Abstract:
OBJECTIVES:The purpose of this study is to report on long-term treatment patterns in a back pain population and to consider whether these may be considered as reflective of under-treatment of pain or poor pain control. METHODS:Data are from a commissioned recontact SELECT survey of persons who had previously reported experiencing pain in the 2010 National Health and Wellness Survey. The analysis covers five countries: the UK, France, Spain, Germany and Italy. It is restricted to patients who reported moderate or severe pain in the last 3 months and who were judged to be experiencing back pain from the pain conditions reported. A total of 1018 subjects met the back pain criteria. Of these, 738 had their back pain initially diagnosed by a physician. It is this latter group that is the focus for the analysis. Subjects were further allocated to categories to assess potential pain chronicity and the intensity and self-limiting aspects of pain experience. RESULTS:Irrespective of the pain classification used, 56.10% of subjects in this back pain population report their first physician diagnosis of pain as occurring at least 6 years ago. At the same time 36.81% report experiencing severe pain in the last 3 months and 63.69% moderate pain. Overall, 53.11% of respondents are assessed as experiencing probable chronic pain and 24.12% as possible chronic pain. Among those experiencing probable chronic pain, 61.48% were diagnosed with back pain more than 6 years ago. In addition, 43.22% of respondents found the impact of pain on daily activities to be severely limiting and 22.63% found it to be moderately limiting. The majority of subjects, whether they were diagnosed and treated initially by primary care or another physician specialty, apparently experience no change in their treatment regimen. The absence of treatment change is 69.03% in the case of those experiencing severe pain and 84.89% in the case of those with moderate pain (p < 0.05). LIMITATIONS:The NHWS is an internet survey, as a self-report there is no separate validation of pain experience reported; as subjects are asked to recall pain and treatment experience there is the possibility of recall error and bias. CONCLUSIONS:Two features of this analysis stand out: (i) time since first diagnosis of pain for those currently experiencing severe or moderate back pain and (ii) the 'inertia' that appears to characterize long-term treatment decisions. Irrespective of current pain status, 70% or more of those experiencing current severe or moderate pain report no change from their initial treating physician or no change in prescription once referred to a pain specialist. This occurs over an extended time frame. Whether this should be interpreted as a failure in pain management is a moot point. The fact remains, however, that despite time since first diagnosis subjects not only currently experience severe or moderate pain but a substantial proportion may be expected to continue.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
Langley PC,Liedgens Hdoi
10.3111/13696998.2013.777346subject
Has Abstractpub_date
2013-01-01 00:00:00pages
701-9issue
5eissn
1369-6998issn
1941-837Xjournal_volume
16pub_type
杂志文章abstract:OBJECTIVES:To perform a cost-utility analysis of a new formulation of mesalazine (Mezavant XL, MMX mesalazine) versus an existing oral mesalazine (Asacol; mesalazine) from the UK National Health Service perspective. METHODS:A 5-year Markov cohort model was developed. Costs were obtained from the literature and utiliti...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990903562861
更新日期:2010-03-01 00:00:00
abstract:AIMS:Patients with psoriasis often undergo treatment with a sequence of biologic agents because of poor/loss of response to initial therapy. With the availability of newer agents like ixekizumab and secukinumab, there is a need for cost-effectiveness analyses to better reflect current clinical practice. This study aime...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1474747
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To characterize patient and physician satisfaction with current standard-of-care botulinum toxin treatment regimens for symptom control in patients with post-stroke spasticity using structured interviews with patients and physicians. RESEARCH DESIGN AND METHODS:Two cross-sectional surveys were conducted in C...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.925462
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:Epilepsy surgery is one of the most effective treatments in modern medicine. Yet, it remains largely under-utilized, in spite of its proven efficacy. The referrals for epilepsy surgery are often delayed until it is too late to prevent the detrimental psychosocial effects of refractory seizures. The reluctance...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.1080/13696998.2017.1412975
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:This study evaluated the overall burden of illness of chemotherapy-induced nausea and vomiting (CINV) and associated all-cause costs from a hospital's perspective (costs to the hospital) in patients with cancer treated with chemotherapy (CT) in the US hospital outpatient setting. METHODS:Patients with a canc...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.547237
更新日期:2011-01-01 00:00:00
abstract:AIMS:Fast-acting insulin analogues (FAIAs) reduce hypoglycaemia and improve administration flexibility compared with short-acting human insulin (SHI). This analysis examines whether these benefits translate into cost offsets when comparing the total treatment costs for FAIA versus SHI used as basal-bolus therapy for tr...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.588892
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Approximately 20-30% of Canadians suffer from chronic pain. Guidelines for the management of chronic pain support the use of controlled-release (CR) opioids to treat chronic pain. Although effective in managing chronic pain, oxycodone is associated with high rates of opioid-induced constipation (OIC). The co...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1116992
更新日期:2016-01-01 00:00:00
abstract::Aims: Estimate the direct costs of high-risk patients presenting with coronary artery disease (CAD) or peripheral artery disease (PAD) in France.Materials and methods: This retrospective cohort study used a representative claims database, the "Echantillon Généraliste de Bénéficiaires" (EGB), to identify patients prese...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1715415
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Percutaneous pulmonary valve implantation (PPVI) using the Melody * transcatheter pulmonary valve is a new procedure introduced in 2000 as a less invasive treatment for right ventricular outflow tract (RVOT) dysfunction. The aim of this new procedure is to restore pulmonary valve competence without the need ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.545465
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:Non-severe nocturnal hypoglycemic events (NSNHEs) may have a major impact on patients. The objective was to determine how NSNHEs affect diabetes management, sleep quality, functioning, and to assess if these impacts differ by diabetes type or country. METHODS:An internet survey to adults with diabetes in th...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.624144
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to describe the economic burden to managed care associated with failure of selective serotonin reuptake inhibitor (SSRI) therapy in terms of direct medical costs. METHODS:A retrospective analysis of the PharMetrics database, a national managed care medical and pharmacy claims ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990802522339
更新日期:2008-01-01 00:00:00
abstract:AIM:Disease-modifying therapies (DMTs) impact the natural history of relapsing forms of multiple sclerosis (RRMS) by reducing annual relapse rates and slowing disability progression. The effect of DMTs on indirect costs has not been consistently explored in cost-effectiveness studies thus far. The value to patients of ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2017.1357564
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost-effectiveness of biphasic insulin lispro mix 75/25 (LM75/25) and mix 50/50 (LM50/50) compared with a long-acting analog insulin (LAAI) regimen from the perspective of a US healthcare payer. METHODS:A published computer simulation model of diabetes was used to evaluate the cost-effectiven...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.675890
更新日期:2012-01-01 00:00:00
abstract:AIMS:In this pharmacoeconomic simulation, we: (1) modeled the cost-efficiency of converting patients from reference pegfilgrastim to biosimilar pegfilgrastim-cbqv for prophylaxis of chemotherapy-induced (febrile) neutropenia (CIN/FN) from the US payer perspective, (2) simulated how savings enable, on a budget-neutral b...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1833339
更新日期:2020-10-24 00:00:00
abstract:OBJECTIVES:This retrospective study aims to examine the association between prescribing information (PI)-concordant oral antidiabetic drug (OAD) treatment and clinical and economic outcomes in patients with type 2 diabetes mellitus and stages 3-5 chronic kidney disease (CKD). METHODS:The study used a large, national a...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.775135
更新日期:2013-01-01 00:00:00
abstract:AIMS:The study compared all-cause and major depressive disorder (MDD)-related healthcare resource use (HRU) and costs in patients with MDD treated with atypical antipsychotic (AAP) adjunctive therapy early or later in treatment. MATERIALS AND METHODS:Adults with MDD and antidepressant treatment (ADT) who newly initiat...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1484373
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:The only effective treatment for severe aortic stenosis (AS) is valve replacement. However, many patients with co-existing conditions are ineligible for surgical valve replacement, historically leaving medical management (MM) as the only option which has a poor prognosis. Transcatheter Aortic Valve Replacemen...
journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.3111/13696998.2013.770747
更新日期:2013-01-01 00:00:00
abstract:AIMS:To compare patient characteristics, rates, and costs of medically attended falls among patients with Parkinson's disease (PD) and probable PD plus neurogenic orthostatic hypotension (PD + nOH). MATERIALS AND METHODS:MarketScan Commercial and Medicare Supplemental databases (January 1, 2009-December 31, 2013) were...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2017.1284668
更新日期:2017-05-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.598202
更新日期:2011-01-01 00:00:00
abstract::Aims: Allopurinol is the most common urate lowering therapy (ULT) used to treat gout but may cause life-threatening severe cutaneous adverse reactions (SCAR) in a small number of patients. Risk of SCAR is increased for patients with the HLA-B*58:01 genotype. When alternative ULT is required, febuxostat or probenecid a...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1757456
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Bipolar 1 disorders (BPD) are a chronic disorder with prevalence rates of up to 2.6% of the adult population or higher and appreciable direct and indirect costs. As a result, these are a concern to health authorities especially given the low age of onset. Consequently, there is a need to treat BPD patients w...
journal_title:Journal of medical economics
pub_type: 评论,社论
doi:10.3111/13696998.2015.1073736
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To compare 1-year costs and benefits of dapagliflozin (DAPA), a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, with those of other treatments for type 2 diabetes (T2D), such as glucagon-like peptide-1 receptor agonists (GLP-1RAs), sulfonylureas (SUs), thiazolidinediones (TZDs), and dipeptidyl peptidase-4 ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1434182
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Global budget (GB) is considered one of the most important payment methods available. Since a new round of healthcare system reforms in 2009, the Chinese government has been paying attention to this prospective payment. However, it is unclear whether GB has influenced cost control and how it works in rural C...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2017.1336448
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Biologic treatments have enhanced the treatment outcomes of patients with active ankylosing spondylitis (AS). Until recently, TNF-alpha-inhibitors have been the only biologics approved for the treatment of active AS. The objective of this study was to assess the potential financial impact of the first non-TN...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1551227
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To quantify and compare hospital length of stay (LOS) and costs between hospitalized non-valvular atrial fibrillation (NVAF) patients treated with either apixaban or warfarin via a large claims database. METHODS:Adult patients hospitalized with AF were selected from the Premier Perspective Claims Database (0...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2016.1171774
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To review, summarize, and analyze both similarities and differences of pharmacoeconomic (PE) guidelines, to enable researchers to access their characteristics and the current state of PE guidelines; furthermore, to learn which methodological issues still remain contested and to promote the methodological deve...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.1080/13696998.2017.1387118
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate medication adherence and persistence of patients treated with Etanercept and Adalimumab for Rheumatoid Arthritis, also giving economic evaluations on therapy costs for Received Daily Dose (RDD). MATERIALS AND METHODS:This retrospective study took into account 6 years fro...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.902844
更新日期:2014-05-01 00:00:00
abstract::Aims: Cumulative exogenous factor VIII (FVIII) exposure is an important predictor of developing neutralizing antibodies (inhibitors) to FVIII in patients with persons with hemophilia A (PwHA). The aim of this study was to model the costs of emicizumab versus FVIII prophylaxis and total treatment costs for patients wit...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1669614
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:To estimate the economic implications of introducing dabigatran etexilate ('dabigatran') for anti-coagulation therapy in Danish patients with non-valvular atrial fibrillation based on results of the RE-LY trial. METHODS:The lifetime cost and outcomes of dabigatran and warfarin were estimated using a previous...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.673525
更新日期:2012-01-01 00:00:00
abstract::Background: IVF is now a wide spread procedure globally, and currently 65 countries report annually all or part of their IVF/ICSI cycles, from which the International Committee Monitoring progress in Assisted Reproduction Technology (ICMART) published its report. There is considerable variation in the utilization (num...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1609484
更新日期:2019-09-01 00:00:00