scholarly journals Perspectives of patients and consumers on the use of generic medicines

Medwave ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. e8155-e8155
Author(s):  
Natalia Celedón ◽  
Cristián González ◽  
Cristóbal Cuadrado
Keyword(s):  
Public Health ◽  
Systematic Reviews ◽  
Information Sources ◽  
Evidence Synthesis ◽  
Access To Medicines ◽  
Generic Medicines ◽  
Pharmaceutical Spending ◽  
Public Health Challenge ◽  
Grade Approach ◽  
Low Rate

INTRODUCTION Access to medicines constitutes a public health challenge worldwide. Promoting utilization of generic medicines is one of the strategies that has been proposed to optimize pharmaceutical spending and thus allow greater coverage. However, its use is not yet widespread enough. This study seeks to explore the perspectives and acceptability to the use of generic medicines from patients and consumers. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a evidence synthesis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified four systematic reviews that together include 47 primary studies, of which one corresponds to a randomized trial. A low rate of patients or consumers has a negative perception regarding generic medicines, including dimensions such as risk, quality, safety, risk of adverse effects, among others.

scholarly journals Atypical antipsychotics for delirium in hospitalized patients

Medwave ◽  
2021 ◽  
Vol 21 (04) ◽  
pp. e8168-e8168
Author(s):  
Daniza Belén Bilicic Ubierna ◽  
Nicolás Cattarinich Schiffrin ◽  
Daniela Coronel Cárdenas ◽  
Rubén Soto Munizaga ◽  
José Miguel Bernucci Piedra
Keyword(s):  
Systematic Reviews ◽  
Atypical Antipsychotics ◽  
Randomized Trials ◽  
Information Sources ◽  
Response Rate ◽  
Meta Analysis ◽  
Low Complexity ◽  
Hospitalized Patients ◽  
Risk Of Mortality ◽  
Grade Approach

Introduction For the pharmacotherapy of delirium in elderly adults who are hospitalized, atypical antipsychotics are used. Currently, there is insufficient evidence on the effectiveness of this treatment in low complexity units. Methods We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE/PubMed, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis, and generated a summary of findings table using the GRADE approach. Results and conclusions We identified 13 systematic reviews that included three randomized trials. We concluded that the use of atypical antipsychotics in hospitalized patients likely increases the risk of mortality compared to placebo and could decrease the response rate associated with reducing the risk of adverse effects. Furthermore, using atypical antipsychotics probably results in low or no difference in the severity of delirium.

scholarly journals What are Systematic Reviews?

2020 ◽  
Vol 7 (1) ◽  
pp. 5
Author(s):  
Jack Nunn ◽  
Steven Chang
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Systematic Reviews ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Research Question ◽  
Secondary Data ◽  
Current Evidence ◽  
Economic Evaluations ◽  
Environmental Interventions

Systematic reviews are a type of review that uses repeatable analytical methods to collect secondary data and analyse it. Systematic reviews are a type of evidence synthesis which formulate research questions that are broad or narrow in scope, and identify and synthesize data that directly relate to the systematic review question. While some people might associate ‘systematic review’ with 'meta-analysis', there are multiple kinds of review which can be defined as ‘systematic’ which do not involve a meta-analysis. Some systematic reviews critically appraise research studies, and synthesize findings qualitatively or quantitatively. Systematic reviews are often designed to provide an exhaustive summary of current evidence relevant to a research question. For example, systematic reviews of randomized controlled trials are an important way of informing evidence-based medicine, and a review of existing studies is often quicker and cheaper than embarking on a new study. While systematic reviews are often applied in the biomedical or healthcare context, they can be used in other areas where an assessment of a precisely defined subject would be helpful. Systematic reviews may examine clinical tests, public health interventions, environmental interventions, social interventions, adverse effects, qualitative evidence syntheses, methodological reviews, policy reviews, and economic evaluations. An understanding of systematic reviews and how to implement them in practice is highly recommended for professionals involved in the delivery of health care, public health and public policy.

scholarly journals Considerations of complexity in rating certainty of evidence in systematic reviews: a primer on using the GRADE approach in global health

2019 ◽  
Vol 4 (Suppl 1) ◽  
pp. e000848 ◽  
Author(s):  
Paul Montgomery ◽  
Ani Movsisyan ◽  
Sean P Grant ◽  
Geraldine Macdonald ◽  
Eva Annette Rehfuess
Keyword(s):  
Public Health ◽  
Systematic Reviews ◽  
Guideline Development ◽  
Complex Interventions ◽  
System Level ◽  
Ongoing Research ◽  
Health Technologies ◽  
Assessment Development ◽  
Contextual Interactions ◽  
Grade Approach

Public health interventions and health technologies are commonly described as ‘complex’, as they involve multiple interacting components and outcomes, and their effects are largely influenced by contextual interactions and system-level processes. Systematic reviewers and guideline developers evaluating the effects of these complex interventions and technologies report difficulties in using existing methods and frameworks, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE). As part of a special series of papers on implications of complexity in the WHO guideline development, this paper serves as a primer on how to consider sources of complexity when using the GRADE approach to rate certainty of evidence. Relevant sources of complexity in systematic reviews, health technology assessments and guidelines of public health are outlined and mapped onto the reported difficulties in rating the estimates of the effect of these interventions. Recommendations on how to address these difficulties are further outlined, and the need for an integrated use of GRADE from the beginning of the review or guideline development is emphasised. The content of this paper is informed by the existing GRADE guidance, an ongoing research project on considering sources of complexity when applying the GRADE approach to rate certainty of evidence in systematic reviews and the review authors’ own experiences with using GRADE.

scholarly journals INFORMATION SOURCES SUPPORTING MANAGERIAL DECISIONS ON HEALTH CARE IN EMERGENCY MEDICAL AND BIOLOGICAL SITUATIONS (ON THE EXAMPLE OF COVID-19 MANAGEMENT)

2020 ◽  
Vol 4 (14) ◽  
pp. 4-16
Author(s):  
D.D. Diachuk ◽  
O.L. Ziukov ◽  
O.M. Lishchyshyna ◽  
A.V. Stepanenko
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Trials ◽  
Infectious Diseases ◽  
Information Disclosure ◽  
Information Sources ◽  
Access To Medicines ◽  
Scientific Data ◽  
Health Care Facilities ◽  
Care Organization

         Abstract. In light of the coronavirus pandemic (COVID-19), we carried out a regular review of the information resources of international organizations specializing in combating infectious diseases, as well as governmental and intergovernmental organizations of the world's leading countries with strong economies and stringent regulatory systems in January-December 2020.          The analysis of the materials accumulated on the monitoring results revealed some differences in the legislation and practice of health care organization in Ukraine. First of all, this is a small number of registered clinical trials on COVID-19 prevention and treatment, as well as the lack of permit to use medicines for the indications which are not in basic prescribing information, in particular, "compassionate treatment" programs or emergency access to medicines, which are in clinical trials.          In the absence of traditional evidence of the health interventions effectiveness, it is necessary to emphasize the importance of identifying reliable information sources, transparency, quick and widespread information disclosure and experience exchange on challenging issues of resource and risk management, communication and public health activities, discussion of organizational forms and clinical activities in public health in the vast majority of countries. The establishment of independent monitoring and analytical centers, the participation of professional communities in various studies is an example of the rapid scientific data acquisition and supporting recommendations on various aspects of countering the pandemic. Based on the analysis of international data published in reliable sources, the legislation has been changed in Ukraine, the approaches to planning the transformation of the health care system have been identified to increase its resistance to the infectious diseases epidemic, the quarantine measures and other restrictions have been justified, the standards of medical and pharmaceutical care have been presented, the measures to ensure the availability of medical care for patients with health disorders of other etiologies and priority areas for the development of health care facilities to protect medical staff and patients have been identified.

scholarly journals Radiosurgery for brain oligometastases in lung cancer

Medwave ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. e8184-e8184
Author(s):  
Gabriela Antúnez ◽  
Tomás Merino
Keyword(s):  
Lung Cancer ◽  
Systematic Reviews ◽  
Poor Prognosis ◽  
Randomized Trials ◽  
Information Sources ◽  
Meta Analysis ◽  
Whole Brain Radiation ◽  
Therapeutic Alternatives ◽  
Brain Radiation ◽  
Grade Approach

INTRODUCTION Brain metastases are a common problem in oncology patients, especially in lung cancer. The usual treatment for cerebral oligometastases is whole brain radiation therapy. Given the persistent poor prognosis of this disease, other therapeutic alternatives such as stereotactic radiosurgery have been considered. However, there is no clarity regarding the effectiveness of its addition. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified 17 systematic reviews including seven studies overall, of which four were randomized trials. All trials assessed patients with brain oligometastases, but none of them included exclusively lung cancer population. We concluded that it is not possible to clearly establish whether radiosurgery decreases neurological functionality, cognitive impairment, mortality or serious adverse effects, as the certainty of the existing evidence has been assessed as very low.

scholarly journals What are Systematic Reviews?

2020 ◽  
Vol 7 (1) ◽  
pp. 4
Author(s):  
Jack Nunn ◽  
◽  
Steven Chang ◽  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Systematic Reviews ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Research Question ◽  
Secondary Data ◽  
Current Evidence ◽  
Economic Evaluations ◽  
Environmental Interventions

Systematic reviews are a type of review that uses repeatable analytical methods to collect secondary data and analyse it. Systematic reviews are a type of evidence synthesis which formulate research questions that are broad or narrow in scope, and identify and synthesize data that directly relate to the systematic review question.[1] While some people might associate ‘systematic review’ with 'meta-analysis', there are multiple kinds of review which can be defined as ‘systematic’ which do not involve a meta-analysis. Some systematic reviews critically appraise research studies, and synthesize findings qualitatively or quantitatively.[2] Systematic reviews are often designed to provide an exhaustive summary of current evidence relevant to a research question. For example, systematic reviews of randomized controlled trials are an important way of informing evidence-based medicine,[3] and a review of existing studies is often quicker and cheaper than embarking on a new study. While systematic reviews are often applied in the biomedical or healthcare context, they can be used in other areas where an assessment of a precisely defined subject would be helpful.[4] Systematic reviews may examine clinical tests, public health interventions, environmental interventions,[5] social interventions, adverse effects, qualitative evidence syntheses, methodological reviews, policy reviews, and economic evaluations.[6][7] An understanding of systematic reviews and how to implement them in practice is highly recommended for professionals involved in the delivery of health care, public health and public policy.

ADDRESSING THE ISSUE OF СOVID-19, SARS-COV-2 VIRUS AND THE DISEASE

2020 ◽  
Vol 99 (6) ◽  
pp. 15-31
Author(s):  
A.A. Korenkova ◽  
◽  
E.M. Mayorova ◽  
V.V. Bahmetjev ◽  
M.V. Tretyak ◽  
...  
Keyword(s):  
Public Health ◽  
Immune Responses ◽  
Molecular Mechanisms ◽  
Herd Immunity ◽  
Significant Problem ◽  
Prevention Measures ◽  
Optimal Therapy ◽  
The World ◽  
Public Health Challenge ◽  
Coronavirus Infection

The new coronavirus infection has posed a major public health challenge around the world, but new data on the disease raises more questions than answers. The lack of optimal therapy is a significant problem. The article examines the molecular mechanisms of SARS-CoV-2 infection and the pathogenesis of COVID-19, special attention is paid to features of pathological processes and immune responses in children. COVID-19 leads to a wide diversity of negative outcomes, many of which can persist for at least months. Many of the consequences have yet to be identified. SARS-CoV-2 may provoke autoimmune reactions. Reinfection, herd immunity, vaccines and other prevention measures are also discussed in this review.

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