SSRI/TCA sequential therapy: a cost effective drug regime for the long term management of depression

2007 ◽  
Vol 3 (2) ◽  
Author(s):  
O Udofia
2019 ◽  
Vol 55 (5) ◽  
pp. 292-305
Author(s):  
Shazia Jamshed ◽  
Akshaya Srikanth Bhagavathula ◽  
Sheikh Muhammad Zeeshan Qadar ◽  
Umaira Alauddin ◽  
Sana Shamim ◽  
...  

Background: Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder that results from regurgitation of acid from the stomach into the esophagus. Treatment available for GERD includes lifestyle changes, antacids, histamine-2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), and anti-reflux surgery. Aim: The aim of this review is to assess the cost-effectiveness of the use of PPIs in the long-term management of patients with GERD. Method: We searched in PubMed to identify related original articles with close consideration based on inclusion and exclusion criteria to choose the best studies for this narrative review. The first section compares the cost-effectiveness of PPIs with H2RAs in long-term heartburn management. The other sections shall only discuss the cost-effectiveness of PPIs in 5 different strategies, namely, continuous (step-up, step-down, and maintenance), on-demand, and intermittent therapies. Results: Of 55 articles published, 10 studies published from 2000 to 2015 were included. Overall, PPIs are more effective in relieving heartburn in comparison with ranitidine. The use of PPIs in managing heartburn in long-term consumption of nonsteroidal anti-inflammatory drug (NSAID) has higher cost compared with H2RA. However, if the decision-maker is willing to pay more than US$174 788.60 per extra quality-adjusted life year (QALY), then the optimal strategy is traditional NSAID (tNSAID) and PPIs. The probability of being cost-effective was also highest for NSAID and PPI co-therapy users. On-demand PPI treatment strategy showed dominant with an incremental cost-effectiveness ratio of US$2197 per QALY gained and was most effective and cost saving compared with all the other treatments. The average cost-effectiveness ratio was lower for rabeprazole therapy than for ranitidine therapy. Conclusion: Our review revealed that long-term treatment with PPIs is effective but costly. To achieve long-term cost-effective approach, we recommend on-demand approach to treat heartburn symptoms, but if the symptoms persist, treatment with continuous step-down therapy should be applied.


2020 ◽  
Vol 2 (4) ◽  
pp. 360-366
Author(s):  
Qurratulain Hyder ◽  
◽  
Khawaja Husnain Haider ◽  

After spillover from Wuhan (China) in December, 2019, SARS-CoV-2 related respiratory disease (COVID-19) has rapidly affected all countries. The pandemic has posed a serious threat to world health resources. At present, there is no recommended treatment or vaccine for SARS-CoV-2. However, various drug combinations are under trial. Reversion to general principles of prevention is the preferred strategy under such circumstances. We discuss the importance of wearing a face mask and present a cost-effective approach for long-term management of COVID-19.


2021 ◽  
Vol 133 (1) ◽  
pp. 27
Author(s):  
David Pollock

The predominant grazing management system used in the arid rangelands regions of Australia, set stocking, is not conducive to sustainable land management. More appropriate grazing management systems based upon periodic rest periods for important pasture species have not been adopted by pastoralists because the unmanaged grazing pressure from animals such as goats and kangaroos has been too high. Dingoes are the only cost-effective and long-term management solution to the effect of unmanaged grazing by goats and kangaroos. Yet government funding targets dingo eradication in pastoral areas, and it does so by adopting misleading and scientifically inaccurate terms for describing dingoes.


2015 ◽  
Vol 20 (4) ◽  
pp. 242-251 ◽  
Author(s):  
Éva Kállay

Abstract. The last several decades have witnessed a substantial increase in the number of individuals suffering from both diagnosable and subsyndromal mental health problems. Consequently, the development of cost-effective treatment methods, accessible to large populations suffering from different forms of mental health problems, became imperative. A very promising intervention is the method of expressive writing (EW), which may be used in both clinically diagnosable cases and subthreshold symptomatology. This method, in which people express their feelings and thoughts related to stressful situations in writing, has been found to improve participants’ long-term psychological, physiological, behavioral, and social functioning. Based on a thorough analysis and synthesis of the published literature (also including most recent meta-analyses), the present paper presents the expressive writing method, its short- and long-term, intra-and interpersonal effects, different situations and conditions in which it has been proven to be effective, the most important mechanisms implied in the process of recovery, advantages, disadvantages, and possible pitfalls of the method, as well as variants of the original technique and future research directions.


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