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Olesen J. From fragmentation to collaboration in European brain research: The early history of the European Brain Council (EBC), an organization that changed our perspective of advocacy. Eur J Neurol 2023. [PMID: 37955553 DOI: 10.1111/ene.16130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 10/02/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND The European Academy of Neurology (EAN) is a member of the European Brain Council (EBC), a coalition of neurologists, psychiatrists, neurosurgeons, neuroscientists, patient organizations and industry with an interest in the brain and its diseases. It was founded by the present author. Here, its formation, early history and the results of its advocacy are described. METHOD Eyewitness report and relevant literature were considered. RESULTS After a long and difficult inception, the European Brain Council (EBC) brought all major players with an interest in the brain and its diseases to work closely together. Important data on the cost of brain diseases, lack of funding and fantastic research possibilities were generated and effectively used in advocacy. During the early years of the collaborative effort, the funding of brain research increased from €85 million in framework program (FP) 5 to €260 million in FP6 and to more than €2000 million in FP7. CONCLUSION The EBC has been extremely successful. It is essential that advocacy in the European Union continues to be united so that those involved in brain research are able to speak with one voice to policy makers. An even bigger task, still insufficiently pursued, is for national brain councils to achieve prioritization of brain research in their national political agenda to bring about improved provision of care to those living with a brain disease.
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Affiliation(s)
- Jes Olesen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark
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2
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Faruqi SJ, Shahbaz NN, Nisa Q, Umer SR, Ali SG, Aziz MY. Cost of Investigating Neurological Disease: Experience of a Tertiary Care Center in Karachi, Pakistan. Cureus 2020; 12:e9291. [PMID: 32832289 PMCID: PMC7437137 DOI: 10.7759/cureus.9291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Neurological disorders, structural or functional, are prevalent all over the world and are accompanied by physical and social morbidity. In this study, we aimed to calculate the cost of investigating neurological disorders and compare the costs incurred in a government hospital with that in a private hospital. MATERIALS AND METHODS This study was conducted at the Dr. Ruth KM Pfau Civil Hospital, Karachi, Pakistan. One hundred patients were enrolled in the study; 10 each investigated for epilepsy, cerebrovascular accidents (CVAs), headache, neuropathy, myopathy, cranial nerve palsies, movement disorders, demyelinating diseases, central nervous system (CNS) infections, and dementia. Receipts and records in the patients' medical history were used for the calculation of the cost of procedures, which was then compared with the costs of these investigations in a private hospital. A bottom-up costing approach was taken with individual costs being estimated and then being grouped to calculate the overall economic burden of the disorders. Data were analyzed using IBM SPSS version 23.0. One-way analysis of variance (ANOVA) was done to compare the mean cost (taken by the patient, covered by the government, total cost in the government hospital, and total cost in the private hospital) across diseases in government and private hospitals separately. Pearson correlation and scatter plot were also done to study the cost in private and public hospitals. p-values less than 0.05 were considered statistically significant. The margin of error in the study was 5%. RESULTS The mean age was 38.2 ± 20.5 years. Some 51% data were received from female samples. The mean income of samples was 13863.6 ± 9715.9 Pakistani Rupees (PKR) or 78.38 ± 58.29 United States Dollars (USD). The mean cost covered by government hospitals was 8866.0 ± 5071.0 PKR (53.19 ± 30.42 USD) per patient, whereas in government hospitals patients were charged on average 2662.9 ± 3774.7 PKR (16 ± 22.65 USD), while in private hospitals patients paid on average 29041.3 ± 12992.6 PKR (174.21 ± 78 USD). CONCLUSION The costs of investigations in private hospitals were approximately three times the costs in government hospitals. The maximum cost was generated by patients being investigated for demyelinating disorders. Investigations conducted in government-run hospitals are more cost effective and these institutions should receive increased funding to cater to the maximum number of patients.
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Affiliation(s)
| | | | - Qamar Nisa
- Neurology, Dow University of Health Sciences, Karachi, PAK
| | - Sumera R Umer
- Neurology, Dow University of Health Sciences, Karachi, PAK
| | - Syed G Ali
- Neurology, Dow University of Health Sciences, Karachi, PAK
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3
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Piano C, Di Stasio E, Primiano G, Janiri D, Luigetti M, Frisullo G, Vollono C, Lucchini M, Brunetti V, Monforte M, Guglielmi V, Della Marca G, Evoli A, Marra C, Mirabella M, Quaranta D, Ricci E, Servidei S, Silvestri G, Bellavia S, Bortolani S, Bove F, Di Iorio R, Di Paolantonio A, Genovese D, Ialongo T, Lo Monaco MR, Marotta J, Patanella AK, Perna A, Petracca M, Presicce G, Riso V, Rollo E, Romano A, Romozzi M, Sancricca C, Scala I, Spagni G, Solito M, Tricoli L, Zinzi P, Calabresi P, Bentivoglio AR. An Italian Neurology Outpatient Clinic Facing SARS-CoV-2 Pandemic: Data From 2,167 Patients. Front Neurol 2020; 11:564. [PMID: 32574249 PMCID: PMC7273723 DOI: 10.3389/fneur.2020.00564] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/18/2020] [Indexed: 01/08/2023] Open
Abstract
Objective: Neurological sequelae of SARS-CoV-2 infection have already been reported, but there is insufficient data about the impact of the pandemic on the management of the patients with chronic neurological diseases. We aim to analyze the effect of COVID-19 pandemic and social restriction rules on these fragile patients. Methods: Patients with chronic neurologic diseases routinely followed at the outpatient clinic of Gemelli University Hospital, Rome, were assessed for symptoms suggestive of SARS-CoV-2 infection in the pandemic period, consequences of social restrictions, and neurological disease features, concomitant medical conditions, current medical and disease-specific treatments. Data source: a dedicated telephone survey designed to encompass questions on COVID-19 symptoms and on pandemic effects in chronic neurologic conditions. Results: Overall, 2,167 individuals were analyzed: 63 patients reported contact with COVID-19 positive cases, 41 performed the swab, and 2 symptomatic patients tested positive for COVID-19 (0.09%). One hundred fifty-eight individuals (7%) needed urgent neurological care, deferred due to the pandemic; 641 patients (30%) suspended hospital treatments, physiotherapy or other support interventions; 405 individuals (19%) reported a subjective worsening of neurological symptoms. Conclusions: In our population, the presence of neurological chronic diseases did not increase the prevalence of COVID-19 infection. Nevertheless, the burden of neurological disorders has been worsened by the lockdown.
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Affiliation(s)
- Carla Piano
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Enrico Di Stasio
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Guido Primiano
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Delfina Janiri
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy
| | - Marco Luigetti
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Frisullo
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Catello Vollono
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Matteo Lucchini
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valerio Brunetti
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mauro Monforte
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Valeria Guglielmi
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giacomo Della Marca
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Amelia Evoli
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Camillo Marra
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimiliano Mirabella
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Davide Quaranta
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Enzo Ricci
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Serenella Servidei
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriella Silvestri
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Simone Bellavia
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sara Bortolani
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Bove
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Riccardo Di Iorio
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Andrea Di Paolantonio
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Genovese
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Tamara Ialongo
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Rita Lo Monaco
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Jessica Marotta
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Alessia Perna
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Martina Petracca
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giorgia Presicce
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vittorio Riso
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Eleonora Rollo
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Marina Romozzi
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Cristina Sancricca
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Irene Scala
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gregorio Spagni
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Marcella Solito
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Tricoli
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paola Zinzi
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paolo Calabresi
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Rita Bentivoglio
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
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4
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Federico A. Experiencing COVID19 pandemic and neurology: learning by the recent reports and by old literary or scientific descriptions. Neurol Sci 2020; 41:1323-1327. [PMID: 32430624 PMCID: PMC7235549 DOI: 10.1007/s10072-020-04471-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Antonio Federico
- Department of Medicine, Surgery and Neurosciences, Medical School, University of Siena, viale Bracci 2, 53100, Siena, Italy.
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5
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Konnopka A, König H. Economic Burden of Anxiety Disorders: A Systematic Review and Meta-Analysis. PHARMACOECONOMICS 2020; 38:25-37. [PMID: 31646432 DOI: 10.1007/s40273-019-00849-7] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Anxiety disorders (AD) are common mental disorders, for which several cost-of-illness (COI) studies have been conducted in the past. OBJECTIVE The aim of this review was to provide a systematic overview of these studies and an aggregation of their results. METHODS A systematic literature search limited to studies published after 1999 was conducted in PubMed/MEDLINE in November 2018. We included top-down COI studies reporting costs for AD, and bottom-up COI studies reporting costs for AD and a non-diseased control group, and extracted data manually. Results of the top-down COI studies were aggregated by calculating the mean percentage of costs on gross domestic product (GDP) and health expenditure, while the results of the bottom-up studies were analyzed meta-analytically using the 'ratio of means' method and inverse-variance pooling. In this review, the logarithm of the relative difference in a continuous outcome between two groups is calculated and aggregated over the studies. The results can be interpreted as the relative change in costs imposed by a specific disease compared with baseline costs. RESULTS We identified 13 top-down and 11 bottom-up COI studies. All top-down COI studies and four bottom-up COI studies reported costs for AD as a diagnostic group, four for generalized anxiety disorder (GAD), four for social anxiety disorder (SAD), and one for panic disorder. In top-down COI studies, direct costs of AD, on average, corresponded to 2.08% of health care costs and 0.22% of GDP, whereas indirect costs, on average, corresponded to 0.23% of GDP. In bottom-up COI studies, direct costs of patients with AD were increased by factor 2.17 (1.29-3.67; p = 0.004) and indirect costs were increased by factor 1.92 (1.05-3.53; p = 0.04), whereas total costs increased by factor 2.52 (1.73-3.68; p < 0.001). Subgroup analysis revealed an increase in direct costs by 1.60 (1.16-2.22; p = 0.005) for SAD and 2.60 (2.01-3.36; p < 0.001) for GAD. Measures of heterogeneity indicated high heterogeneity when pooling studies for direct costs, indirect costs, and total costs, but low to moderate heterogeneity when pooling studies for SAD or GAD. CONCLUSIONS Using methods that focused on relative rather than absolute costs, we were able to aggregate costs reported in different COI studies for ADs. We found that ADs were associated with a low proportion of health care costs on a population level, but significantly increased health care costs on an individual level compared with healthy controls. Our disorder-specific subgroup analysis showed that study findings are most homogeneous within specific ADs. Therefore, to get a more detailed picture of the costs of ADs, more studies for currently under researched ADs, such as panic disorder, are needed.
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Affiliation(s)
- Alexander Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251, Hamburg, Germany.
- Hamburg Center for Health Economics, Hamburg, Germany.
| | - Hannah König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251, Hamburg, Germany
- Hamburg Center for Health Economics, Hamburg, Germany
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6
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Lublóy Á. Economic burden of migraine in Latvia and Lithuania: direct and indirect costs. BMC Public Health 2019; 19:1242. [PMID: 31500616 PMCID: PMC6734255 DOI: 10.1186/s12889-019-7461-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/08/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Migraine is a primary headache disorder which affects all aspects of life. The financial burden of migraine imposed on the society might be substantial. This study aims at estimating the economic cost of migraine in Latvia and Lithuania, including both direct and indirect costs. Direct costs encompass the costs of migraine-related health care resource utilization. Indirect costs are related to productivity loss, the potential or expected earnings lost due to migraine. METHODS Direct cost is assessed by using the prevalence method, a widely used cost-of-illness approach. The prevalence rate of migraine and the migraine-related health care resource utilization are proxied from the literature, whereas unit cost of medical services and procedures are retrieved from national databases and providers. For estimating the indirect cost of migraine, we follow the human capital approach. We quantify three components of indirect costs: reduced labour force participation, absence from work and reduced productivity while at work. The number of unemployed migraineurs, days missed from work and days lost due to impairment while at work are drawn from the literature. Unemployment rate and average income in Latvia and Lithuania are then inserted to assess indirect costs. RESULTS We find that the mean per-person total cost of migraine is €801 annually in Latvia, and €721 in Lithuania. In both countries around 30% of total cost is direct cost; cost related to a wide array of migraine-related medical services and interventions. The total cost of migraine is €112.26 million in Latvia, corresponding to 0.42% of Latvia's GDP. The total cost of migraine is €149.62 million in Lithuania, corresponding to 0.35% of Lithuania's GDP. In both countries two thirds of total cost is related to lost workdays due to absenteeism and presenteeism. CONCLUSIONS The financial burden of migraine imposed on the society is substantial in Latvia and Lithuania. Improvements in care for patients with migraine, such as easier access to structured headache assessment services, wider availability of various procedures and preventive medications would significantly increase direct costs. Nevertheless, this cost increase might be far outweighed by lower migraine-related productivity loss, especially as the prevalence of migraine is the highest in the most productive years of life.
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Affiliation(s)
- Ágnes Lublóy
- Stockholm School of Economics in Riga, Strēlnieku iela 4a, Rīga, LV-1010, Latvia. .,Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary.
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7
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Brusa P, Allais G, Scarinzi C, Baratta F, Parente M, Rolando S, Gnavi R, Spadea T, Costa G, Benedetto C, Mana M, Giaccone M, Mandelli A, Manzoni GC, Bussone G. Self-medication for migraine: A nationwide cross-sectional study in Italy. PLoS One 2019; 14:e0211191. [PMID: 30673780 PMCID: PMC6343913 DOI: 10.1371/journal.pone.0211191] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/08/2019] [Indexed: 01/03/2023] Open
Abstract
Headache disorders are considered the second leading cause of years lived with disability worldwide, and 90% of people have a headache episode at least once a year, thus representing a relevant public health priority. As the pharmacist is often the first and only point of reference for people complaining of headache, we carried out a survey in a nationwide sample of Italian pharmacies, in order to describe the distribution of migraine or non-migraine type headaches and medicines overuse among people entering pharmacies seeking for self-medication; and to evaluate the association, in particular of migraine, with socio-demographic and clinical characteristics, and with the pathway of care followed by the patients. A 14-item questionnaire, including socio-demographic and clinical factors, was administered by trained pharmacists to subjects who entered a pharmacy requesting self-medication for a headache attack. The ID Migraine™ Screener was used to classify headache sufferers in four classes. From June 2016 to January 2017, 4424 people have been interviewed. The prevalence of definite migraines was 40%, significantly higher among women and less educated people. About half of all headache sufferers and a third of migraineurs do not consider their condition as a disease and are not cared by any doctor. Among people seeking self-medication in pharmacies for acute headache attacks, the rate of definite or probable migraine is high, and a large percentage of them is not correctly diagnosed and treated. The pharmacy can be a valuable observatory for the study of headaches, and the first important step to improve the quality of care delivered to these patients.
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Affiliation(s)
- Paola Brusa
- Department of Science and Technology of Drugs, University of Turin, Turin, Italy
- Order of Pharmacists of Turin, Turin, Italy
- * E-mail:
| | - Gianni Allais
- Department of Surgical Sciences, Women’s Headache Center, University of Turin, Turin, Italy
- FI.CEF Onlus, Italian Headache Foundation, Milan, Italy
| | | | - Francesca Baratta
- Department of Science and Technology of Drugs, University of Turin, Turin, Italy
| | - Marco Parente
- Department of Science and Technology of Drugs, University of Turin, Turin, Italy
| | - Sara Rolando
- Department of Surgical Sciences, Women’s Headache Center, University of Turin, Turin, Italy
| | - Roberto Gnavi
- Epidemiology Unit, ASL TO3, Grugliasco (Turin), Italy
| | - Teresa Spadea
- Epidemiology Unit, ASL TO3, Grugliasco (Turin), Italy
| | | | - Chiara Benedetto
- Department of Surgical Sciences, Women’s Headache Center, University of Turin, Turin, Italy
| | | | - Mario Giaccone
- Order of Pharmacists of Turin, Turin, Italy
- FOFI, Federation of the Orders of Italian Pharmacists, Rome, Italy
| | - Andrea Mandelli
- FOFI, Federation of the Orders of Italian Pharmacists, Rome, Italy
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8
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Barrio P, Reynolds J, García-Altés A, Gual A, Anderson P. Social costs of illegal drugs, alcohol and tobacco in the European Union: A systematic review. Drug Alcohol Rev 2017; 36:578-588. [DOI: 10.1111/dar.12504] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/31/2016] [Accepted: 09/08/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Pablo Barrio
- Addictive Behaviors Unit, Clinic Hospital; Neuroscience Institute; Barcelona Spain
| | - Jillian Reynolds
- Addictive Behaviors Unit, Clinic Hospital; Neuroscience Institute; Barcelona Spain
| | - Anna García-Altés
- Catalon Agency of Quality and Health Evaluation; Barcelona Spain
- Biomedical Research Network Centre of Epidemiology and Public Health; Barcelona Spain
- Sant Pau Biomedical Research Institute; Barcelona Spain
| | - Antoni Gual
- Addictive Behaviors Unit, Clinic Hospital; Neuroscience Institute; Barcelona Spain
| | - Peter Anderson
- Institute of Health and Society; Newcastle University; Newcastle upon Tyne UK
- Department of Family Medicine, School for Public Health and Primary Care; Maastricht University; Maastricht The Netherlands
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9
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Evolution of the Healthcare Expenditure in Italy and Effects of Fingolimod Increased Prescribing in Second Line Treatment of Relapsing-Remitting Multiple Sclerosis. GLOBAL & REGIONAL HEALTH TECHNOLOGY ASSESSMENT 2016. [DOI: 10.5301/grhta.5000232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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10
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Ernstsson O, Gyllensten H, Alexanderson K, Tinghög P, Friberg E, Norlund A. Cost of Illness of Multiple Sclerosis - A Systematic Review. PLoS One 2016; 11:e0159129. [PMID: 27411042 PMCID: PMC4943600 DOI: 10.1371/journal.pone.0159129] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/28/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Cost-of-illness (COI) studies of Multiple Sclerosis (MS) are vital components for describing the economic burden of MS, and are frequently used in model studies of interventions of MS. We conducted a systematic review of studies estimating the COI of MS, to compare costs between studies and examine cost drivers, emphasizing generalizability and methodological choices. MATERIAL AND METHOD A literature search on studies published in English on COI of MS was performed in PubMed for the period January 1969 to January 2014, resulting in 1,326 publications. A mapping of studies using a bottom-up approach or top-down approach, respectively, was conducted for the 48 studies assessed as relevant. In a second analysis, the cost estimates were compared between the 29 studies that used a societal perspective on costs, human capital approach for indirect costs, presenting number of patients included, time-period studied, and year of price level used. RESULTS The mapping showed that bottom-up studies and prevalence approaches were most common. The cost ratios between different severity levels within studies were relatively stable, to the ratio of 1 to 2 to 3 for disability level categories. Drugs were the main cost drivers for MS-patients with low disease severity, representing 29% to 82% of all costs in this patient group, while the main cost components for groups with more advanced MS symptoms were production losses due to MS and informal care, together representing 17% to 67% of costs in those groups. CONCLUSION The bottom-up method and prevalence approach dominated in studies of COI of MS. Our findings show that there are difficulties in comparing absolute costs across studies, nevertheless, the relative costs expressed as cost ratios, comparing different severity levels, showed higher resemblance. Costs of drugs were main cost drivers for less severe MS and informal care and production losses for the most severe MS.
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Affiliation(s)
- Olivia Ernstsson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Hanna Gyllensten
- Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Kristina Alexanderson
- Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Petter Tinghög
- Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
- The Swedish Red Cross University College, Stockholm, Sweden
| | - Emilie Friberg
- Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Anders Norlund
- Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
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11
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Pierotti F, Palla I, Treur M, Pippo L, Turchetti G. Assessment of the Economic Impact of Belimumab for the Treatment of Systemic Lupus Erythematosus in the Italian Setting: A Cost-Effectiveness Analysis. PLoS One 2015; 10:e0140843. [PMID: 26488751 PMCID: PMC4619253 DOI: 10.1371/journal.pone.0140843] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/01/2015] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE The purpose of this analysis is to evaluate the cost-effectiveness of belimumab, a new biological treatment specifically developed for the treatment of Systemic Lupus Erythematosus (SLE), in the Italian setting. SLE is a chronic non-organ specific autoimmune disease characterized by a disregulation of the immune system that involves many organs and systems. METHODS A cost-effectiveness micro-simulation model with a lifetime horizon originally developed for the UK was adapted to the Italian setting. The analysis compared Standard of Care (SoC) alone vs belimumab plus SoC from a National Healthcare Service (NHS) and societal perspective. Health-economic consequences of treatments and organ damage progression were calculated. When available, Italian data were used, otherwise UK costs were converted using Purchasing Power Parities (PPPs). Utility values were based on the EQ-5D™ assessments in the belimumab clinical trials (BLISS 52 and 76). Results were discounted with 3% for costs and effects. A maximum belimumab treatment duration of 6 years was assumed and wastage costs were considered. RESULTS Cost per life year gained (Incremental Cost-Effectiveness Ratio, ICER) and cost per Quality Adjusted Life Year (QALY) (Incremental Cost-Utility Ratio, ICUR) were €22,990 and €32,859, respectively. These values reduced to €20,119 and €28,754, respectively, when indirect costs were included. CONCLUSIONS It may be concluded that in the Italian setting and according to the guidelines of the Italian Association of Health Economics (IAHE), belimumab was shown to be cost-effective, in terms of both ICER and ICUR, (€25-40,000/QALY).
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Affiliation(s)
| | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
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12
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Ruggeri M. The cost effectiveness of Botox in Italian patients with chronic migraine. Neurol Sci 2015; 35 Suppl 1:45-7. [PMID: 24867835 DOI: 10.1007/s10072-014-1741-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Migraine is a primary headache which World Health Organization ranks in 19th place in the list of disabling diseases. In Europe, in 2004, the total costs for migraine were quantified by Stovner and Berg, Eur J Neurol, 12(s1) (2005) at <euro>27 billion. The objective of this study is to provide an estimate of the incremental cost-effectiveness ratio (ICER) of the treatment of chronic migraine with Botox compared to treatment with placebo in the perspective of the Italian National Health Service and society. To do this we studied the disease progression in a cohort of 688 individuals (patients enrolled in the study PREEMPT) via the application of a Markov model. Over a period of 2 years, the total costs of the experimental arm of the model amounted to <euro>3,274 compared with a gain of 1.34 QALYs. In contrast, the costs of the control arm amounted to <euro>2,395 with a gain of 1.24 QALYs. It follows that the incremental costs amounted to <euro>889 compared to an incremental gain of 0.09 QALYs in favor of the experimental arm. The relationship between costs and incremental QALYs generated an ICER of <euro>9,407/QALY. The incremental cost-effectiveness ratio, therefore, is favorable compared to the value usually considered by NICE as a threshold limit for reimbursement which ranges between <euro>20,000 and <euro>40,000/QALY.
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Affiliation(s)
- M Ruggeri
- Istituto di Politica Economica e Alta scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy,
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Health technology assessment of belimumab: a new monoclonal antibody for the treatment of systemic lupus erythematosus. BIOMED RESEARCH INTERNATIONAL 2014; 2014:704207. [PMID: 25243173 PMCID: PMC4150460 DOI: 10.1155/2014/704207] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 06/29/2014] [Indexed: 11/25/2022]
Abstract
Objective. Systemic lupus erythematosus (SLE) is treated with anti-inflammatory and immunosuppressive drugs and off-label biologics. Belimumab is the first biologic approved after 50 years as an add-on therapy for active disease. This paper summarizes a health technology assessment performed in Italy. Methods. SLE epidemiology and burden were assessed using the best published international and national evidences and efficacy and safety of belimumab were synthesized using clinical data. A cost-effectiveness analysis was performed by a lifetime microsimulation model comparing belimumab to standard of care (SoC). Organizational and ethical implications were discussed. Results. Literature review showed that SLE affects 47 per 100,000 people for a total of 28,500 patients in Italy, 50% of whom are affected by active form of the disease despite SoC. These patients, if autoantibodies and anti-dsDNA positive with low complement, are eligible for belimumab. SLE determines work disability and a 2–5-fold increase in mortality. Belimumab with SoC may prevent 4,742 flares in three years being cost-effective with an incremental cost-effectiveness ratio of €32,859 per quality adjusted life year gained. From the organizational perspective, the development of clear and comprehensive clinical pathways is crucial. Conclusions. The assessment supports the use of belimumab into the SLE treatment paradigm in Italy.
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14
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Joo H, George MG, Fang J, Wang G. A literature review of indirect costs associated with stroke. J Stroke Cerebrovasc Dis 2014; 23:1753-63. [PMID: 24957313 DOI: 10.1016/j.jstrokecerebrovasdis.2014.02.017] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 02/21/2014] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Stroke is a leading cause of mortality and long-term disability. However, the indirect costs of stroke, such as productivity loss and costs of informal care, have not been well studied. To better understand this, we conducted a literature review of the indirect costs of stroke. METHODS A literature search using PubMed, MEDLINE, and EconLit, with the key words stroke, cerebrovascular disease, subarachnoid hemorrhage, intracerebral hemorrhage, cost-of-illness, productivity loss, indirect cost, economic burden, and informal caregiving was conducted. We identified original research articles published during 1990-2012 in English-language peer-reviewed journals. We summarized indirect costs by study type, cost categories, and study settings. RESULTS We found 31 original research articles that investigated the indirect cost of stroke. Six of these investigated indirect costs only; the other 25 studies were cost-of-illness studies that included indirect costs as a component. Of the 31 articles, 6 examined indirect costs in the United States, with 2 of these focused solely on indirect costs. Because of diverse methods, kinds of data, and definitions of cost used in the studies, the literature indicated a very wide range internationally in the proportion of the total cost of stroke that is represented by indirect costs (from 3% to 71%). CONCLUSIONS Most of the literature indicates that indirect costs account for a significant portion of the economic burden of stroke, and there is a pressing need to develop proper approaches to analyze these costs and to make better use of relevant data sources for such studies or establish new ones.
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Affiliation(s)
- Heesoo Joo
- Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
| | - Mary G George
- Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Jing Fang
- Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Guijing Wang
- Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Nilsson A, Tovar J, Johansson M, Radeborg K, Björck I. A diet based on multiple functional concepts improves cognitive performance in healthy subjects. Nutr Metab (Lond) 2013; 10:49. [PMID: 23855966 PMCID: PMC3720285 DOI: 10.1186/1743-7075-10-49] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 07/11/2013] [Indexed: 01/01/2023] Open
Abstract
Background Disorders such as the metabolic syndrome (MetS), impaired glucose tolerance and diabetes, are associated with increased risk of cognitive decline. Also several of the individual key features that define the MetS, e.g. hypertension, impaired glucose regulation, dyslipidemia, obesity, and inflammation, are related to an increased risk of cognitive decline. Consequently, a diet that prevents metabolic disorders might be expected to prevent cognitive decline. The purpose of the present study was to, in overweight but otherwise healthy subjects, investigate effects on cognitive functions of a dietary regime combining multiple functional concepts potentially beneficial to risk markers associated with MetS. The purpose was in addition to evaluate cognitive performance in relation to results on cardiometabolic risk variables (BMI, blood pressure, glucose, insulin, cholesterol, triglycerides, free fatty acids, lipoprotein A-1 and B, hs-CRP, HbA1c, interleukin-6, TNF-α, and PAI-1). Methods Fourty-four healthy women and men (50–73 years, BMI 25–33, fasting glycemia ≤ 6.1 mmol/L) participated in a randomized, controlled crossover intervention, comparing a multifunctional diet (active diet (AD)) including foods with a potential anti-inflammatory action, with a control diet (CD) devoid of the “active” components. Both diets were composed in close agreement with the Nordic dietary recommendations. Each diet was consumed during 4 wk, separated by a 4 wk washout period. Cognitive tests were performed at fasting and in the postprandial period after a standardized breakfast, after each diet period. Results In comparison with the CD, the AD improved performance in the Rey Auditory-Verbal Learning test (recognition test, p < 0.05, ANOVA, n = 42) and significantly improved performance in test of selective attention, which also included aspects of working memory (p < 0.05, n = 40). Performance in cognitive tests was inversely associated with plasma concentrations of cardiometabolic risk markers (fasting cholesterol, blood glucose, blood pressure) and cardiovascular risk scores (Framingham and Reynols), and positivly associated with apolipoprotein A1 (p < 0.05). Conclusions The results indicate that diet characteristics may modulate cognitive performance. A relationship seems to exist between cardiometabolic risk markers and cognitive performance in apparently healthy subjects. The results provide additional motives for diet based prevention of metabolic disturbances related to the MetS.
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Affiliation(s)
- Anne Nilsson
- Department of Applied Nutrition and Food Chemistry, Lund University, P.O. Box 124, Lund, SE-221 00, Sweden
| | - Juscelino Tovar
- Antidiabetic Food Centre, Lund University, Lund, SE-221 00, Sweden
| | - Maria Johansson
- Antidiabetic Food Centre, Lund University, Lund, SE-221 00, Sweden
| | - Karl Radeborg
- Department of Psychology, Lund University, Lund, Sweden
| | - Inger Björck
- Department of Applied Nutrition and Food Chemistry, Lund University, P.O. Box 124, Lund, SE-221 00, Sweden ; Antidiabetic Food Centre, Lund University, Lund, SE-221 00, Sweden
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A Patient-Based Needs Assessment for Living Well with Parkinson Disease: Implementation via Nominal Group Technique. PARKINSONS DISEASE 2013; 2013:974964. [PMID: 23476891 PMCID: PMC3588173 DOI: 10.1155/2013/974964] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 12/19/2012] [Indexed: 11/17/2022]
Abstract
Background. Parkinson's disease (PD) is a neurodegenerative condition with complex subtleties, making it challenging for physicians to fully inform their patients. Given that approximately 50% of Americans access the Internet for health information, the development of a multimedia, web-based application emphasizing targeted needs of people with Parkinson's disease (PwP) has the potential to change patient's lives.
Objectives. To determine what information PwP perceive could enhance their quality of life. Methods. Group sessions utilizing nominal group technique (NGT) were conducted. Participants were asked “what information do you want to know about that would help you live well with PD?” Silent generation of ideas preceded discussion followed by anonymous ranking of items. A “summary score” (sum of rank × frequency) was calculated. Results. 36 individual items were collapsed into 9 categories. Coping with emotions, changing relationships, and social implications of PD were ranked as most important. Financial supports and skills for self-advocacy were also highly ranked. Conclusions. Qualitative research methodology was utilized to determine the unmet needs of PwP. Results of this survey will inform the development of a patient-oriented, online resource, the goal will be to provide information and strategies to improve symptom management, reduce disability and address all relevant concerns important to those affected by PD.
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Linde M, Gustavsson A, Stovner LJ, Steiner TJ, Barré J, Katsarava Z, Lainez JM, Lampl C, Lantéri-Minet M, Rastenyte D, Ruiz de la Torre E, Tassorelli C, Andrée C. The cost of headache disorders in Europe: the Eurolight project. Eur J Neurol 2011; 19:703-11. [PMID: 22136117 DOI: 10.1111/j.1468-1331.2011.03612.x] [Citation(s) in RCA: 463] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Linde
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
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Patti F, Amato MP, Trojano M, Solaro C, Pappalardo A, Zipoli V, Portaccio E, Paolicelli D, Paolillo A, Mennini FS, Marcellusi A, Ricci C, Battaglia MA. Multiple sclerosis in Italy: cost-of-illness study. Neurol Sci 2011; 32:787-94. [PMID: 21409509 DOI: 10.1007/s10072-011-0499-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 02/16/2011] [Indexed: 12/01/2022]
Abstract
This study estimates the direct costs of multiple sclerosis (MS) in Italy from the perspective of the National Health System. Patients diagnosed with MS for ≥1 year prior to study entry were included in the analysis; neurological disability was assessed using the Expanded Disability Status Scale (EDSS). Cost variables were analyzed according to: MS phenotype, disease course over the previous year and EDSS rating. A total of 510 patients were included in the analysis. Overall costs were significantly higher for relapsing-remitting MS and secondary progressive MS than for primary progressive MS (P < 0.05). Costs were higher for EDSS scores 0.0-3.5 and 4.0-6.0 than for scores > 6.0 (P < 0.05). The extrapolated data gave an estimated annual direct cost of MS per patient of <euro>18,030. In conclusion, relapsing-remitting MS or secondary progressive MS phenotypes and lower estimated EDSS scores appear to be associated with higher costs.
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Affiliation(s)
- F Patti
- Multiple Sclerosis Centre Sicilia Region, First Neurology Clinic, University Hospital Catania, Catania, Italy
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Isaia G, M Bo, Nobili G, Cappa G, Mondino S, Pilon S, Massaia M. Costs of the in-home patients affected by dementia. Arch Gerontol Geriatr 2010; 49 Suppl 1:147-51. [PMID: 19836628 DOI: 10.1016/j.archger.2009.09.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In 2000, Alzheimer's disease (AD) and other dementias were the third most expensive health conditions in the USA and in 2005 their annual costs amounted to more than $148 billion. An observational, non-randomized study aimed to evaluate direct costs of demented patients in their homes. Two hundred thirty-six informal caregivers have been enrolled. A financial support, represented by a disability living allowance (15.3%) or attendance allowance (3.4%), was presented in just 19.7% of the cases. Patients receiving assistance from an employed carer were 39% with a mean cost of 800 Euro/month. Receiving assistance from an employed carer is not correlated with cognitive and functional impairment, with the age of the caregiver and with the duration of the disease (t=1.03; t=-0.86; t=1.41; t=-0.16, respectively). The informal caregivers declared that they thoughts about the possibility of institutionalize the patient were 20.9%. The present study underlines the discrepancy between subjects having assistance from an employed caregiver and subjects receiving financial supports. It often happens that patients not reaching the minimum requisites for social assistant or financial support, need at least a supervision.
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Affiliation(s)
- G Isaia
- Department of Medical and Surgical Disciplines, University of Turin, Torino, Italy
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