Saudi SCD patients’ symptoms and quality of life relative to the number of ED visits

Background Individuals living with sickle cell disease (SCD) have significantly increased emergency department (ED) use compared to the general population. In Saudi Arabia, health care is free for all individuals and therefore has no bearing on increased ED visits. However, little is known about the relationship between quality of life (QoL) and frequency of acute care utilization in this patient population. Methods A cross-sectional study was conducted on 366 patients with SCD who attended the outpatient department at King Fahad Hospital, Hofuf, Saudi Arabia. Data were collected through self-administered surveys, which included: demographics, SCD-related ED visits, clinical issues, and QoL levels. We assessed the ED use by asking for the number of SCD-related ED visits within a 6-month period. Results The self-report survey of ED visits was completed by 308 SCD patients. The median number of SCD-related ED visits within a 6-month time period (IQR) was four (2-7 visits). According to the unadjusted negative binomial model, the rate of SCD-related ED visits increased by (46, 39.3, 40, and 53.5 %) for patients with fever, skin redness with itching, swelling, and blood transfusion, respectively. Poor QoL tends to increase the rate of SCD-related ED visits. Well education and poor general health positively influenced the rate of SCD-related ED visits. Well education tends to increase the rate of SCD-related ED visits by 50.2 %. The rate of SCD-related ED visits decreased by 1.4 % for every point increase in general health. Conclusion Saudi patients with sickle cell disease reported a wide range of SCD-related ED visits. It was estimated that six of 10 SCD patients had at least three ED visits within a 6-month period. Well education and poor general health resulted in an increase in the rate of SCD-related ED visits

Health-related quality of life in patients with sickle cell disease in Saudi Arabia

Background There is a lack of research concerning health-related quality of life (HRQoL) in Saudi patients with sickle cell disease (SCD), particularly among adult populations. The aim of the current study was to describe the characteristics of SCD patients and their impact on their quality of life (QoL). Methods Six hundred twenty-nine adult SCD patients who attended King Fahad Hospital in Hofuf and King Fahad Central Hospital in Jazan were included in the analysis. Demographic/clinical data were collected and an Arabic version of the Medical Outcomes 36-Item Short-Form Health Survey (SF-36) questionnaire was used to assess QoL. Results SCD patients who hold a university degree reported positive impacts on the following domains of SF-36: physical role function, vitality, emotional well being, social function, pain reduction, and general health (P = .002, P = .001, P = .001, P = .003, P = .004, and P = .001, respectively). In general, patients with fever, skin redness, swelling, or history of blood transfusion tended to impair the health status of the SF-36. A multivariate analysis revealed that patients with a university degree tended to report high scores of physical role functions, emotional role function, and vitality. Patients with regular exercise tend to increase vitality, social function, general health, and reduce pain. Unemployment tends to lessen vitality and worsen pain. On average, pain, social function, and physical function scores tended to worsen in patients with swelling or history of blood transfusion. Conclusions This study highlighted that poor education, fever, skin redness, and swelling were negatively associated with specific components of SF-36. SCD patients with a history of blood transfusion found their QoL poorer, whereas regular exercise tended to improve QoL

The Impact of Obesity-Related Complications on Healthcare Costs – Outcomes of a Pharmacoeconomic Weight Loss Model

Esra Safak Yilmaz,1 Simten Malhan,2 Batu Gurser,3 Dilek Gogas Yavuz4 1Novo Nordısk, Patient Access and Public Affairs Department, Istanbul, Istanbul, Turkey; 2Baskent Unıversıty, Department of Healthcare Management, Ankara, Turkey; 3Novo Nordısk, Medical & Scientific Affairs Department, Istanbul, Turkey; 4Department of Endocrinology & Metabolism, Marmara University Medical Faculty, Istanbul, TurkeyCorrespondence: Esra Safak Yilmaz, Novo Nordısk, Patient Access and Public Affairs Department, Etiler, Nispetiye Cd. Akmerkez Is Kuleleri E3 Blok, Istanbul, 34335, Turkey, Tel +90 534 501 8205, Email [email protected]: According to the World Health Organization European Regional Obesity Report, Turkey has the highest rate of overweight and obesity in Europe. This study used a weight loss pharmacoeconomic model to assess the influence of obesity on public health by examining its effects on private health institutions and its financial costs.Patients and Methods: A micro-costing approach was used to estimate the direct healthcare costs of 10 obesity-related comorbidities from the perspective of private healthcare providers in Turkey. A survey was conducted on a representative sample of physicians in Turkey to determine resource utilization rates for comorbidities in expenditures. The unit costs of each cost item were analyzed for type A, B, and C private hospitals. Costs in the different categories were obtained by multiplying the unit costs by the health resource utilization rate.Results: When the obesity-related complications were stratified according to weight loss rate, 5%, 10%, and 20%, a higher cost reduction was observed in the 40– 49, 50– 59, and 60– 69 age groups. It should be noted that this decrease in healthcare expenditure was detected in the older age groups (40 to 69) and not in individuals between 20 and 39 years. Another analysis of the weight loss rate revealed that the decrease was highest in Type 2 Diabetes Mellitus costs. A health expenditure that costs 1 unit in a C-segment institution increases 1.44-fold in B-segment and 3-fold in A-segment hospitals. The effects of weight loss on reducing the cost of obesity-related complications indicated that the highest cost reduction was on T2DM, dyslipidemia, and CKD, respectively. Obesity-related complications constituted 28.87% of total costs in Segment A hospitals, 29.13% in Segment B hospitals, and 28.54% in Segment C hospitals.Conclusion: The current pharmacoeconomic model indicated that complications were the major cost drivers in obesity. Weight loss dramatically reduced healthcare expenditures in obese patients, and T2DM was the leading cause in all age groups.Keywords: weight loss, obesity, complication, healthcare resource utilization, pharmacoeconomic mode

An appeal to the global health community for a tripartite innovation: an ‘‘Essential Diagnostics List,’’ ‘‘Health in All Policies,’’ and ‘‘See-Through 21st Century Science and Ethics"

Diagnostics spanning a wide range of new biotechnologies, including proteomics, metabolomics, and nanotechnology, are emerging as companion tests to innovative medicines. In this Opinion, we present the rationale for promulgating an ‘‘Essential Diagnostics List.’’ Additionally, we explain the ways in which adopting a vision for ‘‘Health in All Policies’’ could link essential diagnostics with robust and timely societal outcomes such as sustainable development, human rights, gender parity, and alleviation of poverty. We do so in three ways. First, we propose the need for a new, ‘‘see through’’ taxonomy for knowledge-based innovation as we transition from the material industries (e.g., textiles, plastic, cement, glass) dominant in the 20th century to the anticipated knowledge industry of the 21st century. If knowledge is the currency of the present century, then it is sensible to adopt an approach that thoroughly examines scientific knowledge, starting with the production aims, methods, quality, distribution, access, and the ends it purports to serve. Second, we explain that this knowledge trajectory focus on innovation is crucial and applicable across all sectors, including public, private, or public–private partnerships, as it underscores the fact that scientific knowledge is a co-product of technology, human values, and social systems. By making the value systems embedded in scientific design and knowledge co-production transparent, we all stand to benefit from sustainable and transparent science. Third, we appeal to the global health community to consider the necessary qualities of good governance for 21st century organizations that will embark on developing essential diagnostics. These have importance not only for science and knowledge based innovation, but also for the ways in which we can build open, healthy, and peaceful civil societies today and for future generations

Saudi SCD patients’ symptoms and quality of life relative to the number of ED visits

Background Individuals living with sickle cell disease (SCD) have significantly increased emergency department (ED) use compared to the general population. In Saudi Arabia, health care is free for all individuals and therefore has no bearing on increased ED visits. However, little is known about the relationship between quality of life (QoL) and frequency of acute care utilization in this patient population. Methods A cross-sectional study was conducted on 366 patients with SCD who attended the outpatient department at King Fahad Hospital, Hofuf, Saudi Arabia. Data were collected through self-administered surveys, which included: demographics, SCD-related ED visits, clinical issues, and QoL levels. We assessed the ED use by asking for the number of SCD-related ED visits within a 6-month period. Results The self-report survey of ED visits was completed by 308 SCD patients. The median number of SCD-related ED visits within a 6-month time period (IQR) was four (2-7 visits). According to the unadjusted negative binomial model, the rate of SCD-related ED visits increased by (46, 39.3, 40, and 53.5 %) for patients with fever, skin redness with itching, swelling, and blood transfusion, respectively. Poor QoL tends to increase the rate of SCD-related ED visits. Well education and poor general health positively influenced the rate of SCD-related ED visits. Well education tends to increase the rate of SCD-related ED visits by 50.2 %. The rate of SCD-related ED visits decreased by 1.4 % for every point increase in general health. Conclusion Saudi patients with sickle cell disease reported a wide range of SCD-related ED visits. It was estimated that six of 10 SCD patients had at least three ED visits within a 6-month period. Well education and poor general health resulted in an increase in the rate of SCD-related ED visits