scholarly journals Prescribing restrictions – a necessary strategy among some European countries to enhance future prescribing efficiency?

2011 ◽  
Vol 3 (1) ◽  
pp. 5-16 ◽  
Author(s):  
Brian Godman ◽  
Rickard Malmström ◽  
Marion Bennie ◽  
Solveig Sakshaug ◽  
Thomas Burkhardt ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Pharmaceutical Expenditure ◽  
Demand Side ◽  
Health Authorities ◽  
Drug Classes ◽  
Variable Impact

The unsustainable growth in pharmaceutical expenditure has resulted in multiple initiatives across Europe to lower prices of generics and enhance their utilisation. These include prescribing restrictions. However, there have been concerns with their impact on subsequent quality of care as well as their influence in reality. OBJECTIVES: (a) Review the influence of prescribing restrictions and whether there are any differences depending on their nature and drug classes; (b) Ascertain whether prescribing restrictions can be added to existing demand-side measures to further enhance prescribing efficiency; (c) Whether they compromise subsequent quality of care. RESULTS: Prescribing restrictions have a variable impact on subsequent utilisation of patented protected products versus generics in a class, with their influence depending on the nature and follow-up of the restrictions rather than the class of drug. This is seen among the proton pump inhibitors, statins, and renin-angiotensin drugs. Prescribing restrictions can be successfully added to existing measures to further enhance prescribing efficiency, and do not appear to compromise subsequent quality of care. CONCLUSIONS: Prescribing restrictions can be a successful strategy as countries strive to maintain the European ideals for healthcare. However, care is needed when planning these programmes: else health authorities could be disappointed with their outcome.

scholarly journals Prescribing restrictions – a necessary strategy among some European countries to enhance future prescribing efficiency?

2011 ◽  
Vol 3 (1) ◽  
pp. 5
Author(s):  
Brian Godman ◽  
Rickard Malmström ◽  
Marion Bennie ◽  
Solveig Sakshaug ◽  
Thomas Burkhardt ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Pharmaceutical Expenditure ◽  
Demand Side ◽  
Health Authorities ◽  
Drug Classes ◽  
Variable Impact

The unsustainable growth in pharmaceutical expenditure has resulted in multiple initiatives across Europe to lower prices of generics and enhance their utilisation. These include prescribing restrictions. However, there have been concerns with their impact on subsequent quality of care as well as their influence in reality. OBJECTIVES: (a) Review the influence of prescribing restrictions and whether there are any differences depending on their nature and drug classes; (b) Ascertain whether prescribing restrictions can be added to existing demand-side measures to further enhance prescribing efficiency; (c) Whether they compromise subsequent quality of care. RESULTS: Prescribing restrictions have a variable impact on subsequent utilisation of patented protected products versus generics in a class, with their influence depending on the nature and follow-up of the restrictions rather than the class of drug. This is seen among the proton pump inhibitors, statins, and renin-angiotensin drugs. Prescribing restrictions can be successfully added to existing measures to further enhance prescribing efficiency, and do not appear to compromise subsequent quality of care. CONCLUSIONS: Prescribing restrictions can be a successful strategy as countries strive to maintain the European ideals for healthcare. However, care is needed when planning these programmes: else health authorities could be disappointed with their outcome.

scholarly journals Penyakit Refluks Gastroesofageal Berat (PRGE) pada Anak dengan Riwayat Gizi Buruk dan Kelahiran Prematur

2021 ◽  
Vol 36 (2) ◽  
pp. 63-70
Author(s):  
Pramita G.D. Poerwantoro ◽  
Yuni Astria
Keyword(s):  
Quality Of Life ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Premature Birth ◽  
Feeding Tube ◽  
Z Score

Abstrak Penyakit refluks gastroesofageal berat (PRGE)adalah gerakan retrograd isi lambung ke kerongkongan. Pada prematuritas, kelemahan peristaltik esofagus terjadi akibat kurangnya relaksasi reseptif bersihan material refluks ke esofagus. Penyakit ini menyebabkan penurunan kualitas hidup dan komplikasi. Laporan ini bertujuan menggambarkan kasus PRGE parah pada anak marasmik dengan kelahiran prematur. Kasus berasal dari seorang anak perempuan berusia tiga tahun dirawat di Rumah Sakit Umum Cipto Mangunkusumo karena menderita muntah terus-menerus setiap kali setelah menyusu. Pasien lahir prematur pada usia kehamilan 31 minggu dengan berat lahir 900 gram, mengalami malnutrisi berat dan keterlambatan perkembangan. Pasien menjalani prosedur endoskopi, pemeriksaan histopatologi dan didapatkan esofagitis berat, gastritis erosif, striktur pilorik, dan refluks laringofaringeal (LPR).Pasien diberikan proton pump inhibitors (PPIs), menjalani dilatasi pilorik satu kali dan pemasangan nasogastricjejunal feeding tube (NJFT), serta susu formula khusus medium chain tryglyceride (MCT) enam kali sehari. Dalam 18 bulan masa tindak lanjut, pasien menunjukkan peningkatan skor Z berat-berdasarkan-panjang badan, panjang berdasarkan usia dan lingkar kepala berdasarkan usia.Dalam menangani bayi prematur, harus mempertimbangkan PRGE sebagai salah satu etiologi pertumbuhan yang terganggu. Prosedur endoskopi dan pemasangan NJFT untuk terapi nutrisi jangka panjang mengurangi komplikasi dan meningkatkan kualitas hidup.Follow up intensif diperlukan agar mencapai pertumbuhan dan perkembangan optimal.   Kata kunci: anak, komplikasi, GERD, lahir prematur, proton pump inhibitors Severe Gastroesophageal Reflux Disease in Malnourished Children with History of Prematurity Abstract Gastroesophageal reflux disease (GERD) is an involuntary retrograde propulsion of gastric contents to esophagus. In prematurity, esophagus peristaltic weakness due to lack of receptive relaxation contribute to inadequate cleaning of material reflux to esophagus which become GERD predisposition. Furthermore, GERD can cause a decline of quality of life and various complications. This report aimed to describe severe GERD case in a marasmic child with premature birth. A 36-month-old girl was hospitalized at dr. Cipto Mangunkusumo General Hospital because of persistent vomitus after every milk feeding. She was prematurely born at 31 weeks of gestation with birthweight of 900 grams, and become severely malnourished with developmental delayed. She then underwent gastrointestinal endoscopic procedure and histopathology examination that revealed a severe esophagitis, erosive gastritis, pyloric stricture, and laryngopharyngeal reflux (LPR).She was treated with proton pump inhibitors (PPI) and underwent one-time pyloric dilatation with nasogastricjejunal feeding tube (NJFT) insertion and continued with medium chain triglycerides formula six times a day. At 18-month follow-up, weight-for-length Z score, length-for-age and head circumference Z score are increased.In dealing with premature baby, we should consider GERD as one of growth faltering etiologies. Endoscopy procedure followed by NJFT insertion for long-term nutrition therapy in severe GERD are the cornerstones to reduce complications and to improve quality of life. Moreover, close follow up for optimal growth and development should be done in such case. Keywords: children, complications, GERD, premature birth, proton pump inhibitors

Proton Pump Inhibitors in 2021: Pros, Cons, and Everything in Between

2021 ◽  
pp. 263451612110217
Author(s):  
Joshua A. Sloan ◽  
Philip O. Katz
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Events ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Drug Class ◽  
Life Threatening

The medical and lay literature has exploded with reports of adverse events associated with proton pump inhibitors over the last 10 to 15 years. The dissemination of these reports to patients and clinicians have created substantial concerns regarding what has been an exceptionally valuable drug class, dramatically improving patient quality of life, and in many cases preventing life threatening side effects of other medication. Patients are more frequently seeking to avoid these medications, and practitioners are reducing or discontinuing them to the patient’s detriment due to a misunderstanding of the data. This review will discuss the data regarding the most commonly publicized adverse events and attempt to put them in perspective.

scholarly journals Effect of a primary care based epilepsy specialist nurse service on quality of care from the patients’ perspective: results at two-years follow-up

Seizure ◽  
1999 ◽  
Vol 8 (5) ◽  
pp. 291-296 ◽  
Author(s):  
Nicola Mills ◽  
Max O. Bachmann ◽  
Rona Campbell ◽  
Iain Hine ◽  
Mervyn McGowan
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Specialist Nurse ◽  
Patients Perspective

scholarly journals Comparison of two Dutch follow-up care models for spinal cord-injured patients and their impact on health problems, re-admissions and quality of care

2007 ◽  
Vol 21 (11) ◽  
pp. 997-1006 ◽  
Author(s):  
J.H.A. Bloemen-Vrencken ◽  
L.P. de Witte ◽  
M.W.M. Post ◽  
C. Pons ◽  
F.W.A. van Asbeck ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Quality Of Care ◽  
Health Problems ◽  
Follow Up Care ◽  
Care Models ◽  
Injured Patients ◽  
Spinal Cord Injured

scholarly journals Are proton-pump inhibitors harmful for the semen quality of men in couples who are planning pregnancy?

2016 ◽  
Vol 106 (7) ◽  
pp. 1666-1672.e2 ◽  
Author(s):  
Nicole A. Huijgen ◽  
Maria A.J. de Ridder ◽  
Katia M. Verhamme ◽  
Gert R. Dohle ◽  
Ann M. Vanrolleghem ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Semen Quality

scholarly journals What Is the Optimal Follow-up Time to Ascertain the Safety of Proton Pump Inhibitors?

2020 ◽  
Vol 158 (4) ◽  
pp. 1175 ◽  
Author(s):  
Giuseppe Losurdo ◽  
Alfredo Di Leo ◽  
Gioacchino Leandro
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump

scholarly journals Beyond coverage: a qualitative study exploring the perceived impact of Gabon’s health insurance plan on access to and quality of prenatal care

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
N’doh Ashken Sanogo ◽  
Arone Wondwossen Fantaye ◽  
Sanni Yaya
Keyword(s):  
Quality Of Care ◽  
Health Insurance ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Professionals ◽  
Supply Side ◽  
Demand Side ◽  
Structured Interviews ◽  
Compulsory Health Insurance

Abstract Background Access to affordable and adequate healthcare in a health system determines the universal health coverage achievement for all residents in a country. Achieving access to healthcare requires the availability of a financing system that ensures access to and provision of adequate care, regardless of the ability to pay. In sub-Saharan Africa, accessibility, use and coverage of prenatal visits are very low and poor, which reduces the quality of care. This paper explored the impact of a social health insurance scheme on the quality of antenatal care in Gabon. Methods This qualitative study involved the analysis of data collected from semi-structured interviews and non-participant observations to assess the quality of antenatal care. The study elicited perceptions on the demand side (pregnant women) and the supply side (health professionals) in health facilities. Fifteen semi-structured interviews were conducted with pregnant women (aged between 15 and 49) and 5 with health professionals, who each had a seniority of at least 10 years, at different levels of care. Nine non-participant observations were also conducted. Coded transcripts were reviewed and analyzed using the Canadian Institute for Public Administration of Citizen-Centered Services model as an analytical guide. Results On the demand side, women were generally satisfied with the prenatal services they receive in health facilities. However, complaints were made about the rudeness of some nurses, the high price of the delivery kit (50,000 XAF), and the fact that some essential medicines for maternity are not covered. On the supply side, participants agreed that compulsory health insurance is important in providing antenatal care access to those who need it the most. However, some problems remain. The participants outlined some logistical problems and a lack of medical equipment, including the stock of drugs, disinfectants, and the absence of clean water. Conclusion Understanding the perceptions of pregnant women and health professionals regarding the quality of antenatal care can help to inform refinements to methods through which the services can be better provided. In addition, the study findings are vital to increasing the use of care, as well as combating high maternal mortality rates. Compulsory health insurance has improved the accessibility and utilization of healthcare services and has contributed to improved quality of care.

Sign in / Sign up

Export Citation Format

Share Document