scholarly journals ANALISIS EFEKTIVITAS BIAYA PENGGUNAAN AMLODIPIN DIBANDINGKAN KAPTOPRIL PADA PASIEN HIPERTENSI DI RUMAH SAKIT UMUM DAERAH MAJENE PERIODE JANUARI HINGGA JUNI TAHUN 2019

2021 ◽  
Vol 6 (2) ◽  
pp. 262-271
Author(s):  
Andi Maulana Kamri ◽  
◽  
Rachmat Kosman ◽  
Dian Rahayu
Keyword(s):  
Cost Effectiveness ◽  
Average Cost ◽  
Sampling Technique ◽  
Cost Effective ◽  
Term Treatment ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Cost Effective Treatment ◽  
Long Term Treatment ◽  
Significant Difference

Hypertension is a chronic disease that requires long-term treatment and high cost. The research aimed to determine a more cost-effective treatment between amlodipine and captopril in hypertensive patients at Majene Hospital from January to June 2019. The sampling technique was purposive sampling with a cross-sectional method. The data collection was obtained from medical records and direct medical costs of hypertensive patients who take amlodipine or captopril. The Mann-Whitney statistical test was performed to determine the significant difference between the treatment groups. The results showed that the Average Cost Effectiveness Rasio (ACER) value of the 5 mg amlodipine and 12.5 mg captopril groups was Rp. 4233.3 and Rp. 4904 with an Incremental Cost Effectiveness rasio (ICER) value of Rp. 1063.5. Meanwhile, the Average Cost Effectiveness Rasio (ACER) value of the 10 mg amlodipine and 25 mg captopril group was Rp. 3764,7 and Rp. 4875.1. In conclusion, amlodipine is more cost effective than captopril.

Compared Incidence of First Myocardial Infarction in Hypertensive Patients under Treatment Containing Propranolol or excluding β-Receptor Blockade

1976 ◽  
Vol 51 (s3) ◽  
pp. 509s-511s ◽  
Author(s):  
I. McD. G. Stewart
Keyword(s):  
Myocardial Infarction ◽  
Term Treatment ◽  
Receptor Blocker ◽  
Receptor Blockade ◽  
Hypertensive Patients ◽  
Long Term Treatment ◽  
Significant Difference ◽  
Group A ◽  
Β Receptor

1. After some exclusions, 169 severe uncomplicated essential hypertensive patients presenting consecutively were divided into two groups according to their treatment. Of these, 121 had been given long-term treatment containing propranolol (PC group) and forty-eight had been treated with hypotensive agents excluding any β-receptor-blocker group, the non-β-receptor-blocker (NBB) group. 2. There were no significant differences in myocardial infarction risk factors between the two groups. 3. After a mean follow-up of 5·25 years, nine of the 121 subjects (7·5%) in the PC group had suffered first infarctions and fifteen of the forty-eight subjects (31%) in the NBB group, a significant difference (P < 0·01). 4. It was concluded that the presence of propranolol had prevented more or caused fewer infarctions, perhaps a combination of both, than had the older hypotensive agents unsupported by β-receptor blockade.

scholarly journals Knowledge and Perception Regarding Hypertension among Hypertensive Patients at a Tertiary Hospital in Kathmandu, Nepal

2020 ◽  
Vol 7 (1) ◽  
pp. 51-62
Author(s):  
Sabita Pandey Bashyal ◽  
Narbada Thapa
Keyword(s):  
Sampling Technique ◽  
Simple Random Sampling ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Uncontrolled Hypertension ◽  
Severe Illness ◽  
Cross Sectional ◽  
Middle Income ◽  
Hypertensive Patients ◽  
Significant Difference

Background: Hypertension has a great impact on cardiovascular disease and death all over the world. Low and middle-income countries including Nepal are facing higher disease burden because of complications arise from uncontrolled hypertension. Patient’s knowledge and perception play an important role for the proper management of hypertension. There are limited studies related to knowledge and perception of hypertension, therefore, this study aimed to assess the knowledge and perception of hypertension among hypertensive patients at a tertiary hospital in Nepal. Methods: This is a hospital based, mixed-method, cross-sectional study which was conducted among 400 hypertensive patients in the outpatient department of Sahid Gangalal National Heart Center, Kathmandu, Nepal. Patients who were diagnosed as hypertensive at least 6 months before were selected by simple random sampling technique and were interviewed using semi- structured questionnaire, and interview schedule from March to May 2019. Data were analyzed using descriptive and inferential statistics.    Results: The mean age of the respondents was 58.86 ±11.07 years and nearly half (47.8%) of them were in the age group of 60 years and above. More than half, (58%) were male, 77.8% were overweight, about half of them had a significant family history of hypertension with first degree relatives. Regarding the knowledge, the total mean score was 16.16±3.032 and had significant difference with age (p= 0.002), gender (p=.000), education (p=0.002), occupation (p=0.000), and duration of HTN diagnosis (p=0.000). Majority of them perceived hypertension as less serious illness and had significant difference with education level (p=0.001) and duration of HTN diagnosis (p=0.000). Conclusions: Majority of participants had inadequate knowledge of hypertension and they perceived hypertension as less severe illness which might hinder the adherence to treatment recommendations. Hence, mass awareness program strategies might be helpful to increase hypertension related knowledge and perception.

Otomycosis in Turkey: predisposing factors, aetiology and therapy

2003 ◽  
Vol 117 (1) ◽  
pp. 39-42 ◽  
Author(s):  
K. Murat Ozcan ◽  
Muge Ozcan ◽  
Aydin Karaarslan ◽  
Filiz Karaarslan
Keyword(s):  
Effective Treatment ◽  
Bacterial Infections ◽  
Pathogenic Fungus ◽  
Cost Effective ◽  
Term Treatment ◽  
Predisposing Factors ◽  
Control Group ◽  
Cost Effective Treatment ◽  
Long Term Treatment ◽  
Pathogenic Agents

Otomycosis usually requires long-term treatment and tends to recur. This study was performed on 87 patients with the clinical diagnosis of otomycosis and 20 controls in order to determine the pathogenic agents, predisposing factors and a cost-effective treatment. The predisposing factors included wearing head clothes (74.7 per cent), presence of dermatomycoses (34.5 per cent) and swimming (27.6 per cent). The most common pathogenic fungus was Aspergillus niger (44.8 per cent) in the otomycosis group. The only isolate was Candida albicans in the control group (2.5 per cent). We concluded that administration of four per cent boric acid solution in alcohol and frequent suction cleaning of the ear canal might be a cost-effective treatment for otomycosis since 77 per cent of the patients were treated effectively this way. Eighty per cent of the resistant cases had mixed fungal-bacterial infections, and 50 per cent of them had dermatomycoses. These resistant cases were treated by administration of tioconazole ointment.

scholarly journals Cost Effectiveness Kombinasi Antihipertensi Candesartan-Bisoprolol dan Candesartan-Amlodipin Pada Pasien Rawat Jalan Penderita Hipertensi

2019 ◽  
Vol 13 (2) ◽  
Author(s):  
Eny Nurhikma ◽  
Randa Wulaisfan ◽  
Musdalipah Musdalipah
Keyword(s):  
Cost Effectiveness ◽  
Average Cost ◽  
Cross Sectional Study ◽  
Cost Effectiveness Analysis ◽  
Sectional Study ◽  
Cost Effectiveness Ratio ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Effectiveness Analysis ◽  
The Cost

Today, in various countries, especially in Indonesia, the cost of health services is increasing. Hypertension is a degenerative disease that requires health costs for a long time. Increasing costs due to increasing chronic diseases threaten access and quality of health services, by which it is necessary to find a solution to overcome the problem of health financing. One method used is to analyze the guidelines for hypertension therapy and drug classes in the pharmacoeconomic aspects, namely Cost Effectiveness Analysis. This study aims to analyze the effectiveness of antihypertensive combination therapy in hypertensive patients at Bhayangkara Hospital, Kendari in 2019. The research method is descriptive with cross sectional study design. The analysis conducted is the cost effectiveness analysis (CEA) performed by calculating direct medical costs, the effectiveness of therapy based on blood pressure that reaches the target and calculating the value of ACER (Average Cost Effectiveness Ratio) and ICER (Incremenal Cost Effectiveness Ratio). Data were collected prospectively which fulfilled the inclusion and exclusion criteria. The results showed the therapeutic effectiveness and the value of ACER obtained from 31 hypertensive patients were a combination of Candesartan – Bisoprolol  that was ACER value of 85.71% (2,314), and combination of Candesartan – Amlodipin of 70.58% (2,643). ICER value of 7,832 indicates that the price of drugs is more expensive but more effective therapy.Keywords : cost effective, ACER, ICER, Hypertension, Candesartan, Amlodipin Abstrak: Dewasa ini, diberbagai negara khususnya di Indonesia biaya pelayanan kesehatan semakin meningkat. Hipertensi merupakan salah satu penyakit degeneratif yang membutuhkan biaya kesehatan dalam jangka waktu yang lama. Peningkatan biaya akibat semakin meningkatnya penyakit kronik mengancam akses dan mutu pelayanan kesehatan, olehnya itu perlu dicari solusi untuk mengatasi masalah pembiayaan kesehatan. Salah satu metode yang dilakukan yaitu dengan menganalisis pedoman terapi hipertensi dan golongan obat dalam aspek farmakoekonomi, yaitu Analisis Efektivitas Biaya. Penelitian ini bertujuan untuk menganalisis efektivitas terapi kombinasi antihipertensi pada pasien hipertensi di Rumah Sakit Bhayangkara Kendari tahun 2019. Metode penelitian ialah deskriptif dengan rancangan cross sectional study. Data diambil secara prospektif yang memenuhi kriteria inklusi dan eksklusi. Analisis yang dilakukan adalah cost effectiveness analysis (CEA) dilakukan dengan menghitung biaya medik langsung, efektivitas terapi berdasarkan tekanan darah yang mencapai target dan menghitung nilai ACER (Average Cost Effectiveness Ratio) dan ICER (Incremenal Cost Effectiveness Ratio). Hasil penelitian menunjukkan efektifitas terapi dan nilai ACER yang diperoleh dari 31 pasien hipertensi ialah kombinasi Candesartan – Bisoprolol  yaitu nilai ACER sebesar 85,71%  (2.314), dan kombinasi Candesartan – Amlodipin  sebesar 70,58% (2.643). Nilai ICER  sebesar 7.832 menunjukkan bahwa harga obat lebih mahal namun terapi lebih efektif. Kata Kunci : Efektivitas biaya, ACER, ICER, Hipertensi, Candesartan, Amlodipin

Knowledge of and Compliance with Therapeutic Regimens among Hypertensive Patients in Nigeria

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Timothy A Ehwarieme ◽  
Emmanuelson N Chukwuyem ◽  
Cynthia O Osayande
Keyword(s):  
Significant Relationship ◽  
Lifestyle Modification ◽  
Sampling Technique ◽  
Further Education ◽  
Public Health Issue ◽  
Global Public Health ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Treatment Regimens ◽  
Significant Difference

Hypertension is a global public health issue as it is the most common cardiovascular disease worldwide. Being one the few diseases that come with complications, this study investigated the level of compliance of hypertensive patients with treatment regimens among such patients attending outpatient departments of selected tertiary hospitals in Benin City, Edo State, Nigeria. A cross-sectional descriptive research design was used. A sample size of 309 was selected from a total population of 946. A convenient sampling technique and self-structured questionnaire were used as an instrument for data collection. Results showed that only 40.7 per cent of the respondents had a good knowledge of hypertension. The majority (90 %) (N = 270) of the respondents were not compliant with treatment regimens. There was a significant relationship between knowledge of hypertension and lifestyle modification among the respondents at (χ2 = 0.022; < p = 0.05). There was no significant difference in the level of compliance with antihypertensive treatment between respondents in the selected hospitals (p = 0.791). The monthly income was found to have a significant relationship with compliance with treatment regimens at (χ2 = 0.000, 0.037, 0.001, 0.008, 0.010, 0.000 and 0.000; < p = 0.05). The study also shows that there was no significant difference in knowledge and the rate of compliance among the selected hospitals (0.883 and 0.798 respectively). Therefore it is recommended that nurses engage in health education and awareness programmes to meet the needs for increased awareness and further education of the people on the advantages of adherence to their medication and treatment regimens.

Landscape of Combination Therapy – Which Way Forward? Proceedings of the Satellite Symposium Held at the ESH European Meeting on Hypertension and Cardiovascular Protection, 27 April 2012, London

2012 ◽  
Vol 8 (3) ◽  
pp. 192
Author(s):  
Patricia Fonseca ◽  
Anna F Dominiczak ◽  
Stephen Harrap ◽  
◽  
◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Combination Therapy ◽  
Enzyme Inhibitor ◽  
Synergistic Effects ◽  
Term Treatment ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
Hypertensive Patients ◽  
Long Term Treatment

Early combination therapy is more effective for hypertension control in high-risk patients than monotherapy, and current guidelines recommend the use of either an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) for first-line therapy in patients younger than 55 years. Recent evidence shows that ACEIs reduce mortality, whereas ARBs show no apparent benefit despite their blood pressure lowering action. However, it is important to consider which blood pressure parameters should be targeted given that different drugs have distinct effects on key parameters. Remarkably, a high percentage of hypertensive patients whose treatment has brought these parameters within target ranges still remain at high risk of cardiovascular disease due to additional risk factors. Combination therapy with synergistic effects on blood pressure and metabolic control should thus be considered for the long-term treatment of hypertensive patients with co-morbid conditions.

Long-term treatment costs and cost-effectiveness of restoration repair versus replacement

2021 ◽  
Author(s):  
Philipp Kanzow ◽  
Joachim Krois ◽  
Annette Wiegand ◽  
Falk Schwendicke
Keyword(s):  
Cost Effectiveness ◽  
Term Treatment ◽  
Treatment Costs ◽  
Long Term Treatment

Cost-effectiveness Analysis of Submandibular Gland Preservation With Sialendoscopy for the Management of Sialolithiasis

2021 ◽  
pp. 019459982110268
Author(s):  
Joseph R. Acevedo ◽  
Ashley C. Hsu ◽  
Jeffrey C. Yu ◽  
Dale H. Rice ◽  
Daniel I. Kwon ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Submandibular Gland ◽  
Average Cost ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Probability Of Success ◽  
Markov Decision Model ◽  
The Cost

Objective To compare the cost-effectiveness of sialendoscopy with gland excision for the management of submandibular gland sialolithiasis. Study Design Cost-effectiveness analysis. Setting Outpatient surgery centers. Methods A Markov decision model compared the cost-effectiveness of sialendoscopy versus gland excision for managing submandibular gland sialolithiasis. Surgical outcome probabilities were found in the primary literature. The quality of life of patients was represented by health utilities, and costs were estimated from a third-party payer’s perspective. The effectiveness of each intervention was measured in quality-adjusted life-years (QALYs). The incremental costs and effectiveness of each intervention were compared, and a willingness-to-pay ratio of $150,000 per QALY was considered cost-effective. One-way, multivariate, and probabilistic sensitivity analyses were performed to challenge model conclusions. Results Over 10 years, sialendoscopy yielded 9.00 QALYs at an average cost of $8306, while gland excision produced 8.94 QALYs at an average cost of $6103. The ICER for sialendoscopy was $36,717 per QALY gained, making sialendoscopy cost-effective by our best estimates. The model was sensitive to the probability of success and the cost of sialendoscopy. Sialendoscopy must meet a probability-of-success threshold of 0.61 (61%) and cost ≤$11,996 to remain cost-effective. A Monte Carlo simulation revealed sialendoscopy to be cost-effective 60% of the time. Conclusion Sialendoscopy appears to be a cost-effective management strategy for sialolithiasis of the submandibular gland when certain thresholds are maintained. Further studies elucidating the clinical factors that determine successful sialendoscopy may be aided by these thresholds as well as future comparisons of novel technology.

scholarly journals Rivaroxaban for the treatment of cerebral venous thrombosis

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara Esmaeili ◽  
Meysam Abolmaali ◽  
Sobhan Aarabi ◽  
Mohammad Reza Motamed ◽  
Samira Chaibakhsh ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Bleeding Risk ◽  
Term Treatment ◽  
Background Information ◽  
Minor Bleeding ◽  
Long Term Treatment ◽  
Significant Difference

Abstract Background New Oral Anticoagulants (NOACs) such as Rivaroxaban are introduced as alternatives to conventional vitamin-K antagonists in the long-term treatment of thrombotic events due to their lower bleeding risk. There is a lack of evidence on the effectiveness and safety of Rivaroxaban in Cerebral venous thrombosis (CVT). This study aims to assess the effectiveness and bleeding risk of Rivaroxaban in comparison with Warfarin for the treatment of CVT. Materials and methods 36 patients with diagnosis of CVT were included. Clinical and background information was assessed on admission and patients were followed for at least 12 months. Measured outcomes were modified Rankin Scale (mRS), evidence of recanalization on contrast-enhanced Brain MR venography (MRV) and major or minor bleeding. Patients were divided into two groups according to the type of oral anticoagulant (Rivaroxaban vs Warfarin). Groups were compared in terms of final outcomes and side effects. Result Overall, 13 (36.11%) patients received Warfarin and 23 (63.89%) received Rivaroxaban. Optimal mRS score (0–1) was attained in 9 of 10 (90%) of patients treated with Rivaroxaban and 19 of 22 (86.36%) of patients received Warfarin. MRV showed complete or partial recanalization in 12 of 14 (85.71%) patients treated with Rivaroxaban and all patients in the Warfarin group. There was no significant difference between the two groups in terms of major and minor hemorrhage. Conclusion Rivaroxaban holds promise for the treatment of CVT.

scholarly journals What Differs between Patients under Methadone and under Buprenorphine for Opioid Use Disorder (OUD) in Daily Clinical Practice in France? A Short Report

2021 ◽  
Vol 18 (4) ◽  
pp. 1425
Author(s):  
Morgane Guillou-Landreat ◽  
Antoine Dany ◽  
Gaëlle Challet-Bouju ◽  
Edouard Laforgue ◽  
Juliette Leboucher ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Opioid Use Disorder ◽  
Term Treatment ◽  
Pharmacological Therapy ◽  
Daily Clinical Practice ◽  
Short Report ◽  
Opioid Use ◽  
Cross Sectional ◽  
Long Term Treatment ◽  
Social Profiles

(1) Background: Opioid use disorder (OUD) is a complex condition that can require long-term treatment. Pharmacological therapy for OUD involves treatment with opioid agonists (OMT) tailored to individual profiles. The aim of our study in daily clinical practice was to compare the profiles of patients treated with methadone (MTD) and those using buprenorphine (BHD or BHD-naloxone-NX). (2) Methods: A cross-sectional multicentre study explored the psychological, somatic and social profiles of patients with Opioid Use Disorder (OUD) following Opioid Maintenance Treatment (BHD, BHD/NX, or MTD). Descriptive and comparative analyses were performed (3) Results: 257 patients were included, a majority were men using heroin. 68% (178) were on MTD, 32% (79) were on BHD. Patients with MTD were significantly more likely to report socio-affective damage, and more likely to be younger and not to report oral or sublingual use as the main route for heroin or non-medical opioids (4) Conclusions: In daily clinical practice, regarding OUD damage, only socio-affective damage was significantly more prevalent among patients on MTD than among those on BHD in the multivariate model. Age and route of administration also differed, and our results could raise the issue of the type of OMT prescribed in case of non-medical use of prescribed opioids. These hypothesis should be confirmed in larger studies.

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