). The physical component of QoL was better among the population (54.5 vs 43.8; p < 0.001); the reverse was true for patients’ psychological well-being (44.6 vs 39.6; p < 0.001). The qualitative data supported such results, showing a reduced psychological effect on the patients with cancer compared to the controls. Various reasons explain this result, including the awareness of being treated for cancer and nevertheless protected against getting infected in a cancer center of public health reorganized to continue treating patients by protecting them and personnel from the risk of infection. Conclusions: The experience of a cancer diagnosis, together with proper hospital reorganization, may act as protective factors from fears and psychological consequences of the COVID-19 outbreak.

Analysis of Voiding Impairment after Prostate Biopsy and the Effect of Doxazosin Treatment: Outcomes from a Regional Cancer Center

2021 ◽  
pp. 1-6
Author(s):  
Yi Zheng ◽  
Fuding Bai ◽  
Nan Zhang ◽  
Huifeng Wu
Keyword(s):  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Urine Volume ◽  
Cancer Center ◽  
Control Group ◽  
Urinary Flow ◽  
Voiding Difficulty ◽  
Male Patients ◽  
Baseline Values

<b><i>Introduction:</i></b> The aim of this study was to investigate the association of transrectal ultrasound (TRUS)-guided prostate biopsy with voiding impairment and the efficacy of doxazosin treatment. <b><i>Methods:</i></b> A prospective observational study including 200 male patients undergoing TRUS-guided prostate biopsy was performed between May 2020 and December 2020. One hundred patients underwent biopsy with doxazosin (doxazosin group). The remaining 100 patients underwent biopsy without doxazosin (control group). All patients were questioned regarding post-biopsy voiding difficulty and acute urinary retention. The International Prostate Symptom Score (IPSS), maximal urinary flow rate (Q<sub>max</sub>), and residual urine volume were recorded before biopsy and at 7 and 30 days after biopsy. <b><i>Results:</i></b> There were no significant differences in baseline parameters between the two groups. The rate of post-biopsy voiding difficulty in the doxazosin group was significantly lower than that in the control group. Compared with baseline values, doxazosin treatment significantly improved IPSS, quality of life scores, and Q<sub>max</sub> after biopsy (<i>p</i> &#x3c; 0.05). The baseline values of IPSS and prostate size may be risk factors for post-biopsy voiding difficulty. <b><i>Conclusion:</i></b> TRUS-guided prostate biopsy causes transient voiding impairments, which may be improved by doxazosin treatment.

scholarly journals Allocation of foreign direct investment across brazilian states

2013 ◽  
Vol 43 (2) ◽  
pp. 241-269 ◽  
Author(s):  
Maurício Mesquita Bortoluzzo ◽  
Sergio Naruhiko Sakurai ◽  
Adriana Bruscato Bortoluzzo
Keyword(s):  
Foreign Direct Investment ◽  
Panel Data ◽  
Foreign Investment ◽  
Direct Investment ◽  
Transport Infrastructure ◽  
Market Size ◽  
Consumer Market ◽  
Determining Factors ◽  
Econometric Study

Foreign direct investment (FDI) has become increasingly important for the Brazilian economy: the ratio of FDI inflow to the country's gross domestic product (GDP) increased from a 0.6% average in the 1980's to 2.5% from 2001 to 2010, according to data from UNCTAD. However, there is great inequality in the distribution of this investment among Brazilian federation units. This study aims at investigating the determining factors for the location of foreign direct investment across Brazilian states, based on an econometric study with panel data for the years 1995, 2000 and 2005. The results showed that foreign investment responded positively to consumer market size, quality of labor and transport infrastructure, but negatively to cost of labor and tax burden.

scholarly journals UPAYA PEMERINTAH DAERAH DALAM PENGENDALIAN PRODUKSI MINUMAN BERALKOHOL TRADISIONAL

Yuridika ◽  
2018 ◽  
Vol 33 (1) ◽  
pp. 93
Author(s):  
Luffita Alfianti
Keyword(s):  
Local Government ◽  
Food Production ◽  
Alcoholic Beverage ◽  
Regional Governance ◽  
Alcoholic Beverages ◽  
Industry Regulation ◽  
Control Production

Traditional alcoholic beverage, traditionally produced with hereditay recipe which is drunk to celebrate religious or tradition event. Government have not regulated a distinctive act to control production, so it needs to be analyzed the writer compose a thesis with systematical interpretation and extention to Regional Governance Act Number 23/2014, Ministry of Industry Regulation number 63/M-IND/PER/7/2014 in Restraining and Controlling The Industry and Quality of Beverage, Ministry of Trade Ragulation No. 20/M-Dag/Per/4/2014 in Restraining and Controlling of Supply, Distribution and Sale of Alcoholic Beverage, Head of Drug and Food Board Regulation Number HK.03.1.23.04.12.2205 in Guidelines On The Provision of Certificates of Food Production of Household Industries. Furthermore, writer also examine about Regional Government’s liability in controlling the production of traditional alcoholic beverage. Based on systematical interpretation and extention to regulation above, Regional/Local government has authorization in issuing a permit of traditional alcoholic beverage. However, there is no regulation that organizes the authority of local government to give license to the production of it. In contrast, local government has authority to control the distribution of traditional alcoholic beverage with implements the regulation inforcement to business activities that violate the license to trade by selling traditional alcoholic beverages.

scholarly journals Perception of Iranian Patients with Cancer, Their Relatives, and Health Care Professionals Towards Length of Life and Quality of Life: A Local Survey

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Negin Nourbakhsh ◽  
Bahareh Tahani ◽  
Azadeh Moghaddas
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Survival Time ◽  
Health Care Professionals ◽  
Treatment Modalities ◽  
Cancer Center ◽  
Treatment Choices ◽  
Patients With Cancer ◽  
Length Of Life

Background: Recently, therapeutic decision-making in oncology is changed to a big challenge for both patients and involved oncologists due to an increase in available treatment modalities with a variety of benefits or adverse effects. Objectives: The current study aimed at comparing the perception of treatment priorities regarding lengthening of survival time or maintenance of the quality of life (QoL) among patients with cancer by health care professionals (HCPs). Methods: The current cross-sectional study was conducted on patients with cancer, their relatives, and healthcare professionals in the referral cancer center of Omid affiliated to Isfahan University of Medical Sciences. To identify treatment choices, priority, and related variables influencing their opinions, all participants were interviewed using a standard and valid questionnaire in Persian. The collected data were analyzed using the SPSS software version 20, and the P-value less than 0.05 was considered statistically significant. Results: A total of 299 participants, including 100 patients, 109 relatives, and 90 HCPs (74.2% nurses, 20.2% physicians, 5.6% others) participated in the study. The priority of treatment between survival time (66.1% for relatives vs. 47.9% for patients and 21.3% for HCP) and QoL (33.9% vs.52.1% and 78.7%) was significantly different between the three groups (P < 0.001). Most of the HCPs, patients, and their relatives believed that the physician is the only person who should accept the responsibility of treatment choices and process (98.9% vs. 100% and 98%, respectively; P = 0.002). Conclusions: Among the Iranian population, both the length of life and QoL were valuable; however, it was observed that patients with cancer and HCPs preferred mostly to expand the QoL, while the length of life was more valuable for relatives. Also, all patients, their relatives, and HCPs preferred to choose the physicians as the decision-makers. The results of the study can be helpful in choosing treatment regimens and designing clinical trials.

scholarly journals Diet and weight management by people with nonmetastatic colorectal cancer during chemotherapy: mixed methods research

2020 ◽  
Vol 9 (2) ◽  
pp. CRC16
Author(s):  
Jane B Hopkinson ◽  
Catherine Kazmi ◽  
Jayne Elias ◽  
Sally Wheelwright ◽  
Rhiannon Williams ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Dietary Intake ◽  
Mixed Methods Research ◽  
Nutritional Risk ◽  
Self Management ◽  
Cancer Center ◽  
Colorectal Cancer Patients ◽  
Treatment Tolerance ◽  
Maximum Variation Sample

Aim: To investigate self-management of dietary intake by colorectal cancer patients receiving chemotherapy. Methods: A questionnaire was administered to 92 patients with nonmetastatic colorectal cancer receiving chemotherapy treatment at a UK cancer center in 2018–19. A maximum variation sample of 20 patients who completed the questionnaire were interviewed. Results: More than three in five patients were at nutritional risk but fewer than one in five were concerned about dietary intake or weight. Self-management of diet and weight was inconsistent with achieving the nutritional intake recommended by clinical guidelines on nutrition in cancer. Conclusion: There is potential for psychoeducation to support change in self-management of nutritional risk, with implications for better treatment tolerance and outcomes including quality of life.

Determining Factors of User Satisfaction for Bicycle-Sharing Systems

2020 ◽  
pp. 204-220
Author(s):  
Sebastian Molinillo ◽  
Francisco J. Liébana-Cabanillas ◽  
Miguel Ruiz-Montañez ◽  
Guadalupe González-Sánchez
Keyword(s):  
Significant Relationship ◽  
User Satisfaction ◽  
Special Interest ◽  
Transportation Services ◽  
Determining Factors ◽  
Mode Of Transportation ◽  
Town Halls

With the development of new shared transportation services, changes are occurring in the habitual consumption of these kinds of services, and it is expected that this trend will continue in the coming years. Given the rise of public bicycle-sharing systems (PBSS) and the increase in their use as a new mode of transportation in many cities, it is considered necessary to analyze and understand the main aspects that determine satisfaction with PBSS. This chapter proposes 10 aspects related to PBSS, grouped according to service infrastructure and other factors that are typical of this service. The results show that all the variables maintain a significant relationship with the established levels of satisfaction. In addition, it has been demonstrated that concessionaires and town halls must take special interest in the quality of the city's bicycles, bike lanes, and network of stations.

Sign in / Sign up

Export Citation Format

Share Document