Επιστημονικά Περιοδικά
1.
Athanasakis, Kostas
'Inclusive' health systems increase healthy life expectancy Journal Article
In: Rural Remote Health, vol. 22, no. 2, pp. 7014, 2022.
@article{Athanasakis2022-dw,
title = {'Inclusive' health systems increase healthy life expectancy},
author = {Kostas Athanasakis},
year = {2022},
date = {2022-05-01},
journal = {Rural Remote Health},
volume = {22},
number = {2},
pages = {7014},
address = {Australia},
abstract = {INTRODUCTION: This article attempts to investigate whether
inclusive health systems increase societal welfare, with the
latter expressed through estimates of healthy life expectancy
(HLE). METHODS: The analysis uses publicly available data by the
Organisation for Economic Co-operation and Development and
explores the relationship of HLE at the age of 65 years (HLE_65)
with four variables that are representative of institutional
inclusivity or extractiveness of health systems. RESULTS: Results
indicate that HLE_65 is positively associated with healthcare
system institutional inclusivity as expressed in terms of the
share of public healthcare expenditure and the spending on
preventive care. HLE_65 is inversely associated with the
strength of extracting characteristics of the system, such as the
market power of physicians and the share of specialists in the
total number of physicians. CONCLUSION: In this light, the
development of health policies that aim to strengthen inclusive
institutions, such as the focus on prevention, financial
protection and primary care, could have a significant positive
impact in collective welfare and social cohesion - especially for
populations in rural, remote and less developed parts of the
world.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: This article attempts to investigate whether
inclusive health systems increase societal welfare, with the
latter expressed through estimates of healthy life expectancy
(HLE). METHODS: The analysis uses publicly available data by the
Organisation for Economic Co-operation and Development and
explores the relationship of HLE at the age of 65 years (HLE_65)
with four variables that are representative of institutional
inclusivity or extractiveness of health systems. RESULTS: Results
indicate that HLE_65 is positively associated with healthcare
system institutional inclusivity as expressed in terms of the
share of public healthcare expenditure and the spending on
preventive care. HLE_65 is inversely associated with the
strength of extracting characteristics of the system, such as the
market power of physicians and the share of specialists in the
total number of physicians. CONCLUSION: In this light, the
development of health policies that aim to strengthen inclusive
institutions, such as the focus on prevention, financial
protection and primary care, could have a significant positive
impact in collective welfare and social cohesion - especially for
populations in rural, remote and less developed parts of the
world.
inclusive health systems increase societal welfare, with the
latter expressed through estimates of healthy life expectancy
(HLE). METHODS: The analysis uses publicly available data by the
Organisation for Economic Co-operation and Development and
explores the relationship of HLE at the age of 65 years (HLE_65)
with four variables that are representative of institutional
inclusivity or extractiveness of health systems. RESULTS: Results
indicate that HLE_65 is positively associated with healthcare
system institutional inclusivity as expressed in terms of the
share of public healthcare expenditure and the spending on
preventive care. HLE_65 is inversely associated with the
strength of extracting characteristics of the system, such as the
market power of physicians and the share of specialists in the
total number of physicians. CONCLUSION: In this light, the
development of health policies that aim to strengthen inclusive
institutions, such as the focus on prevention, financial
protection and primary care, could have a significant positive
impact in collective welfare and social cohesion - especially for
populations in rural, remote and less developed parts of the
world.
2.
Garani-Papadatos, Tina; Natsiavas, Pantelis; Meyerheim, Marcel; Hoffmann, Stefan; Karamanidou, Christina; Payne, Sheila A
Ethical Principles in Digital Palliative Care for Children: The MyPal Project and Experiences Made in Designing a Trustworthy Approach Journal Article
In: Front Digit Health, vol. 4, pp. 730430, 2022.
@article{Garani-Papadatos2022-il,
title = {Ethical Principles in Digital Palliative Care for Children: The
MyPal Project and Experiences Made in Designing a Trustworthy
Approach},
author = {Tina Garani-Papadatos and Pantelis Natsiavas and Marcel Meyerheim and Stefan Hoffmann and Christina Karamanidou and Sheila A Payne},
year = {2022},
date = {2022-03-01},
journal = {Front Digit Health},
volume = {4},
pages = {730430},
abstract = {This paper explores the ethical dimension of the opportunity to
offer improved electronic patient-reported outcome (ePRO) systems
addressing personal needs of pediatric cancer patients, their
parents and caregivers, with regard to technological advance of
digital health. This opportunity has been explored in the MyPal
research project, which aims to assess a patient-centered service
for palliative care relying on the adaptation and extension of
digital health tools and concepts available from previous
projects. Development and implementation of ePROs need to take
place in a safe, secure and responsible manner, preventing any
possible harm and safeguarding the integrity of humans. To that
end, although the final results will be published at the end of
the project, this paper aims to increase awareness of the ethical
ramifications we had to address in the design and testing of new
technologies and to show the essentiality of protection and
promotion of privacy, safety and ethical standards. We have thus
reached a final design complying with the following principles:
(a) respect for the autonomy of participants, especially
children, (b) data protection and transparency, (c) fairness and
non-discrimination, (d) individual wellbeing of participants in
relation to their physical and psychological health status and e)
accessibility and acceptability of digital health technologies
for better user-engagement. These principles are adapted from the
Ethics Guidelines for a trustworthy Artificial Intelligence (AI)
which provide the framework for similar interventions to be
lawful, complying with all applicable laws and regulations,
ethical, ensuring compliance to ethical principles and values and
robust, both from a technical and social perspective.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This paper explores the ethical dimension of the opportunity to
offer improved electronic patient-reported outcome (ePRO) systems
addressing personal needs of pediatric cancer patients, their
parents and caregivers, with regard to technological advance of
digital health. This opportunity has been explored in the MyPal
research project, which aims to assess a patient-centered service
for palliative care relying on the adaptation and extension of
digital health tools and concepts available from previous
projects. Development and implementation of ePROs need to take
place in a safe, secure and responsible manner, preventing any
possible harm and safeguarding the integrity of humans. To that
end, although the final results will be published at the end of
the project, this paper aims to increase awareness of the ethical
ramifications we had to address in the design and testing of new
technologies and to show the essentiality of protection and
promotion of privacy, safety and ethical standards. We have thus
reached a final design complying with the following principles:
(a) respect for the autonomy of participants, especially
children, (b) data protection and transparency, (c) fairness and
non-discrimination, (d) individual wellbeing of participants in
relation to their physical and psychological health status and e)
accessibility and acceptability of digital health technologies
for better user-engagement. These principles are adapted from the
Ethics Guidelines for a trustworthy Artificial Intelligence (AI)
which provide the framework for similar interventions to be
lawful, complying with all applicable laws and regulations,
ethical, ensuring compliance to ethical principles and values and
robust, both from a technical and social perspective.
offer improved electronic patient-reported outcome (ePRO) systems
addressing personal needs of pediatric cancer patients, their
parents and caregivers, with regard to technological advance of
digital health. This opportunity has been explored in the MyPal
research project, which aims to assess a patient-centered service
for palliative care relying on the adaptation and extension of
digital health tools and concepts available from previous
projects. Development and implementation of ePROs need to take
place in a safe, secure and responsible manner, preventing any
possible harm and safeguarding the integrity of humans. To that
end, although the final results will be published at the end of
the project, this paper aims to increase awareness of the ethical
ramifications we had to address in the design and testing of new
technologies and to show the essentiality of protection and
promotion of privacy, safety and ethical standards. We have thus
reached a final design complying with the following principles:
(a) respect for the autonomy of participants, especially
children, (b) data protection and transparency, (c) fairness and
non-discrimination, (d) individual wellbeing of participants in
relation to their physical and psychological health status and e)
accessibility and acceptability of digital health technologies
for better user-engagement. These principles are adapted from the
Ethics Guidelines for a trustworthy Artificial Intelligence (AI)
which provide the framework for similar interventions to be
lawful, complying with all applicable laws and regulations,
ethical, ensuring compliance to ethical principles and values and
robust, both from a technical and social perspective.
3.
Athanasakis), Polaris Observatory HCV Collaborators (Kostas
Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: a modelling study Journal Article
In: Lancet Gastroenterol Hepatol, vol. 7, no. 5, pp. 396–415, 2022.
@article{Polaris_Observatory_HCV_Collaborators2022-ib,
title = {Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: a modelling study},
author = {Polaris Observatory HCV Collaborators (Kostas Athanasakis)},
year = {2022},
date = {2022-02-01},
urldate = {2022-02-01},
journal = {Lancet Gastroenterol Hepatol},
volume = {7},
number = {5},
pages = {396--415},
address = {Netherlands},
abstract = {BACKGROUND: Since the release of the first global hepatitis
elimination targets in 2016, and until the COVID-19 pandemic
started in early 2020, many countries and territories were making
progress toward hepatitis C virus (HCV) elimination. This study
aims to evaluate HCV burden in 2020, and forecast HCV burden by
2030 given current trends. METHODS: This analysis includes a
literature review, Delphi process, and mathematical modelling to
estimate HCV prevalence (viraemic infection, defined as HCV
RNA-positive cases) and the cascade of care among people of all
ages (age $geq$0 years from birth) for the period between Jan 1,
2015, and Dec 31, 2030. Epidemiological data were collected from
published sources and grey literature (including government
reports and personal communications) and were validated among
country and territory experts. A Markov model was used to
forecast disease burden and cascade of care from 1950 to 2050 for
countries and territories with data. Model outcomes were
extracted from 2015 to 2030 to calculate population-weighted
regional averages, which were used for countries or territories
without data. Regional and global estimates of HCV prevalence,
cascade of care, and disease burden were calculated based on 235
countries and territories. FINDINGS: Models were built for 110
countries or territories: 83 were approved by local experts and
27 were based on published data alone. Using data from these
models, plus population-weighted regional averages for countries and territories without models (n=125), we estimated a global
prevalence of viraemic HCV infection of 0·7% (95% UI 0·7-0·9),
corresponding to 56·8 million (95% UI 55·2-67·8) infections, on
Jan 1, 2020. This number represents a decrease of 6·8 million
viraemic infections from a 2015 (beginning of year) prevalence
estimate of 63·6 million (61·8-75·8) infections (0·9% [0·8-1·0]
prevalence). By the end of 2020, an estimated 12·9 million
(12·5-15·4) people were living with a diagnosed viraemic
infection. In 2020, an estimated 641 000 (623 000-765 000)
patients initiated treatment. INTERPRETATION: At the beginning of
2020, there were an estimated 56·8 million viraemic HCV
infections globally. Although this number represents a decrease
from 2015, our forecasts suggest we are not currently on track to
achieve global elimination targets by 2030. As countries recover
from COVID-19, these findings can help refocus efforts aimed at
HCV elimination. FUNDING: John C Martin Foundation, Gilead
Sciences, AbbVie, ZeShan Foundation, and The Hepatitis Fund.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Since the release of the first global hepatitis
elimination targets in 2016, and until the COVID-19 pandemic
started in early 2020, many countries and territories were making
progress toward hepatitis C virus (HCV) elimination. This study
aims to evaluate HCV burden in 2020, and forecast HCV burden by
2030 given current trends. METHODS: This analysis includes a
literature review, Delphi process, and mathematical modelling to
estimate HCV prevalence (viraemic infection, defined as HCV
RNA-positive cases) and the cascade of care among people of all
ages (age $geq$0 years from birth) for the period between Jan 1,
2015, and Dec 31, 2030. Epidemiological data were collected from
published sources and grey literature (including government
reports and personal communications) and were validated among
country and territory experts. A Markov model was used to
forecast disease burden and cascade of care from 1950 to 2050 for
countries and territories with data. Model outcomes were
extracted from 2015 to 2030 to calculate population-weighted
regional averages, which were used for countries or territories
without data. Regional and global estimates of HCV prevalence,
cascade of care, and disease burden were calculated based on 235
countries and territories. FINDINGS: Models were built for 110
countries or territories: 83 were approved by local experts and
27 were based on published data alone. Using data from these
models, plus population-weighted regional averages for countries and territories without models (n=125), we estimated a global
prevalence of viraemic HCV infection of 0·7% (95% UI 0·7-0·9),
corresponding to 56·8 million (95% UI 55·2-67·8) infections, on
Jan 1, 2020. This number represents a decrease of 6·8 million
viraemic infections from a 2015 (beginning of year) prevalence
estimate of 63·6 million (61·8-75·8) infections (0·9% [0·8-1·0]
prevalence). By the end of 2020, an estimated 12·9 million
(12·5-15·4) people were living with a diagnosed viraemic
infection. In 2020, an estimated 641 000 (623 000-765 000)
patients initiated treatment. INTERPRETATION: At the beginning of
2020, there were an estimated 56·8 million viraemic HCV
infections globally. Although this number represents a decrease
from 2015, our forecasts suggest we are not currently on track to
achieve global elimination targets by 2030. As countries recover
from COVID-19, these findings can help refocus efforts aimed at
HCV elimination. FUNDING: John C Martin Foundation, Gilead
Sciences, AbbVie, ZeShan Foundation, and The Hepatitis Fund.
elimination targets in 2016, and until the COVID-19 pandemic
started in early 2020, many countries and territories were making
progress toward hepatitis C virus (HCV) elimination. This study
aims to evaluate HCV burden in 2020, and forecast HCV burden by
2030 given current trends. METHODS: This analysis includes a
literature review, Delphi process, and mathematical modelling to
estimate HCV prevalence (viraemic infection, defined as HCV
RNA-positive cases) and the cascade of care among people of all
ages (age $geq$0 years from birth) for the period between Jan 1,
2015, and Dec 31, 2030. Epidemiological data were collected from
published sources and grey literature (including government
reports and personal communications) and were validated among
country and territory experts. A Markov model was used to
forecast disease burden and cascade of care from 1950 to 2050 for
countries and territories with data. Model outcomes were
extracted from 2015 to 2030 to calculate population-weighted
regional averages, which were used for countries or territories
without data. Regional and global estimates of HCV prevalence,
cascade of care, and disease burden were calculated based on 235
countries and territories. FINDINGS: Models were built for 110
countries or territories: 83 were approved by local experts and
27 were based on published data alone. Using data from these
models, plus population-weighted regional averages for countries and territories without models (n=125), we estimated a global
prevalence of viraemic HCV infection of 0·7% (95% UI 0·7-0·9),
corresponding to 56·8 million (95% UI 55·2-67·8) infections, on
Jan 1, 2020. This number represents a decrease of 6·8 million
viraemic infections from a 2015 (beginning of year) prevalence
estimate of 63·6 million (61·8-75·8) infections (0·9% [0·8-1·0]
prevalence). By the end of 2020, an estimated 12·9 million
(12·5-15·4) people were living with a diagnosed viraemic
infection. In 2020, an estimated 641 000 (623 000-765 000)
patients initiated treatment. INTERPRETATION: At the beginning of
2020, there were an estimated 56·8 million viraemic HCV
infections globally. Although this number represents a decrease
from 2015, our forecasts suggest we are not currently on track to
achieve global elimination targets by 2030. As countries recover
from COVID-19, these findings can help refocus efforts aimed at
HCV elimination. FUNDING: John C Martin Foundation, Gilead
Sciences, AbbVie, ZeShan Foundation, and The Hepatitis Fund.
4.
Pronk, Anjoeka; Loh, Miranda; Kuijpers, Eelco; Albin, Maria; Selander, Jenny; Godderis, Lode; Ghosh, Manosij; Vermeulen, Roel; Peters, Susan; Mehlum, Ingrid Sivesind; Turner, Michelle C; Schlünssen, Vivi; Goldberg, Marcel; Kogevinas, Manolis; Harding, Barbara N; Solovieva, Svetlana; Garani-Papadatos, Tina; Tongeren, Martie; Consortium, EPHOR; Stierum, Rob
Applying the exposome concept to working life health: The EU EPHOR project Journal Article
In: Environ Epidemiol, vol. 6, no. 2, pp. e185, 2022.
@article{Pronk2022-pt,
title = {Applying the exposome concept to working life health: The EU
EPHOR project},
author = {Anjoeka Pronk and Miranda Loh and Eelco Kuijpers and Maria Albin and Jenny Selander and Lode Godderis and Manosij Ghosh and Roel Vermeulen and Susan Peters and Ingrid Sivesind Mehlum and Michelle C Turner and Vivi Schlünssen and Marcel Goldberg and Manolis Kogevinas and Barbara N Harding and Svetlana Solovieva and Tina Garani-Papadatos and Martie Tongeren and EPHOR Consortium and Rob Stierum},
year = {2022},
date = {2022-02-01},
journal = {Environ Epidemiol},
volume = {6},
number = {2},
pages = {e185},
abstract = {Exposures at work have a major impact on noncommunicable diseases
(NCDs). Current risk reduction policies and strategies are
informed by existing scientific evidence, which is limited due to
the challenges of studying the complex relationship between
exposure at work and outside work and health. We define the
working life exposome as all occupational and related
nonoccupational exposures. The latter includes nonoccupational
exposures that may be directly or indirectly influenced by or
interact with the working life of the individual in their
relation to health. The Exposome Project for Health and
Occupational Research aims to advance knowledge on the complex
working life exposures in relation to disease beyond the single
high exposure-single health outcome paradigm, mapping and
relating interrelated exposures to inherent biological pathways,
key body functions, and health. This will be achieved by
combining (1) large-scale harmonization and pooling of existing
European cohorts systematically looking at multiple exposures and
diseases, with (2) the collection of new high-resolution external
and internal exposure data. Methods and tools to characterize the
working life exposome will be developed and applied, including
sensors, wearables, a harmonized job exposure matrix (EuroJEM),
noninvasive biomonitoring, omics, data mining, and
(bio)statistics. The toolbox of developed methods and knowledge
will be made available to policy makers, occupational health
practitioners, and scientists. Advanced knowledge on working life
exposures in relation to NCDs will serve as a basis for
evidence-based and cost-effective preventive policies and
actions. The toolbox will also enable future scientists to
further expand the working life exposome knowledge base.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Exposures at work have a major impact on noncommunicable diseases
(NCDs). Current risk reduction policies and strategies are
informed by existing scientific evidence, which is limited due to
the challenges of studying the complex relationship between
exposure at work and outside work and health. We define the
working life exposome as all occupational and related
nonoccupational exposures. The latter includes nonoccupational
exposures that may be directly or indirectly influenced by or
interact with the working life of the individual in their
relation to health. The Exposome Project for Health and
Occupational Research aims to advance knowledge on the complex
working life exposures in relation to disease beyond the single
high exposure-single health outcome paradigm, mapping and
relating interrelated exposures to inherent biological pathways,
key body functions, and health. This will be achieved by
combining (1) large-scale harmonization and pooling of existing
European cohorts systematically looking at multiple exposures and
diseases, with (2) the collection of new high-resolution external
and internal exposure data. Methods and tools to characterize the
working life exposome will be developed and applied, including
sensors, wearables, a harmonized job exposure matrix (EuroJEM),
noninvasive biomonitoring, omics, data mining, and
(bio)statistics. The toolbox of developed methods and knowledge
will be made available to policy makers, occupational health
practitioners, and scientists. Advanced knowledge on working life
exposures in relation to NCDs will serve as a basis for
evidence-based and cost-effective preventive policies and
actions. The toolbox will also enable future scientists to
further expand the working life exposome knowledge base.
(NCDs). Current risk reduction policies and strategies are
informed by existing scientific evidence, which is limited due to
the challenges of studying the complex relationship between
exposure at work and outside work and health. We define the
working life exposome as all occupational and related
nonoccupational exposures. The latter includes nonoccupational
exposures that may be directly or indirectly influenced by or
interact with the working life of the individual in their
relation to health. The Exposome Project for Health and
Occupational Research aims to advance knowledge on the complex
working life exposures in relation to disease beyond the single
high exposure-single health outcome paradigm, mapping and
relating interrelated exposures to inherent biological pathways,
key body functions, and health. This will be achieved by
combining (1) large-scale harmonization and pooling of existing
European cohorts systematically looking at multiple exposures and
diseases, with (2) the collection of new high-resolution external
and internal exposure data. Methods and tools to characterize the
working life exposome will be developed and applied, including
sensors, wearables, a harmonized job exposure matrix (EuroJEM),
noninvasive biomonitoring, omics, data mining, and
(bio)statistics. The toolbox of developed methods and knowledge
will be made available to policy makers, occupational health
practitioners, and scientists. Advanced knowledge on working life
exposures in relation to NCDs will serve as a basis for
evidence-based and cost-effective preventive policies and
actions. The toolbox will also enable future scientists to
further expand the working life exposome knowledge base.
5.
Naoum, Vasiliki; Nomikos, Nikos; Naoum, Panagiota; Athanasakis, Kostas; Kyriopoulos, John
Self-medication in Greece: the financial impact from expanding the OTC market Journal Article
In: Int J Pharm Pract, vol. 29, no. 6, pp. 541–547, 2021.
@article{Naoum2021-xa,
title = {Self-medication in Greece: the financial impact from expanding
the OTC market},
author = {Vasiliki Naoum and Nikos Nomikos and Panagiota Naoum and Kostas Athanasakis and John Kyriopoulos},
year = {2021},
date = {2021-12-01},
journal = {Int J Pharm Pract},
volume = {29},
number = {6},
pages = {541--547},
address = {England},
abstract = {OBJECTIVES: To assess the financial impact of self-medication
enhancement through a potential expansion of the over-the-counter
(OTC) drug list in Greece. METHODS: An analysis consisting of two
scenarios was conducted. The first scenario estimated the
financial effects of hypothetically switching 5% of the volume
of the total sales of reimbursed drugs in Greece to OTC, while
the second scenario estimated the effects of switching to OTC the
total sales volume of a set of active substances (which are
currently reimbursed), facilitated by a consensus panel meeting.
The analysis was conducted from the third-party payer, individual
and societal perspectives. Data and costs refer to the year 2019.
KEY FINDINGS: Switching 5% of the volume of the total sales of
reimbursed drugs to OTC was estimated to lead to total annual
savings of 227.57 million euros. The annual savings from the
third-party payer, individual and societal perspectives were
estimated at 97.06 million euros, 91.81 million euros and 38.69
million euros, respectively. Switching the total sales volume of
the reimbursed drugs of the active substances which emerged from
the consensus panel meeting was estimated to lead to total annual
savings of 567.57 million euros. The annual savings for the
third-party payer, individuals and society were estimated at
232.91 million euros, 241.01 million euros and 93.65 million
euros, respectively. CONCLUSIONS: Although the present analysis
is model-based, and thus did not incorporate some potentially
significant parameters, it demonstrated the financial savings
which a potential expansion of the OTC drug list could produce
for the third-party payer, individuals and society in Greece.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: To assess the financial impact of self-medication
enhancement through a potential expansion of the over-the-counter
(OTC) drug list in Greece. METHODS: An analysis consisting of two
scenarios was conducted. The first scenario estimated the
financial effects of hypothetically switching 5% of the volume
of the total sales of reimbursed drugs in Greece to OTC, while
the second scenario estimated the effects of switching to OTC the
total sales volume of a set of active substances (which are
currently reimbursed), facilitated by a consensus panel meeting.
The analysis was conducted from the third-party payer, individual
and societal perspectives. Data and costs refer to the year 2019.
KEY FINDINGS: Switching 5% of the volume of the total sales of
reimbursed drugs to OTC was estimated to lead to total annual
savings of 227.57 million euros. The annual savings from the
third-party payer, individual and societal perspectives were
estimated at 97.06 million euros, 91.81 million euros and 38.69
million euros, respectively. Switching the total sales volume of
the reimbursed drugs of the active substances which emerged from
the consensus panel meeting was estimated to lead to total annual
savings of 567.57 million euros. The annual savings for the
third-party payer, individuals and society were estimated at
232.91 million euros, 241.01 million euros and 93.65 million
euros, respectively. CONCLUSIONS: Although the present analysis
is model-based, and thus did not incorporate some potentially
significant parameters, it demonstrated the financial savings
which a potential expansion of the OTC drug list could produce
for the third-party payer, individuals and society in Greece.
enhancement through a potential expansion of the over-the-counter
(OTC) drug list in Greece. METHODS: An analysis consisting of two
scenarios was conducted. The first scenario estimated the
financial effects of hypothetically switching 5% of the volume
of the total sales of reimbursed drugs in Greece to OTC, while
the second scenario estimated the effects of switching to OTC the
total sales volume of a set of active substances (which are
currently reimbursed), facilitated by a consensus panel meeting.
The analysis was conducted from the third-party payer, individual
and societal perspectives. Data and costs refer to the year 2019.
KEY FINDINGS: Switching 5% of the volume of the total sales of
reimbursed drugs to OTC was estimated to lead to total annual
savings of 227.57 million euros. The annual savings from the
third-party payer, individual and societal perspectives were
estimated at 97.06 million euros, 91.81 million euros and 38.69
million euros, respectively. Switching the total sales volume of
the reimbursed drugs of the active substances which emerged from
the consensus panel meeting was estimated to lead to total annual
savings of 567.57 million euros. The annual savings for the
third-party payer, individuals and society were estimated at
232.91 million euros, 241.01 million euros and 93.65 million
euros, respectively. CONCLUSIONS: Although the present analysis
is model-based, and thus did not incorporate some potentially
significant parameters, it demonstrated the financial savings
which a potential expansion of the OTC drug list could produce
for the third-party payer, individuals and society in Greece.
6.
Athanasakis, Kostas; Naoum, Vasiliki; Naoum, Panagiota; Nomikos, Nikos; Theodoratou, Dorina; Kyriopoulos, John
A 10-year economic analysis of HIV management in Greece: evidence of efficient resource allocation Journal Article
In: Curr Med Res Opin, vol. 38, no. 2, pp. 265–271, 2021.
@article{Athanasakis2021-cu,
title = {A 10-year economic analysis of HIV management in Greece:
evidence of efficient resource allocation},
author = {Kostas Athanasakis and Vasiliki Naoum and Panagiota Naoum and Nikos Nomikos and Dorina Theodoratou and John Kyriopoulos},
year = {2021},
date = {2021-12-01},
journal = {Curr Med Res Opin},
volume = {38},
number = {2},
pages = {265--271},
address = {England},
abstract = {OBJECTIVE: Human Immunodeficiency Virus (HIV) prevalence has
substantially increased over the years, leading to increased
direct medical costs. The aim of the present study was to assess
the long-term cost of HIV care in Greece incurred over the last
decade. METHODS: In order to assess the long-term cost of HIV
care, a cost analysis was undertaken for three discrete time
points (which reflect major changes in the HIV treatment
paradigm), incorporating the evolution of the cost of
pharmaceuticals, hospitalization, primary care visits and
diagnostic tests. The cost per life year gained (LYG) was also
estimated. RESULTS: Total cost of HIV care increased by 57% over
the last decade (€53.7 million in 2010 vs €84.5 million in 2019),
which can be mainly attributed to a 107% (5084 in 2010 vs.
10,523 in 2019) increase observed in the number of people living
with HIV (PLWH) under care. As a result, the cost per person on
treatment has decreased by 24.0% (€10,567 in 2010 vs €8032 in
2019). Lifetime cost was lower and life expectancy higher in 2019
compared to 2010, leading to a - €711 cost per LYG, suggesting
that the current treatment paradigm produces better health
outcomes at a lower cost compared to a decade ago, implying that
resources are used in a more efficient way. CONCLUSION: The paper
presents some evidence towards the direction that HIV management
in Greece can be considered efficient in both clinical and
financial terms, as it offers measurable clinical outcomes at
well-controlled, almost inelastic spending.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: Human Immunodeficiency Virus (HIV) prevalence has
substantially increased over the years, leading to increased
direct medical costs. The aim of the present study was to assess
the long-term cost of HIV care in Greece incurred over the last
decade. METHODS: In order to assess the long-term cost of HIV
care, a cost analysis was undertaken for three discrete time
points (which reflect major changes in the HIV treatment
paradigm), incorporating the evolution of the cost of
pharmaceuticals, hospitalization, primary care visits and
diagnostic tests. The cost per life year gained (LYG) was also
estimated. RESULTS: Total cost of HIV care increased by 57% over
the last decade (€53.7 million in 2010 vs €84.5 million in 2019),
which can be mainly attributed to a 107% (5084 in 2010 vs.
10,523 in 2019) increase observed in the number of people living
with HIV (PLWH) under care. As a result, the cost per person on
treatment has decreased by 24.0% (€10,567 in 2010 vs €8032 in
2019). Lifetime cost was lower and life expectancy higher in 2019
compared to 2010, leading to a - €711 cost per LYG, suggesting
that the current treatment paradigm produces better health
outcomes at a lower cost compared to a decade ago, implying that
resources are used in a more efficient way. CONCLUSION: The paper
presents some evidence towards the direction that HIV management
in Greece can be considered efficient in both clinical and
financial terms, as it offers measurable clinical outcomes at
well-controlled, almost inelastic spending.
substantially increased over the years, leading to increased
direct medical costs. The aim of the present study was to assess
the long-term cost of HIV care in Greece incurred over the last
decade. METHODS: In order to assess the long-term cost of HIV
care, a cost analysis was undertaken for three discrete time
points (which reflect major changes in the HIV treatment
paradigm), incorporating the evolution of the cost of
pharmaceuticals, hospitalization, primary care visits and
diagnostic tests. The cost per life year gained (LYG) was also
estimated. RESULTS: Total cost of HIV care increased by 57% over
the last decade (€53.7 million in 2010 vs €84.5 million in 2019),
which can be mainly attributed to a 107% (5084 in 2010 vs.
10,523 in 2019) increase observed in the number of people living
with HIV (PLWH) under care. As a result, the cost per person on
treatment has decreased by 24.0% (€10,567 in 2010 vs €8032 in
2019). Lifetime cost was lower and life expectancy higher in 2019
compared to 2010, leading to a - €711 cost per LYG, suggesting
that the current treatment paradigm produces better health
outcomes at a lower cost compared to a decade ago, implying that
resources are used in a more efficient way. CONCLUSION: The paper
presents some evidence towards the direction that HIV management
in Greece can be considered efficient in both clinical and
financial terms, as it offers measurable clinical outcomes at
well-controlled, almost inelastic spending.
7.
Voo, Teck Chuan; Smith, Maxwell J.; Mastroleo, Ignacio; Dawson, Angus; & COVID-19 Working Group, WHO Ethics
COVID-19 vaccination certificates and lifting public health and social measures: ethical considerations Journal Article
In: Eastern Mediterranean Health Journal, 2021.
@article{nokey,
title = {COVID-19 vaccination certificates and lifting public health and social measures: ethical considerations},
author = {Teck Chuan Voo and Maxwell J. Smith and Ignacio Mastroleo and Angus Dawson and WHO Ethics & COVID-19 Working Group},
doi = {http://doi.org/10.26719/emhj.22.023},
year = {2021},
date = {2021-11-29},
urldate = {2021-06-01},
journal = {Eastern Mediterranean Health Journal},
abstract = {Background: To reopen society, various countries are planning or have implemented differential public health and social measures (PHSMs) for COVID-19-vaccinated individuals, by exempting these individuals from some of these measures or restricting access to specific activities or services to them.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background: To reopen society, various countries are planning or have implemented differential public health and social measures (PHSMs) for COVID-19-vaccinated individuals, by exempting these individuals from some of these measures or restricting access to specific activities or services to them.
8.
Koulierakis, George; Dermatis, Anastasia; Vassilakou, Nair-Tonia; Pavi, Elpida; Zavras, Dimitris; Kyriopoulos, John
Determinants of healthy diet choices during austerity in Greece Journal Article
In: British Food Journal, 2021.
@article{Koulierakis2021,
title = {Determinants of healthy diet choices during austerity in Greece},
author = {George Koulierakis and Anastasia Dermatis and Nair-Tonia Vassilakou and Elpida Pavi and Dimitris Zavras and John Kyriopoulos},
url = {https://doi.org/10.1108/bfj-10-2020-0883},
doi = {10.1108/bfj-10-2020-0883},
year = {2021},
date = {2021-11-01},
journal = {British Food Journal},
publisher = {Emerald},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
9.
Scarf`o, Lydia; Karamanidou, Christina; Doubek, Michael; Garani-Papadatos, Tina; Didi, Jana; Pontikoglou, Charalampos; Ling, Julie; Payne, Cathy; Papadaki, Helen $A$; Rosenquist, Richard; Stavroyianni, Niki; Payne, Sheila; Ghia, Paolo; Natsiavas, Pantelis; Maramis, Christos; Stamatopoulos, Kostas
MyPal ADULT study protocol: a randomised clinical trial of the MyPal ePRO-based early palliative care system in adult patients with haematological malignancies Journal Article
In: BMJ Open, vol. 11, no. 11, pp. e050256, 2021.
@article{Scarfo2021-jm,
title = {MyPal ADULT study protocol: a randomised clinical trial of
the MyPal ePRO-based early palliative care system in adult
patients with haematological malignancies},
author = {Lydia Scarf`o and Christina Karamanidou and Michael Doubek and Tina Garani-Papadatos and Jana Didi and Charalampos Pontikoglou and Julie Ling and Cathy Payne and Helen $A$ Papadaki and Richard Rosenquist and Niki Stavroyianni and Sheila Payne and Paolo Ghia and Pantelis Natsiavas and Christos Maramis and Kostas Stamatopoulos},
year = {2021},
date = {2021-11-01},
journal = {BMJ Open},
volume = {11},
number = {11},
pages = {e050256},
abstract = {INTRODUCTION: The systematic collection of electronic
patient-reported outcome (ePRO) in the routine care of patients
with chronic haematological malignancies such as chronic
lymphocytic leukaemia (CLL) and myelodysplasia syndromes (MDS)
can constitute a very ambitious but worthwhile challenge. MyPal
is a Horizon 2020 Research & Innovation Action aiming to meet
this challenge and foster palliative care for patients with CLL
or MDS by leveraging ePRO systems to adapt to the personal needs
of patients and caregiver(s). METHODS AND ANALYSIS: In this
interventional randomised trial, 300 patients with CLL or MDS
will be recruited across Europe. Patients will be randomly allocated to early palliative care using the MyPal system (n=150)
versus standard care including general palliative care if needed (n=150). Patients in the experimental arm will be given access to
the MyPal digital health platform which consists of purposely
designed software available on smartphones and/or tablets. The
platform entails different functionalities including physical and
psychoemotional symptom reporting via regular questionnaire
completion, spontaneous self-reporting, motivational messages,
medication management and a personalised search engine for health
information. Data on patients' activity (daily steps and sleep
quality) will be automatically collected via wearable devices.
ETHICS AND DISSEMINATION: The integration of ePROs via mobile
applications has raised ethical concerns regarding inclusion
criteria, information provided to participants, free and
voluntary consent, and respect for their autonomy. These have
been carefully addressed by a multidisciplinary team. Data
processing, dissemination and exploitation of the study findings
will take place in full compliance with European Union data
protection law. A participatory design was adopted in the
development of the digital platform involving focus groups and
discussions with patients to identify needs and preferences. The
protocol was approved by the ethics committees of San Raffaele
(8/2020), Thessaloniki 'George Papanikolaou' Hospital (849),
Karolinska Institutet (20.10.2020), University General Hospital
of Heraklion (07/15.4.2020) and University of Brno
(01-120220/EK). TRIAL REGISTRATION NUMBER: NCT04370457.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: The systematic collection of electronic
patient-reported outcome (ePRO) in the routine care of patients
with chronic haematological malignancies such as chronic
lymphocytic leukaemia (CLL) and myelodysplasia syndromes (MDS)
can constitute a very ambitious but worthwhile challenge. MyPal
is a Horizon 2020 Research & Innovation Action aiming to meet
this challenge and foster palliative care for patients with CLL
or MDS by leveraging ePRO systems to adapt to the personal needs
of patients and caregiver(s). METHODS AND ANALYSIS: In this
interventional randomised trial, 300 patients with CLL or MDS
will be recruited across Europe. Patients will be randomly allocated to early palliative care using the MyPal system (n=150)
versus standard care including general palliative care if needed (n=150). Patients in the experimental arm will be given access to
the MyPal digital health platform which consists of purposely
designed software available on smartphones and/or tablets. The
platform entails different functionalities including physical and
psychoemotional symptom reporting via regular questionnaire
completion, spontaneous self-reporting, motivational messages,
medication management and a personalised search engine for health
information. Data on patients' activity (daily steps and sleep
quality) will be automatically collected via wearable devices.
ETHICS AND DISSEMINATION: The integration of ePROs via mobile
applications has raised ethical concerns regarding inclusion
criteria, information provided to participants, free and
voluntary consent, and respect for their autonomy. These have
been carefully addressed by a multidisciplinary team. Data
processing, dissemination and exploitation of the study findings
will take place in full compliance with European Union data
protection law. A participatory design was adopted in the
development of the digital platform involving focus groups and
discussions with patients to identify needs and preferences. The
protocol was approved by the ethics committees of San Raffaele
(8/2020), Thessaloniki 'George Papanikolaou' Hospital (849),
Karolinska Institutet (20.10.2020), University General Hospital
of Heraklion (07/15.4.2020) and University of Brno
(01-120220/EK). TRIAL REGISTRATION NUMBER: NCT04370457.
patient-reported outcome (ePRO) in the routine care of patients
with chronic haematological malignancies such as chronic
lymphocytic leukaemia (CLL) and myelodysplasia syndromes (MDS)
can constitute a very ambitious but worthwhile challenge. MyPal
is a Horizon 2020 Research & Innovation Action aiming to meet
this challenge and foster palliative care for patients with CLL
or MDS by leveraging ePRO systems to adapt to the personal needs
of patients and caregiver(s). METHODS AND ANALYSIS: In this
interventional randomised trial, 300 patients with CLL or MDS
will be recruited across Europe. Patients will be randomly allocated to early palliative care using the MyPal system (n=150)
versus standard care including general palliative care if needed (n=150). Patients in the experimental arm will be given access to
the MyPal digital health platform which consists of purposely
designed software available on smartphones and/or tablets. The
platform entails different functionalities including physical and
psychoemotional symptom reporting via regular questionnaire
completion, spontaneous self-reporting, motivational messages,
medication management and a personalised search engine for health
information. Data on patients' activity (daily steps and sleep
quality) will be automatically collected via wearable devices.
ETHICS AND DISSEMINATION: The integration of ePROs via mobile
applications has raised ethical concerns regarding inclusion
criteria, information provided to participants, free and
voluntary consent, and respect for their autonomy. These have
been carefully addressed by a multidisciplinary team. Data
processing, dissemination and exploitation of the study findings
will take place in full compliance with European Union data
protection law. A participatory design was adopted in the
development of the digital platform involving focus groups and
discussions with patients to identify needs and preferences. The
protocol was approved by the ethics committees of San Raffaele
(8/2020), Thessaloniki 'George Papanikolaou' Hospital (849),
Karolinska Institutet (20.10.2020), University General Hospital
of Heraklion (07/15.4.2020) and University of Brno
(01-120220/EK). TRIAL REGISTRATION NUMBER: NCT04370457.
10.
Naoum, Panagiota; Pavi, Elpida; Athanasakis, Kostas
Economic Evaluation of Digital Health Interventions in Palliative Care: A Systematic Review of the Literature Journal Article
In: Front Digit Health, vol. 3, pp. 730755, 2021.
@article{Naoum2021-ih,
title = {Economic Evaluation of Digital Health Interventions in Palliative
Care: A Systematic Review of the Literature},
author = {Panagiota Naoum and Elpida Pavi and Kostas Athanasakis},
year = {2021},
date = {2021-11-01},
journal = {Front Digit Health},
volume = {3},
pages = {730755},
abstract = {Introduction: Digital health interventions can facilitate the
provision of palliative care. However, the economic evaluation of
such interventions has not yet been a standard practice. The
present study aimed to identify the existing literature on the
particular subject. Methods: A systematic search was conducted in
six literature databases between 2010 and 2021: PubMed, Scopus,
DARE, NHS EED, Cochrane Database of Systematic Reviews, and
Cochrane Central Register of Controlled Trials. Methodological
quality was assessed with the Drummond Checklist. Results: The
search identified 423 publications, 66 of which were removed as
duplicates, resulting in 357 records to be screened by title and
abstract. Ten studies were subjected to full-text review and 3
were included in the analysis. The interventions of these studies
referred to video consultations and eHealth interventions for
symptom management. Overall, the digital health interventions
incurred lower costs compared with usual care or no intervention
and were considered cost saving and cost-effective. The
methodological quality of the studies was considered good.
Conclusion: The results of this systematic review indicate that
the use of digital health interventions has the potential to be
cost-effective in palliative care. However, applicability and
generalizability of the evidence is uncertain, mainly due to
methodological heterogeneity and scarcity of research.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Introduction: Digital health interventions can facilitate the
provision of palliative care. However, the economic evaluation of
such interventions has not yet been a standard practice. The
present study aimed to identify the existing literature on the
particular subject. Methods: A systematic search was conducted in
six literature databases between 2010 and 2021: PubMed, Scopus,
DARE, NHS EED, Cochrane Database of Systematic Reviews, and
Cochrane Central Register of Controlled Trials. Methodological
quality was assessed with the Drummond Checklist. Results: The
search identified 423 publications, 66 of which were removed as
duplicates, resulting in 357 records to be screened by title and
abstract. Ten studies were subjected to full-text review and 3
were included in the analysis. The interventions of these studies
referred to video consultations and eHealth interventions for
symptom management. Overall, the digital health interventions
incurred lower costs compared with usual care or no intervention
and were considered cost saving and cost-effective. The
methodological quality of the studies was considered good.
Conclusion: The results of this systematic review indicate that
the use of digital health interventions has the potential to be
cost-effective in palliative care. However, applicability and
generalizability of the evidence is uncertain, mainly due to
methodological heterogeneity and scarcity of research.
provision of palliative care. However, the economic evaluation of
such interventions has not yet been a standard practice. The
present study aimed to identify the existing literature on the
particular subject. Methods: A systematic search was conducted in
six literature databases between 2010 and 2021: PubMed, Scopus,
DARE, NHS EED, Cochrane Database of Systematic Reviews, and
Cochrane Central Register of Controlled Trials. Methodological
quality was assessed with the Drummond Checklist. Results: The
search identified 423 publications, 66 of which were removed as
duplicates, resulting in 357 records to be screened by title and
abstract. Ten studies were subjected to full-text review and 3
were included in the analysis. The interventions of these studies
referred to video consultations and eHealth interventions for
symptom management. Overall, the digital health interventions
incurred lower costs compared with usual care or no intervention
and were considered cost saving and cost-effective. The
methodological quality of the studies was considered good.
Conclusion: The results of this systematic review indicate that
the use of digital health interventions has the potential to be
cost-effective in palliative care. However, applicability and
generalizability of the evidence is uncertain, mainly due to
methodological heterogeneity and scarcity of research.
11.
Meyerheim, Marcel; Burns-Gebhart, Anna; Mirzaie, Kasra; Garani-Papadatos, Tina; Braun, Yvonne; Graf, Norbert
Challenges and Pitfalls for Implementing Digital Health Solutions in Clinical Studies in Europe Journal Article
In: Front Digit Health, vol. 3, pp. 730680, 2021.
@article{Meyerheim2021-qw,
title = {Challenges and Pitfalls for Implementing Digital Health Solutions
in Clinical Studies in Europe},
author = {Marcel Meyerheim and Anna Burns-Gebhart and Kasra Mirzaie and Tina Garani-Papadatos and Yvonne Braun and Norbert Graf},
year = {2021},
date = {2021-09-01},
journal = {Front Digit Health},
volume = {3},
pages = {730680},
abstract = {The increasing number of digital solutions developed for use in
clinical health care settings is accompanied by new challenges to
develop and conduct clinical studies that include eHealth
technologies. Clinical study implementation plans often disregard
or underestimate the necessity of additional administrative and
logistic tasks required at clinical sites as well as ethical
aspects to test digital solutions. Experiences made in the run-up
of an observational clinical feasibility study at three
international clinical sites in the framework of the MyPal
project (https://mypal-project.eu/) result in recommendations to
avoid delays and barriers in the planning of such prospective
studies in clinical and also palliative care for increased
efficiency.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The increasing number of digital solutions developed for use in
clinical health care settings is accompanied by new challenges to
develop and conduct clinical studies that include eHealth
technologies. Clinical study implementation plans often disregard
or underestimate the necessity of additional administrative and
logistic tasks required at clinical sites as well as ethical
aspects to test digital solutions. Experiences made in the run-up
of an observational clinical feasibility study at three
international clinical sites in the framework of the MyPal
project (https://mypal-project.eu/) result in recommendations to
avoid delays and barriers in the planning of such prospective
studies in clinical and also palliative care for increased
efficiency.
clinical health care settings is accompanied by new challenges to
develop and conduct clinical studies that include eHealth
technologies. Clinical study implementation plans often disregard
or underestimate the necessity of additional administrative and
logistic tasks required at clinical sites as well as ethical
aspects to test digital solutions. Experiences made in the run-up
of an observational clinical feasibility study at three
international clinical sites in the framework of the MyPal
project (https://mypal-project.eu/) result in recommendations to
avoid delays and barriers in the planning of such prospective
studies in clinical and also palliative care for increased
efficiency.
12.
Nomikos, Nikos; Naoum, Panagiota; Naoum, Vasiliki; Athanasakis, Kostas; Kyriopoulos, John; Pavi, Elpida
Individuals' personal characteristics associated with private health insurance policy possession in Greece Journal Article
In: Int J Health Plann Manage, vol. 37, no. 1, pp. 361–371, 2021.
@article{Nomikos2021-dk,
title = {Individuals' personal characteristics associated with private
health insurance policy possession in Greece},
author = {Nikos Nomikos and Panagiota Naoum and Vasiliki Naoum and Kostas Athanasakis and John Kyriopoulos and Elpida Pavi},
year = {2021},
date = {2021-09-01},
journal = {Int J Health Plann Manage},
volume = {37},
number = {1},
pages = {361--371},
address = {England},
abstract = {BACKGROUND: Possession of private health insurance has been
associated with personal and socioeconomic characteristics, such
as income and age. The objective of the present study is to
assess the individuals' personal characteristics associated with
private health insurance possession in Greece. METHODS: The data
used in the present analysis derived from the 'Health and
Welfare' survey conducted by the Hellenic National School of
Public Health in Greece and refer to year 2017. The sample of the
analysis consisted of 1,932 adults aged 18 years or older. $A$
binary logistic regression model was conducted, in order to
investigate the factors associated with private health insurance
possession. RESULTS: The factors that were found to be associated
with private health insurance possession were: area of residence;
Attica, family income level; 1,501€-2,000€, 2,001€+, absence of
chronic condition, occupation; employer/self-employed, absence of
public insurance, time since last health check-up; less than or
equal to 5 and more than 1 years ago, more than 5 years or never
and level of education; secondary, tertiary. CONCLUSIONS: Private
health insurance covers a low percent of the Greek population and
has a low contribution to private health spending, compared with
other countries. The personal characteristics that were found to
be associated with private health insurance possession in Greece
by the present study are in line with previous studies in other
countries. These results are expected to provide policy advice on
how to enhance coverage in order to reduce out-of-pocket
expenditure, which is considered high in Greece.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Possession of private health insurance has been
associated with personal and socioeconomic characteristics, such
as income and age. The objective of the present study is to
assess the individuals' personal characteristics associated with
private health insurance possession in Greece. METHODS: The data
used in the present analysis derived from the 'Health and
Welfare' survey conducted by the Hellenic National School of
Public Health in Greece and refer to year 2017. The sample of the
analysis consisted of 1,932 adults aged 18 years or older. $A$
binary logistic regression model was conducted, in order to
investigate the factors associated with private health insurance
possession. RESULTS: The factors that were found to be associated
with private health insurance possession were: area of residence;
Attica, family income level; 1,501€-2,000€, 2,001€+, absence of
chronic condition, occupation; employer/self-employed, absence of
public insurance, time since last health check-up; less than or
equal to 5 and more than 1 years ago, more than 5 years or never
and level of education; secondary, tertiary. CONCLUSIONS: Private
health insurance covers a low percent of the Greek population and
has a low contribution to private health spending, compared with
other countries. The personal characteristics that were found to
be associated with private health insurance possession in Greece
by the present study are in line with previous studies in other
countries. These results are expected to provide policy advice on
how to enhance coverage in order to reduce out-of-pocket
expenditure, which is considered high in Greece.
associated with personal and socioeconomic characteristics, such
as income and age. The objective of the present study is to
assess the individuals' personal characteristics associated with
private health insurance possession in Greece. METHODS: The data
used in the present analysis derived from the 'Health and
Welfare' survey conducted by the Hellenic National School of
Public Health in Greece and refer to year 2017. The sample of the
analysis consisted of 1,932 adults aged 18 years or older. $A$
binary logistic regression model was conducted, in order to
investigate the factors associated with private health insurance
possession. RESULTS: The factors that were found to be associated
with private health insurance possession were: area of residence;
Attica, family income level; 1,501€-2,000€, 2,001€+, absence of
chronic condition, occupation; employer/self-employed, absence of
public insurance, time since last health check-up; less than or
equal to 5 and more than 1 years ago, more than 5 years or never
and level of education; secondary, tertiary. CONCLUSIONS: Private
health insurance covers a low percent of the Greek population and
has a low contribution to private health spending, compared with
other countries. The personal characteristics that were found to
be associated with private health insurance possession in Greece
by the present study are in line with previous studies in other
countries. These results are expected to provide policy advice on
how to enhance coverage in order to reduce out-of-pocket
expenditure, which is considered high in Greece.
13.
Ubalde-Lopez, Monica; Garani-Papadatos, Tina; Scelo, Ghislaine; Casas, Maribel; Lissåker, Claudia; Peters, Susan; Nohr, Ellen Aagaard; Albin, Maria; Lucas, Raquel; Papantoniou, Kyriaki; Pola'nska, Kinga; Ramlau-Hansen, Cecilia H; Sarac, Jelena; Selander, Jenny; Skröder, Helena; Vasileiou, Elena; Kogevinas, Manolis; Bültmann, Ute; Mehlum, Ingrid Sivesind; Maule, Milena
Working life, health and well-being of parents: a joint effort to uncover hidden treasures in European birth cohorts Journal Article
In: Scand J Work Environ Health, vol. 47, no. 7, pp. 550–560, 2021.
@article{Ubalde-Lopez2021-ml,
title = {Working life, health and well-being of parents: a joint effort to
uncover hidden treasures in European birth cohorts},
author = {Monica Ubalde-Lopez and Tina Garani-Papadatos and Ghislaine Scelo and Maribel Casas and Claudia Lissåker and Susan Peters and Ellen Aagaard Nohr and Maria Albin and Raquel Lucas and Kyriaki Papantoniou and Kinga Pola'nska and Cecilia H Ramlau-Hansen and Jelena Sarac and Jenny Selander and Helena Skröder and Elena Vasileiou and Manolis Kogevinas and Ute Bültmann and Ingrid Sivesind Mehlum and Milena Maule},
year = {2021},
date = {2021-08-01},
journal = {Scand J Work Environ Health},
volume = {47},
number = {7},
pages = {550--560},
abstract = {OBJECTIVE: Birth cohorts collect valuable and under-utilized
information on employment and health of parents before and during
pregnancy, at birth, and sometimes after birth. In this
discussion paper, we examine how these data could be exploited to
study the complex relationships and interactions between
parenthood, work, and health among parents themselves. METHODS:
Using a web-based database of birth cohorts, we summarize
information on maternal employment and health conditions and
other potentially related variables in cohorts spread throughout
Europe. This provided information on what data are available and
could be used in future studies, and what was missing if specific
questions are to be addressed, exploiting the opportunity to
explore work-health associations across heterogenous geographical
and social contexts. RESULTS: We highlight the many
potentialities provided by birth cohorts and identify gaps that
need to be addressed to adopt a life-course approach and
investigate topics specific to the peri-pregnancy period, such as
psychosocial aspects. We address the technical difficulties
implied by data harmonization and the ethical challenges related
to the repurposing of data, and provide scientific, ecological
and economic arguments in favor of improving the value of data
already available as a result of a serious investment in human
and material resources. CONCLUSIONS: There is a hidden treasure
in birth cohorts that deserves to be brought out to study the
relationships between employment and health among working parents
in a time when the boundaries between work and life are being
stretched more than ever before.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: Birth cohorts collect valuable and under-utilized
information on employment and health of parents before and during
pregnancy, at birth, and sometimes after birth. In this
discussion paper, we examine how these data could be exploited to
study the complex relationships and interactions between
parenthood, work, and health among parents themselves. METHODS:
Using a web-based database of birth cohorts, we summarize
information on maternal employment and health conditions and
other potentially related variables in cohorts spread throughout
Europe. This provided information on what data are available and
could be used in future studies, and what was missing if specific
questions are to be addressed, exploiting the opportunity to
explore work-health associations across heterogenous geographical
and social contexts. RESULTS: We highlight the many
potentialities provided by birth cohorts and identify gaps that
need to be addressed to adopt a life-course approach and
investigate topics specific to the peri-pregnancy period, such as
psychosocial aspects. We address the technical difficulties
implied by data harmonization and the ethical challenges related
to the repurposing of data, and provide scientific, ecological
and economic arguments in favor of improving the value of data
already available as a result of a serious investment in human
and material resources. CONCLUSIONS: There is a hidden treasure
in birth cohorts that deserves to be brought out to study the
relationships between employment and health among working parents
in a time when the boundaries between work and life are being
stretched more than ever before.
information on employment and health of parents before and during
pregnancy, at birth, and sometimes after birth. In this
discussion paper, we examine how these data could be exploited to
study the complex relationships and interactions between
parenthood, work, and health among parents themselves. METHODS:
Using a web-based database of birth cohorts, we summarize
information on maternal employment and health conditions and
other potentially related variables in cohorts spread throughout
Europe. This provided information on what data are available and
could be used in future studies, and what was missing if specific
questions are to be addressed, exploiting the opportunity to
explore work-health associations across heterogenous geographical
and social contexts. RESULTS: We highlight the many
potentialities provided by birth cohorts and identify gaps that
need to be addressed to adopt a life-course approach and
investigate topics specific to the peri-pregnancy period, such as
psychosocial aspects. We address the technical difficulties
implied by data harmonization and the ethical challenges related
to the repurposing of data, and provide scientific, ecological
and economic arguments in favor of improving the value of data
already available as a result of a serious investment in human
and material resources. CONCLUSIONS: There is a hidden treasure
in birth cohorts that deserves to be brought out to study the
relationships between employment and health among working parents
in a time when the boundaries between work and life are being
stretched more than ever before.
14.
Athanasakis, Kostas; Igoumenidis, Michael; Boubouchairopoulou, Nadia; Vitsou, Elli; Kyriopoulos, John
Two Sides of the Same Coin? A Dual Multiple Criteria Decision Analysis of Novel Treatments Against Rheumatoid Arthritis in Physicians and Patients Journal Article
In: Clin Ther, vol. 43, no. 9, pp. 1547–1557, 2021.
@article{Athanasakis2021-je,
title = {Two Sides of the Same Coin? A Dual Multiple Criteria Decision
Analysis of Novel Treatments Against Rheumatoid Arthritis in
Physicians and Patients},
author = {Kostas Athanasakis and Michael Igoumenidis and Nadia Boubouchairopoulou and Elli Vitsou and John Kyriopoulos},
year = {2021},
date = {2021-08-01},
journal = {Clin Ther},
volume = {43},
number = {9},
pages = {1547--1557},
address = {United States},
abstract = {PURPOSE: Available treatment options for rheumatoid arthritis
(RA) differ in important aspects. In this sense, each RA
treatment option is accompanied by a spectrum of characteristics
that collectively constitute its comprehensive ``value,'' as
viewed from the physician's or the patient's perspective. The
objective of this study was to perform a multiple criteria
decision analysis of different RA treatments from the perspective
of physicians and patients and to outline the respective aspects
of value for each treatment METHODS: A literature review was performed for constructing a set of criteria (N = 8) for the
multiple criteria decision analysis. Workshops for the
elicitation of preferences occurred separately for physicians and
patients. A performance matrix was populated via 2 network
meta-analyses plus converged clinical opinion. Criteria were
hierarchically classified by application of pairwise comparisons,
and criteria weights were attributed by point allocation through
convergence of opinions. Performances in both panels were scored
by using a 100-point scale. A linear additive value function was
used for the calculation of total value estimates. FINDINGS: Both
panels provided their consensus. The hierarchical classification
of attributes from the physician perspective placed the highest
values on the criteria of severe adverse events, clinical
efficacy, route of administration, and cost per year for the
third-party payer. From the patient perspective, the highest
ranking criteria were clinical efficacy, severe adverse events,
percentage of patients remaining with the same targeted immune
modulator for 1 year (``drug survival''), and cost per year for
the third-party payer. IMPLICATIONS: In an era of multiple
options and varying preferences, RA treatments must be evaluated
by taking into consideration patients' preferences as well, as to
cover the full spectrum of value elements rather than simply
clinical outcomes. The results of this analysis show that
physicians and patients share similarities but also marked
differences in terms of the aspects of treatment that they
perceive as more valuable.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: Available treatment options for rheumatoid arthritis
(RA) differ in important aspects. In this sense, each RA
treatment option is accompanied by a spectrum of characteristics
that collectively constitute its comprehensive ``value,'' as
viewed from the physician's or the patient's perspective. The
objective of this study was to perform a multiple criteria
decision analysis of different RA treatments from the perspective
of physicians and patients and to outline the respective aspects
of value for each treatment METHODS: A literature review was performed for constructing a set of criteria (N = 8) for the
multiple criteria decision analysis. Workshops for the
elicitation of preferences occurred separately for physicians and
patients. A performance matrix was populated via 2 network
meta-analyses plus converged clinical opinion. Criteria were
hierarchically classified by application of pairwise comparisons,
and criteria weights were attributed by point allocation through
convergence of opinions. Performances in both panels were scored
by using a 100-point scale. A linear additive value function was
used for the calculation of total value estimates. FINDINGS: Both
panels provided their consensus. The hierarchical classification
of attributes from the physician perspective placed the highest
values on the criteria of severe adverse events, clinical
efficacy, route of administration, and cost per year for the
third-party payer. From the patient perspective, the highest
ranking criteria were clinical efficacy, severe adverse events,
percentage of patients remaining with the same targeted immune
modulator for 1 year (``drug survival''), and cost per year for
the third-party payer. IMPLICATIONS: In an era of multiple
options and varying preferences, RA treatments must be evaluated
by taking into consideration patients' preferences as well, as to
cover the full spectrum of value elements rather than simply
clinical outcomes. The results of this analysis show that
physicians and patients share similarities but also marked
differences in terms of the aspects of treatment that they
perceive as more valuable.
(RA) differ in important aspects. In this sense, each RA
treatment option is accompanied by a spectrum of characteristics
that collectively constitute its comprehensive ``value,'' as
viewed from the physician's or the patient's perspective. The
objective of this study was to perform a multiple criteria
decision analysis of different RA treatments from the perspective
of physicians and patients and to outline the respective aspects
of value for each treatment METHODS: A literature review was performed for constructing a set of criteria (N = 8) for the
multiple criteria decision analysis. Workshops for the
elicitation of preferences occurred separately for physicians and
patients. A performance matrix was populated via 2 network
meta-analyses plus converged clinical opinion. Criteria were
hierarchically classified by application of pairwise comparisons,
and criteria weights were attributed by point allocation through
convergence of opinions. Performances in both panels were scored
by using a 100-point scale. A linear additive value function was
used for the calculation of total value estimates. FINDINGS: Both
panels provided their consensus. The hierarchical classification
of attributes from the physician perspective placed the highest
values on the criteria of severe adverse events, clinical
efficacy, route of administration, and cost per year for the
third-party payer. From the patient perspective, the highest
ranking criteria were clinical efficacy, severe adverse events,
percentage of patients remaining with the same targeted immune
modulator for 1 year (``drug survival''), and cost per year for
the third-party payer. IMPLICATIONS: In an era of multiple
options and varying preferences, RA treatments must be evaluated
by taking into consideration patients' preferences as well, as to
cover the full spectrum of value elements rather than simply
clinical outcomes. The results of this analysis show that
physicians and patients share similarities but also marked
differences in terms of the aspects of treatment that they
perceive as more valuable.
15.
Zavras, Dimitris
Feeling Uncertainty during the Lockdown That Commenced in March 2020 in Greece Journal Article
In: International Journal of Environmental Research and Public Health, vol. 18, no. 10, pp. 5105, 2021.
@article{Zavras2021,
title = {Feeling Uncertainty during the Lockdown That Commenced in March 2020 in Greece},
author = {Dimitris Zavras},
url = {https://doi.org/10.3390/ijerph18105105},
doi = {10.3390/ijerph18105105},
year = {2021},
date = {2021-05-01},
journal = {International Journal of Environmental Research and Public Health},
volume = {18},
number = {10},
pages = {5105},
publisher = {MDPI AG},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
16.
Vardavas, Constantine; Nikitara, Katerina; Zisis, Konstantinos; Athanasakis, Kostas; Phalkey, Revati; Leonardi-Bee, Jo; Johnson, Helen; Tsolova, Svetla; Ciotti, Massimo; Suk, Jonathan E
Cost-effectiveness of emergency preparedness measures in response to infectious respiratory disease outbreaks: a systematic review and econometric analysis Journal Article
In: BMJ Open, vol. 11, no. 4, pp. e045113, 2021.
@article{Vardavas2021-do,
title = {Cost-effectiveness of emergency preparedness measures in response to infectious respiratory disease outbreaks: a systematic review and econometric analysis},
author = {Constantine Vardavas and Katerina Nikitara and Konstantinos Zisis and Kostas Athanasakis and Revati Phalkey and Jo Leonardi-Bee and Helen Johnson and Svetla Tsolova and Massimo Ciotti and Jonathan E Suk},
year = {2021},
date = {2021-04-01},
urldate = {2021-04-01},
journal = {BMJ Open},
volume = {11},
number = {4},
pages = {e045113},
abstract = {OBJECTIVES: Respiratory infectious disease outbreaks pose a
threat for loss of life, economic instability and social
disruption. We conducted a systematic review of published
econometric analyses to assess the direct and indirect costs of
infectious respiratory disease outbreaks that occurred between
2003 and 2019. SETTING: Respiratory infectious disease outbreaks
or public health preparedness measures or interventions
responding to respiratory outbreaks in OECD countries (excluding
South Korea and Japan) so as to assess studies relevant to the
European context. The cost-effectiveness of interventions was
assessed through a dominance ranking matrix approach. All cost
data were adjusted to the 2017 Euro, with interventions compared
with the null. We included data from 17 econometric studies.
PRIMARY AND SECONDARY OUTCOME MEASURES: Direct and indirect costs
for disease and preparedness and/or response or cost-benefit and
cost-utility were measured. RESULTS: Overall, the economic burden
of infectious respiratory disease outbreaks was found to be
significant to healthcare systems and society. Indirect costs
were greater than direct costs mainly due to losses of
productivity. With regard to non-pharmaceutical strategies,
prehospitalisation screening and the use of protective masks were
identified as both an effective strategy and cost-saving.
Community contact reduction was effective but had ambiguous
results for cost saving. School closure was an effective measure,
but not cost-saving in the long term. Targeted antiviral
prophylaxis was the most cost-saving and effective pharmaceutical
intervention. CONCLUSIONS: Our cost analysis results provide
evidence to policymakers on the cost-effectiveness of
pharmaceutical and non-pharmaceutical intervention strategies
which may be applied to mitigate or respond to infectious
respiratory disease outbreaks.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: Respiratory infectious disease outbreaks pose a
threat for loss of life, economic instability and social
disruption. We conducted a systematic review of published
econometric analyses to assess the direct and indirect costs of
infectious respiratory disease outbreaks that occurred between
2003 and 2019. SETTING: Respiratory infectious disease outbreaks
or public health preparedness measures or interventions
responding to respiratory outbreaks in OECD countries (excluding
South Korea and Japan) so as to assess studies relevant to the
European context. The cost-effectiveness of interventions was
assessed through a dominance ranking matrix approach. All cost
data were adjusted to the 2017 Euro, with interventions compared
with the null. We included data from 17 econometric studies.
PRIMARY AND SECONDARY OUTCOME MEASURES: Direct and indirect costs
for disease and preparedness and/or response or cost-benefit and
cost-utility were measured. RESULTS: Overall, the economic burden
of infectious respiratory disease outbreaks was found to be
significant to healthcare systems and society. Indirect costs
were greater than direct costs mainly due to losses of
productivity. With regard to non-pharmaceutical strategies,
prehospitalisation screening and the use of protective masks were
identified as both an effective strategy and cost-saving.
Community contact reduction was effective but had ambiguous
results for cost saving. School closure was an effective measure,
but not cost-saving in the long term. Targeted antiviral
prophylaxis was the most cost-saving and effective pharmaceutical
intervention. CONCLUSIONS: Our cost analysis results provide
evidence to policymakers on the cost-effectiveness of
pharmaceutical and non-pharmaceutical intervention strategies
which may be applied to mitigate or respond to infectious
respiratory disease outbreaks.
threat for loss of life, economic instability and social
disruption. We conducted a systematic review of published
econometric analyses to assess the direct and indirect costs of
infectious respiratory disease outbreaks that occurred between
2003 and 2019. SETTING: Respiratory infectious disease outbreaks
or public health preparedness measures or interventions
responding to respiratory outbreaks in OECD countries (excluding
South Korea and Japan) so as to assess studies relevant to the
European context. The cost-effectiveness of interventions was
assessed through a dominance ranking matrix approach. All cost
data were adjusted to the 2017 Euro, with interventions compared
with the null. We included data from 17 econometric studies.
PRIMARY AND SECONDARY OUTCOME MEASURES: Direct and indirect costs
for disease and preparedness and/or response or cost-benefit and
cost-utility were measured. RESULTS: Overall, the economic burden
of infectious respiratory disease outbreaks was found to be
significant to healthcare systems and society. Indirect costs
were greater than direct costs mainly due to losses of
productivity. With regard to non-pharmaceutical strategies,
prehospitalisation screening and the use of protective masks were
identified as both an effective strategy and cost-saving.
Community contact reduction was effective but had ambiguous
results for cost saving. School closure was an effective measure,
but not cost-saving in the long term. Targeted antiviral
prophylaxis was the most cost-saving and effective pharmaceutical
intervention. CONCLUSIONS: Our cost analysis results provide
evidence to policymakers on the cost-effectiveness of
pharmaceutical and non-pharmaceutical intervention strategies
which may be applied to mitigate or respond to infectious
respiratory disease outbreaks.
17.
Meyerheim, Marcel; Karamanidou, Christina; Payne, Sheila; Garani-Papadatos, Tina; Sander, Annette; Downing, Julia; Stamatopoulos, Kostas; Ling, J; Payne, Cathy; Scarf`o, Lydia; Lokaj, Petr; Maramis, Christos; Graf, Norbert
MyPal-Child study protocol: an observational prospective clinical feasibility study of the MyPal ePRO-based early palliative care digital system in paediatric oncology patients Journal Article
In: BMJ Open, vol. 11, no. 4, pp. e045226, 2021.
@article{Meyerheim2021-nz,
title = {MyPal-Child study protocol: an observational prospective
clinical feasibility study of the MyPal ePRO-based early
palliative care digital system in paediatric oncology patients},
author = {Marcel Meyerheim and Christina Karamanidou and Sheila Payne and Tina Garani-Papadatos and Annette Sander and Julia Downing and Kostas Stamatopoulos and J Ling and Cathy Payne and Lydia Scarf`o and Petr Lokaj and Christos Maramis and Norbert Graf},
year = {2021},
date = {2021-04-01},
journal = {BMJ Open},
volume = {11},
number = {4},
pages = {e045226},
abstract = {INTRODUCTION: Electronic patient-reported outcomes (ePROs) have
tremendous potential to optimise palliative and supportive care
for children with cancer, their families and healthcare
providers. Particularly, these children and their families are
subjected to multiple strains caused by the disease and its
treatment. The MyPal digital health platform is designed to
address these complex demands by offering pursuant ePRO-based
functionalities via two mobile applications, one developed for
children and the other for their parents. METHODS AND ANALYSIS:
In this observational prospective feasibility study, 100
paediatric oncology patients aged between 6 and 17 years and at
least one of their parents/legal guardians will be recruited at
three clinical sites in two European countries (Germany and Czech
Republic). They will use the mobile applications which are part
of the novel digital health platform. During a 6-month study
period, participants will complete various ePROs via the
applications addressing quality of life, satisfaction with care
and impact of the disease on the family at monthly intervals.
Additionally, priority-based symptom reporting is integrated into
a serious game for children. Outcomes that will be assessed
concern the feasibility and the evaluation of the newly designed
digital health platform to contribute to the evidence base of
clinical ePRO use in paediatric oncology and palliative care
process. ETHICS AND DISSEMINATION: The MyPal-Child study obtained
ethical approval from the Ethics Committee responsible for the
University of Saarland, that is, the Ärztekammer des
Saarlandes, the Ethics Committee of the Medical School Hannover
and the Ethics Committee of the University of Brno. Study results
will be disseminated through scientific publications,
presentations at international conferences, congresses and a
final report to the European Commission. General publicly
accessible information can be found on the project website
(www.mypal-project.eu) and social media. TRIAL REGISTRATION
NUMBERS: U1111-1251-0043, DRKS00021458, NCT04381221.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Electronic patient-reported outcomes (ePROs) have
tremendous potential to optimise palliative and supportive care
for children with cancer, their families and healthcare
providers. Particularly, these children and their families are
subjected to multiple strains caused by the disease and its
treatment. The MyPal digital health platform is designed to
address these complex demands by offering pursuant ePRO-based
functionalities via two mobile applications, one developed for
children and the other for their parents. METHODS AND ANALYSIS:
In this observational prospective feasibility study, 100
paediatric oncology patients aged between 6 and 17 years and at
least one of their parents/legal guardians will be recruited at
three clinical sites in two European countries (Germany and Czech
Republic). They will use the mobile applications which are part
of the novel digital health platform. During a 6-month study
period, participants will complete various ePROs via the
applications addressing quality of life, satisfaction with care
and impact of the disease on the family at monthly intervals.
Additionally, priority-based symptom reporting is integrated into
a serious game for children. Outcomes that will be assessed
concern the feasibility and the evaluation of the newly designed
digital health platform to contribute to the evidence base of
clinical ePRO use in paediatric oncology and palliative care
process. ETHICS AND DISSEMINATION: The MyPal-Child study obtained
ethical approval from the Ethics Committee responsible for the
University of Saarland, that is, the Ärztekammer des
Saarlandes, the Ethics Committee of the Medical School Hannover
and the Ethics Committee of the University of Brno. Study results
will be disseminated through scientific publications,
presentations at international conferences, congresses and a
final report to the European Commission. General publicly
accessible information can be found on the project website
(www.mypal-project.eu) and social media. TRIAL REGISTRATION
NUMBERS: U1111-1251-0043, DRKS00021458, NCT04381221.
tremendous potential to optimise palliative and supportive care
for children with cancer, their families and healthcare
providers. Particularly, these children and their families are
subjected to multiple strains caused by the disease and its
treatment. The MyPal digital health platform is designed to
address these complex demands by offering pursuant ePRO-based
functionalities via two mobile applications, one developed for
children and the other for their parents. METHODS AND ANALYSIS:
In this observational prospective feasibility study, 100
paediatric oncology patients aged between 6 and 17 years and at
least one of their parents/legal guardians will be recruited at
three clinical sites in two European countries (Germany and Czech
Republic). They will use the mobile applications which are part
of the novel digital health platform. During a 6-month study
period, participants will complete various ePROs via the
applications addressing quality of life, satisfaction with care
and impact of the disease on the family at monthly intervals.
Additionally, priority-based symptom reporting is integrated into
a serious game for children. Outcomes that will be assessed
concern the feasibility and the evaluation of the newly designed
digital health platform to contribute to the evidence base of
clinical ePRO use in paediatric oncology and palliative care
process. ETHICS AND DISSEMINATION: The MyPal-Child study obtained
ethical approval from the Ethics Committee responsible for the
University of Saarland, that is, the Ärztekammer des
Saarlandes, the Ethics Committee of the Medical School Hannover
and the Ethics Committee of the University of Brno. Study results
will be disseminated through scientific publications,
presentations at international conferences, congresses and a
final report to the European Commission. General publicly
accessible information can be found on the project website
(www.mypal-project.eu) and social media. TRIAL REGISTRATION
NUMBERS: U1111-1251-0043, DRKS00021458, NCT04381221.
18.
Naoum, Panagiota; Palioura, Sotiria; Naoum, Vasiliki; Nomikos, Nikos; Bachtalia, Konstantina; Zisis, Konstantinos; Athanasakis, Kostas; Kyriopoulos, John
Cost-Benefit Analysis of Single versus Repeated Use of Single-Use Devices in Cataract Surgery Journal Article
In: Clin Ophthalmol, vol. 15, pp. 1491–1501, 2021.
@article{Naoum2021-zj,
title = {Cost-Benefit Analysis of Single versus Repeated Use of
Single-Use Devices in Cataract Surgery},
author = {Panagiota Naoum and Sotiria Palioura and Vasiliki Naoum and Nikos Nomikos and Konstantina Bachtalia and Konstantinos Zisis and Kostas Athanasakis and John Kyriopoulos},
year = {2021},
date = {2021-04-01},
journal = {Clin Ophthalmol},
volume = {15},
pages = {1491--1501},
abstract = {PURPOSE: To estimate the net cost effect associated with the
real-world practice of repeated use of designated single-use
medical devices (SUDs) versus their proper single use in cataract
surgery in Greece. DESIGN: A cost-benefit analysis model was
constructed in the form of a decision tree. METHODS: A digital
expert panel was assembled in order to estimate the probabilities
of intraoperative and postoperative complications associated with
single and repeated use of SUDs. Unit costs for the management of
each complication were obtained from the official Greek
bulletins. A Monte Carlo-type sensitivity analysis was performed
to assess the robustness of the results. RESULTS: Based on the
probabilities of complications attained from the expert panel,
repeated use of SUDs is associated with a higher chance of
complications compared to single use, which results in higher
cost of complication management. Under the healthcare sector
perspective, the total expected cost per cataract surgery is
1,403.98€ (1,244.20€ the initial cost of cataract surgery plus
159.78€ the cost of adverse events) in the case of single use,
while for repeated use the total cost is 1,486.29€ (1,146.86€ +
339.43€, respectively) and, thus, repeated use of SUDs in
cataract surgery results in 82.31€ higher expected cost per
patient compared to their single use. Moreover, the societal
perspective analysis indicated even higher additional costs in
the case of SUD reuse (108.24€). CONCLUSION: Repeated use of SUDs
in cataract surgery is not appropriate, it jeopardizes patient
safety and carries a legal liability for the reuser. The present
study, which is the first to attach a monetary value to the
common yet questionable practice of SUD reuse, shows that it is
not cost beneficial. Therefore, it is expected that the results
will have implications in policy formulations to improve the
delivery of cataract healthcare.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: To estimate the net cost effect associated with the
real-world practice of repeated use of designated single-use
medical devices (SUDs) versus their proper single use in cataract
surgery in Greece. DESIGN: A cost-benefit analysis model was
constructed in the form of a decision tree. METHODS: A digital
expert panel was assembled in order to estimate the probabilities
of intraoperative and postoperative complications associated with
single and repeated use of SUDs. Unit costs for the management of
each complication were obtained from the official Greek
bulletins. A Monte Carlo-type sensitivity analysis was performed
to assess the robustness of the results. RESULTS: Based on the
probabilities of complications attained from the expert panel,
repeated use of SUDs is associated with a higher chance of
complications compared to single use, which results in higher
cost of complication management. Under the healthcare sector
perspective, the total expected cost per cataract surgery is
1,403.98€ (1,244.20€ the initial cost of cataract surgery plus
159.78€ the cost of adverse events) in the case of single use,
while for repeated use the total cost is 1,486.29€ (1,146.86€ +
339.43€, respectively) and, thus, repeated use of SUDs in
cataract surgery results in 82.31€ higher expected cost per
patient compared to their single use. Moreover, the societal
perspective analysis indicated even higher additional costs in
the case of SUD reuse (108.24€). CONCLUSION: Repeated use of SUDs
in cataract surgery is not appropriate, it jeopardizes patient
safety and carries a legal liability for the reuser. The present
study, which is the first to attach a monetary value to the
common yet questionable practice of SUD reuse, shows that it is
not cost beneficial. Therefore, it is expected that the results
will have implications in policy formulations to improve the
delivery of cataract healthcare.
real-world practice of repeated use of designated single-use
medical devices (SUDs) versus their proper single use in cataract
surgery in Greece. DESIGN: A cost-benefit analysis model was
constructed in the form of a decision tree. METHODS: A digital
expert panel was assembled in order to estimate the probabilities
of intraoperative and postoperative complications associated with
single and repeated use of SUDs. Unit costs for the management of
each complication were obtained from the official Greek
bulletins. A Monte Carlo-type sensitivity analysis was performed
to assess the robustness of the results. RESULTS: Based on the
probabilities of complications attained from the expert panel,
repeated use of SUDs is associated with a higher chance of
complications compared to single use, which results in higher
cost of complication management. Under the healthcare sector
perspective, the total expected cost per cataract surgery is
1,403.98€ (1,244.20€ the initial cost of cataract surgery plus
159.78€ the cost of adverse events) in the case of single use,
while for repeated use the total cost is 1,486.29€ (1,146.86€ +
339.43€, respectively) and, thus, repeated use of SUDs in
cataract surgery results in 82.31€ higher expected cost per
patient compared to their single use. Moreover, the societal
perspective analysis indicated even higher additional costs in
the case of SUD reuse (108.24€). CONCLUSION: Repeated use of SUDs
in cataract surgery is not appropriate, it jeopardizes patient
safety and carries a legal liability for the reuser. The present
study, which is the first to attach a monetary value to the
common yet questionable practice of SUD reuse, shows that it is
not cost beneficial. Therefore, it is expected that the results
will have implications in policy formulations to improve the
delivery of cataract healthcare.
19.
Athanasakis, Kostas; Kyriopoulos, Ilias; Kyriopoulos, John
Can We Incorporate Societal Values in Resource Allocation Decisions Among Disease Categories? An Empirical Approach Journal Article
In: Value Health Reg Issues, vol. 25, pp. 29–36, 2021.
@article{Athanasakis2021-qb,
title = {Can We Incorporate Societal Values in Resource Allocation
Decisions Among Disease Categories? An Empirical Approach},
author = {Kostas Athanasakis and Ilias Kyriopoulos and John Kyriopoulos},
year = {2021},
date = {2021-02-01},
journal = {Value Health Reg Issues},
volume = {25},
pages = {29--36},
address = {United States},
abstract = {OBJECTIVES: Historically, resource allocation decisions in
healthcare are based on univariate approaches, inevitably
overlooking value dimensions that are essential from a societal
welfare maximization perspective. This article aims to present a
wider perspective on decision making that incorporates societal
values when prioritizing future resource allocation among disease
areas. METHODS: Sociotechnical application of multiple-criteria
decision analysis with a set of criteria (value judgments) that
are based on positive as well as normative dimensions of resource
allocation. We use Greece as a case study. Societal value
judgments were sourced via a multidisciplinary panel of experts
who collectively provided criteria weights and scores for each
alternative (16 disease categories, classified according to the
Global Burden of Disease study) against each criterion. An
additive value function provided the total value in priority
preference for each alternative. RESULTS: The criteria that were
deemed relevant to the decision-making process and their
respective relative weights were burden of disease (0.245),
capacity to benefit (0.190), direct cost and projected changes in
the next 5 years (0.160), indirect cost (0.132), intensity of
unmet needs (0.109), incidence of catastrophic expenditure
(0.091), and caring externalities (0.073). The additive value
function revealed that the top 5 priorities in highest total
value scores were neoplasms, circulatory diseases, injuries,
neurologic diseases, and musculoskeletal diseases. CONCLUSIONS:
Incorporation of societal value criteria in resource allocation
decisions can highlight priorities and lead to different sets of
planning decisions than solely demand-driven allocation.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: Historically, resource allocation decisions in
healthcare are based on univariate approaches, inevitably
overlooking value dimensions that are essential from a societal
welfare maximization perspective. This article aims to present a
wider perspective on decision making that incorporates societal
values when prioritizing future resource allocation among disease
areas. METHODS: Sociotechnical application of multiple-criteria
decision analysis with a set of criteria (value judgments) that
are based on positive as well as normative dimensions of resource
allocation. We use Greece as a case study. Societal value
judgments were sourced via a multidisciplinary panel of experts
who collectively provided criteria weights and scores for each
alternative (16 disease categories, classified according to the
Global Burden of Disease study) against each criterion. An
additive value function provided the total value in priority
preference for each alternative. RESULTS: The criteria that were
deemed relevant to the decision-making process and their
respective relative weights were burden of disease (0.245),
capacity to benefit (0.190), direct cost and projected changes in
the next 5 years (0.160), indirect cost (0.132), intensity of
unmet needs (0.109), incidence of catastrophic expenditure
(0.091), and caring externalities (0.073). The additive value
function revealed that the top 5 priorities in highest total
value scores were neoplasms, circulatory diseases, injuries,
neurologic diseases, and musculoskeletal diseases. CONCLUSIONS:
Incorporation of societal value criteria in resource allocation
decisions can highlight priorities and lead to different sets of
planning decisions than solely demand-driven allocation.
healthcare are based on univariate approaches, inevitably
overlooking value dimensions that are essential from a societal
welfare maximization perspective. This article aims to present a
wider perspective on decision making that incorporates societal
values when prioritizing future resource allocation among disease
areas. METHODS: Sociotechnical application of multiple-criteria
decision analysis with a set of criteria (value judgments) that
are based on positive as well as normative dimensions of resource
allocation. We use Greece as a case study. Societal value
judgments were sourced via a multidisciplinary panel of experts
who collectively provided criteria weights and scores for each
alternative (16 disease categories, classified according to the
Global Burden of Disease study) against each criterion. An
additive value function provided the total value in priority
preference for each alternative. RESULTS: The criteria that were
deemed relevant to the decision-making process and their
respective relative weights were burden of disease (0.245),
capacity to benefit (0.190), direct cost and projected changes in
the next 5 years (0.160), indirect cost (0.132), intensity of
unmet needs (0.109), incidence of catastrophic expenditure
(0.091), and caring externalities (0.073). The additive value
function revealed that the top 5 priorities in highest total
value scores were neoplasms, circulatory diseases, injuries,
neurologic diseases, and musculoskeletal diseases. CONCLUSIONS:
Incorporation of societal value criteria in resource allocation
decisions can highlight priorities and lead to different sets of
planning decisions than solely demand-driven allocation.
20.
Koulierakis, George; Dermatis, Anastasia; Vassilakou, Nair-Tonia; Pavi, Elpida; Zavras, Dimitris; Kyriopoulos, John
Determinants of healthy diet choices during austerity in Greece Journal Article
In: British Food Journal, 2021.
@article{Koulierakis2021DeterminantsOH,
title = {Determinants of healthy diet choices during austerity in Greece},
author = {George Koulierakis and Anastasia Dermatis and Nair-Tonia Vassilakou and Elpida Pavi and Dimitris Zavras and John Kyriopoulos},
year = {2021},
date = {2021-01-01},
urldate = {2021-01-01},
journal = {British Food Journal},
keywords = {},
pubstate = {published},
tppubtype = {article}
}