@article{Konerding2018-ie,

title = {Do Caregiver Characteristics Affect Caregiver Burden Differently 

 in Different Countries?},

author = {Uwe Konerding and Tom Bowen and Paul Forte and Eleftheria Karampli and Tomi Malmström and Elpida Pavi and Paulus Torkki and Elmar Graessel},

year  = {2018},

date = {2018-12-01},

journal = {Am J Alzheimers Dis Other Demen},

volume = {34},

number = {3},

pages = {148--152},

address = {United States},

abstract = {The relationships between caregiver burden as measured with the 

 Burden Scale for Family Caregivers-short form and 6 

 characteristics of caregivers caring for patients with dementia were investigated for caregivers from England (n = 36), Finland (n = 42), and Greece (n = 46) using survey data. In all 3 

 countries, caregiver burden increases with physical problems of 

 the caregiver, emotional problems of the caregiver, and weekly 

 hours of care. Hence, in all 3 countries, special support for 

 informal care is required when these characteristics are at high 

 levels. When the caregiver is a spouse or long-term partner of 

 the person with dementia, lives in the same house as this person, 

 or spends fewer than 20 h/wk for other duties than care, this is 

 associated with less caregiver burden in England but with more 

 caregiver burden in Greece. Accordingly, special support is 

 required for Greek caregivers with these characteristics, but the 

 opposite is true for English caregivers.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kostaras2018-lk,

title = {Vaccination against HPV virus: a systematic review of economic 

 evaluation studies for developed countries},

author = {Dimitris Kostaras and Eleftheria Karampli and Kostas Athanasakis},

year  = {2018},

date = {2018-12-01},

journal = {Expert Rev Pharmacoecon Outcomes Res},

volume = {19},

number = {2},

pages = {147--158},

address = {England},

abstract = {INTRODUCTION: During the last years, a significant number 

 economic evaluations of HPV vaccination has been published. Given 

 that cost-effectiveness constitutes an essential part of 

 decision-making with regards to the reimbursement of a health 

 technology, the purpose of this study is to provide a supportive 

 tool to decision-makers regarding the economic efficiency of the 

 introduction of HPV vaccination to national immunization 

 programs. AREAS COVERED: The PubMed database was searched in 

 order to identify cost-effectiveness studies for HPV vaccination. 

 A total of 42 articles were finally retrieved. All retrieved 

 cost-effectiveness ratios (ICERs) were converted in the same 

 currency unit (I$) and then inflated to the same year (2015) in 

 order to facilitate cross-country comparisons. RESULTS: Overall, 

 vaccination against HPV 6,11,16,18 types appears to have a ICER 

 with mean value of I$25132/QALY, whereas the mean ICER of 

 vaccination against oncogenic HPV 16,18 types is estimated at 

 I$38,253/QALY. EXPERT COMMENTARY: HPV vaccination would be a 

 cost-effective intervention in the setting of high-income 

 countries and could reduce the incidence of HPV-related diseases.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Tsironis2018-vn,

title = {Patterns of practice and pharmacoeconomic analysis of the  management of patients with metastatic renal cell carcinoma  (mRCC) in Greece--the CRISIS study. A retrospective analysis  by the Hellenic Genitourinary Cancer Group (HGUCG)},

author = {Georgiops Tsironis and Konstantinos Koutsoukos and Kostas Athanasakis and Anna Tsiara and Kimon Tzannis and Margarita Gerolympou and Anastasios Visvikis and Georgios Oikonomopoulos and Alexandra Kollia and Efstathia Giannopoulou and Marialena Dimitra and Efthymios Kostouros and Athanasios Papatsoris and Athanasios Dellis and Konstantinos Stravodimos and Ioannis Varkarakis and Epaminontas Samantas and Gerasimos Aravantinos and Nikolaos Kentepozidis and Christos Christodoulou and Vasiliki Bozionelou and Meletios Athanasios Dimopoulos and Aristotle Bamias},

year  = {2018},

date = {2018-11-01},

urldate = {2018-11-01},

journal = {Expert Rev Pharmacoecon Outcomes Res},

volume = {19},

number = {4},

pages = {491--501},

address = {England},

abstract = {Background:Metastatic RCC (mRCC) treatment has been 

 revolutionized with 11 approved targeted agents. We report 

 patterns of practice, outcomes and pharmacoeconomic analyses 

 after the introduction of targeted therapy. Patients and methods: 

 CRISIS was a retrospective multicenter study of mRCCpatients who 

 received targeted therapy . Results were related to the start of 

 1st-line therapy, with a cut off at 1 January 2011 in order to 

 depict the impact of increased availability of effective options. 

 Results: 164 patients, were included. 70.1% and 44.5% received 

 2nd and 3rd-line therapy, respectively. More patients were 

 treated in 2nd-line after 1 January 2011. After a median 

 follow-up of 55.1 months, median progression-free (PFS) and 

 overall survival (OS) were 10.7 (95% confidence intervals [CI]: 

 8.3-13.7), 7.3 (95% CI: 5.1-8.6), 5.8 (95% CI: 3.8-7.8) and 34 

 (95% CI: 28.5-39.8), 22.4 (95% CI: 16-32.1), 18.3 (95% CI: 

 12.4-26.4) months for first, second and third line, respectively. 

 Efficacy of sunitinib and pazopanib in 1st-line were similar. The 

 mean total cost/patient was 35,012.2 Euros (standard deviation 

 [SD]: 28,971.5). Conclusions: Our study confirms previous 

 real-world data suggesting that continuing advances in the 

 treatment of mRCC produce favorable outcomes in everyday 

 practice. Pharmacoeconomic analyses are important for 

 cost-effective utilization of emerging novel therapies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Beletsi2018-jr,

title = {Comparing Use of Health Technology Assessment in Pharmaceutical 

 Policy among Earlier and More Recent Adopters in the European 

 Union},

author = {Alexandra Beletsi and Vassiliki Koutrafouri and Eleftheria Karampli and Elpida Pavi},

year  = {2018},

date = {2018-10-01},

journal = {Value Health Reg Issues},

volume = {16},

pages = {81--91},

address = {United States},

abstract = {OBJECTIVES: To examine and compare the use of health technology 

 assessment (HTA) for the reimbursement of new medicines in 

 selected European Union member states with decades of experience 

 in the use of HTA and in countries that have used it regularly 

 since 2000. METHODS: The selected countries were categorized into 

 ``earlier'' adopters (group A: England, Germany, France, and 

 Sweden) and more ``recent'' adopters (group B: Poland, Bulgaria, 

 Hungary, and Romania). A systematic review of published 

 literature was performed. The analysis and comparison of HTA 

 procedures were done by using an analytical framework. RESULTS: 

 In all countries, the assessment criteria used include 

 effectiveness, safety, relative effectiveness, and economic data. 

 In group A countries, the main objectives are improving quality 

 of care, ensuring equal access, and efficient use of resources. 

 Group B countries have established HTA organizations with 

 official guidelines but often seek the decisions of other 

 developed countries. They place considerable emphasis on the 

 budget impact of new therapies, and HTA is also used as a cost 

 estimation tool for state budgets. CONCLUSIONS: HTA organizations 

 have been developed dynamically not only in high-income countries 

 but also in countries with limited resources. The experience and 

 evolution of both can be used by countries that are in the dawn 

 of creating an HTA organization.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kyriopoulos2018-ck,

title = {Are happy people healthier? An instrumental variable approach 

 using data from Greece},

author = {Ilias Kyriopoulos and Kostas Athanasakis and John Kyriopoulos},

year  = {2018},

date = {2018-07-01},

journal = {J Epidemiol Community Health},

volume = {72},

number = {12},

pages = {1153--1161},

address = {England},

abstract = {BACKGROUND: From a theoretical perspective, several studies 

 indicate that happiness and health are-in some 

 extent-interrelated. Despite the mechanisms explaining the 

 relationship between happiness and health, there is still no 

 consensus regarding this link. Using recently collected primary 

 data, this study aims to examine the relationship between 

 happiness and health, and identify potential heterogeneity in the 

 association depending on socioeconomic status (SES). METHODS: 

 This study draws on data from a nationally representative 

 cross-sectional survey, conducted by the Greek National School of 

 Public Health in 2015. We applied an instrumental variable (IV) 

 approach to address the endogeneity, arising from the 

 simultaneous determination of happiness and health. Controlling 

 for several confounders (ie, socioeconomic, demographic, 

 lifestyle, social capital variables) we employed several IV 

 models, including two-stage least squares, IV probit and 

 bivariate probit models. RESULTS: We report strong evidence of a 

 relationship between happiness and health. This association 

 remains strong after correcting for endogeneity, and is robust 

 across different specifications. Further, we find a positive 

 relationship between happiness and self-rated health (SRH) for 

 low educated, but not for high educated. Similarly, we find a 

 strong relationship between happiness and health for the lower 

 socioeconomic strata, but not for the higher ones. CONCLUSIONS: 

 Overall, we show that happiness is positively associated with 

 health. Further, happiness significantly influences SRH in 

 low-SES individuals, but this association wanes for the higher 

 socioeconomic strata. This finding has significant implications 

 for health promotion, prevention and public health, and suggests 

 that policymakers have a wider array of choices for improving 

 health and tackling health inequalities.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Tentolouris2018-xd,

title = {Prevalence of diabetes mellitus as well as cardiac and other main 

 comorbidities in a representative sample of the adult Greek 

 population in comparison with the general population},

author = {Anastasios Tentolouris and Ioanna Eleftheriadou and Kostas Athanasakis and John Kyriopoulos and Diamantis I Tsilimigras and Pinelopi Grigoropoulou and John Doupis and Nikolaos Tentolouris},

year  = {2018},

date = {2018-05-01},

journal = {Hellenic J Cardiol},

volume = {61},

number = {1},

pages = {15--22},

address = {Netherlands},

abstract = {BACKGROUND: Diabetes mellitus (DM) is the most common metabolic 

 disorder that increases the risk of cardiovascular disease by two 

 to four times compared with the general population. There are 

 limited data on the prevalence of heart diseases in subjects with 

 DM in Greece. In this study, we examined the prevalence of 

 self-reported DM as well as cardiac and other main comorbidities 

 in a representative sample of the adult Greek population. 

 METHODS: The target study population included 30,843 participants 

 stratified by gender, age, and district, and this was a 

 representative sample of the adult Greek population in 2010. A 

 structured questionnaire was built to report the prevalence of 

 self-reported DM and the main comorbidities in participants with 

 and without DM. Collection of data was performed through 

 telephone interviews. RESULTS: The prevalence of self-reported DM 

 was 6.6%. The prevalence of the main comorbidities in 

 participants with DM vs. those without DM was as follows: heart 

 diseases 24.0% vs. 8.9%, p<0.001; lung diseases 11.3% vs. 5.3%, p<0.001; kidney diseases 3.4% vs. 1.2},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Polaris_Observatory_Collaborators2018-xp,

title = {Global prevalence, treatment, and prevention of hepatitis B 

 virus infection in 2016: a modelling study},

author = {Polaris Observatory Collaborators},

year  = {2018},

date = {2018-03-01},

journal = {Lancet Gastroenterol Hepatol},

volume = {3},

number = {6},

pages = {383--403},

address = {Netherlands},

abstract = {BACKGROUND: The 69th World Health Assembly approved the Global 

 Health Sector Strategy to eliminate viral hepatitis by 2030. 

 Although no virological cure exists for hepatitis B virus (HBV) 

 infection, existing therapies to control viral replication and 

 prophylaxis to minimise mother-to-child transmission make 

 elimination of HBV feasible. We aimed to estimate the national, 

 regional, and global prevalence of HBsAg in the general 

 population and in the population aged 5 years in 2016, as well as 

 coverage of prophylaxis, diagnosis, and treatment. METHODS: In 

 this modelling study, we used a Delphi process that included a 

 literature review in PubMed and Embase, followed by interviews 

 with experts, to quantify the historical epidemiology of HBV 

 infection. We then used a dynamic HBV transmission and 

 progression model to estimate the country-level and 

 regional-level prevalence of HBsAg in 2016 and the effect of 

 prophylaxis and treatment on disease burden. FINDINGS: We 

 developed models for 120 countries, 78 of which were populated 

 with data approved by experts. Using these models, we estimated 

 that the global prevalence of HBsAg in 2016 was 3·9% (95% 

 uncertainty interval [UI] 3·4-4·6), corresponding to 291 992 000 

 (251 513 000-341 114 000) infections. Of these infections, around 

 29 million (10%) were diagnosed, and only 4·8 million (5%) of 

 94 million individuals eligible for treatment actually received 

 antiviral therapy. Around 1·8 (1·6-2·2) million infections were 

 in children aged 5 years, with a prevalence of 1·4% (1·2-1·6). 

 We estimated that 87% of infants had received the three-dose HBV 

 vaccination in the first year of life, 46% had received timely 

 birth-dose vaccination, and 13% had received hepatitis B 

 immunoglobulin along with the full vaccination regimen. Less than 

 1% of mothers with a high viral load had received antiviral 

 therapy to reduce mother-to-child transmission. INTERPRETATION: 

 Our estimate of HBV prevalence in 2016 differs from previous 

 studies, potentially because we took into account the effect of 

 infant prophylaxis and early childhood vaccination, as well as 

 changing prevalence over time. Although some regions are well on 

 their way to meeting prophylaxis and prevalence targets, all 

 regions must substantially scale-up access to diagnosis and 

 treatment to meet the global targets. FUNDING: John C Martin 

 Foundation.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Mahdavi2018-xz,

title = {The relationship between context, structure, and processes with 

 outcomes of 6 regional diabetes networks in Europe},

author = {Mahdi Mahdavi and Jan Vissers and Sylvia Elkhuizen and Mattees Dijk and Antero Vanhala and Eleftheria Karampli and Raquel Faubel and Paul Forte and Elena Coroian and Joris Klundert},

year  = {2018},

date = {2018-02-01},

journal = {PLoS One},

volume = {13},

number = {2},

pages = {e0192599},

abstract = {BACKGROUND: While health service provisioning for the chronic 

 condition Type 2 Diabetes (T2D) often involves a network of 

 organisations and professionals, most evidence on the 

 relationships between the structures and processes of service 

 provisioning and the outcomes considers single organisations or 

 solo practitioners. Extending Donabedian's 

 Structure-Process-Outcome (SPO) model, we investigate how 

 differences in quality of life, effective coverage of diabetes, 

 and service satisfaction are associated with differences in the 

 structures, processes, and context of T2D services in six regions 

 in Finland, Germany, Greece, Netherlands, Spain, and UK. METHODS: 

 Data collection consisted of: a) systematic modelling of provider 

 network's structures and processes, and b) a cross-sectional 

 survey of patient reported outcomes and other information. The 

 survey resulted in data from 1459 T2D patients, during 2011-2012. 

 Stepwise linear regression models were used to identify how 

 independent cumulative proportion of variance in quality of life 

 and service satisfaction are related to differences in context, 

 structure and process. The selected context, structure and 

 process variables are based on Donabedian's SPO model, a service 

 quality research instrument (SERVQUAL), and previous organization 

 and professional level evidence. Additional analysis deepens the 

 possible bidirectional relation between outcomes and processes. 

 RESULTS: The regression models explain 44% of variance in 

 service satisfaction, mostly by structure and process variables 

 (such as human resource use and the SERVQUAL dimensions). The 

 models explained 23% of variance in quality of life between the 

 networks, much of which is related to contextual variables. Our 

 results suggest that effectiveness of A1c control is negatively 

 correlated with process variables such as total hours of care 

 provided per year and cost of services per year. CONCLUSIONS: 

 While the selected structure and process variables explain much 

 of the variance in service satisfaction, this is less the case 

 for quality of life. Moreover, it appears that the effect of the 

 clinical outcome A1c control on processes is stronger than the 

 other way around, as poorer control seems to relate to more 

 service use, and higher cost. The standardized operational models 

 used in this research prove to form a basis for expanding the 

 network level evidence base for effective T2D service 

 provisioning.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Naoum2018-lg,

title = {Factors associated with the utilization of mammographic screening 

 in Greece},

author = {Panagiota Naoum and Anastasis Skroumpelos and Kostas Athanasakis and John Kyriopoulos},

year  = {2018},

date = {2018-01-01},

journal = {Eur J Cancer Prev},

volume = {27},

number = {1},

pages = {13--19},

address = {England},

abstract = {Breast cancer is the most commonly diagnosed type of cancer in 

 women and the primary cause of death by cancer in women globally. 

 Early diagnosis and treatment can be achieved through screening, 

 mainly mammographic; however, international experience has shown 

 that women do not attend mammographic screening adequately. The 

 aim of the present study was to investigate and assess the 

 factors that affect demand for mammography by women to improve 

 and enhance the use of mammography by women in Greece, especially 

 those in the 50-70 age group. The data used in the analysis were 

 extracted from the National Health Survey of 2009, conducted by 

 the Hellenic Statistical Authority. The sample for the analysis 

 included 2294 women aged 30-70 years. To investigate the factors 

 that affect mammography use, binary logistic regression models 

 were constructed for women in the 30-39, 40-49 and 50-70 age 

 groups. 61.70% of the sample had ever undergone a mammogram, 

 46.80% of which were during the last 12 months. Factors 

 associated with mammography use in at least one of the binary 

 logistic regression models were pap-test, blood cholesterol test, 

 level of education, income level and country of birth. In the 50-70 age group, income level [odds ratio (OR)=1.164; 95% confidence interval (CI)=1.038, 1.305], blood cholesterol test ever (OR=6.096; 95% CI=2.498, 14.872) and pap-test (OR=20.148; 95% CI=11.264, 36.040) were found to be statistically 

 significant predictors of mammography uptake. As mammography 

 utilization in Greece is mostly opportunistic, it is necessary to 

 organize screening provision to cover the majority of the 

 population through nationally organized screening programmes, 

 with a focus on women 50-70 years of age.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Athanasakis2017-lu,

title = {Cost-effectiveness of Ingenol Mebutate Gel for the Treatment of 

 Actinic Keratosis in Greece},

author = {Kostas Athanasakis and Nadia Boubouchairopoulou and Filippos Tarantilis and Vasiliki Tsiantou and Stathis Kontodimas and John Kyriopoulos},

year  = {2017},

date = {2017-04-01},

journal = {Clin Ther},

volume = {39},

number = {5},

pages = {993--1002},

address = {United States},

abstract = {PURPOSE: The present study aimed to perform a cost-effectiveness 

 analysis of ingenol mebutate (IM) versus other topical 

 alternatives for the treatment of actinic keratosis (AK). 

 METHODS: The analysis used a decision tree to calculate the 

 clinical effects and costs of AK first-line treatments, IM (2-3 

 days), diclofenac 3% (for 8 or 12 weeks), imiquimod 5% (for 4 

 or 8 weeks), during a 24-month horizon, using discrete intervals 

 of 6 months. A hypothetical cohort of immunocompetent adult 

 patients with clinically confirmed AK on the face and scalp or 

 trunk and extremities was considered. Clinical data on the 

 relative efficacy were obtained from a network meta-analysis. 

 Inputs concerning resource use derived from an expert panel. All 

 costs were calculated from a Greek third-party payer perspective. 

 FINDINGS: IM 0.015% and 0.05% were both cost-effective compared 

 with diclofenac and below a willingness-to-pay threshold of 

 €30,000 per quality-adjusted life-year (QALY) (€199 and €167 per 

 QALY, respectively). Comparing IM on the face and scalp AK 

 lesions for 3 days versus imiquimod for 4 weeks resulted in an 

 incremental cost-effectiveness ratio of €10,868 per QALY. IM was 

 dominant during the 8-week imiquimod period. IM use on the trunk 

 and extremities compared with diclofenac (8 or 12 weeks) led to 

 incremental cost-effectiveness ratios estimated at €1584 and 

 €1316 per QALY accordingly. Results remained robust to 

 deterministic and probabilistic sensitivity analyses. 

 IMPLICATIONS: From a social insurance perspective in Greece, IM 

 0.015% and IM 0.05% could be the most cost-effective first-line 

 topical field treatment options in all cases for AK treatment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{European_Union_HCV_Collaborators2017-le,

title = {Hepatitis C virus prevalence and level of intervention required 

 to achieve the WHO targets for elimination in the European 

 Union by 2030: a modelling study},

author = {European Union HCV Collaborators},

year  = {2017},

date = {2017-03-01},

journal = {Lancet Gastroenterol Hepatol},

volume = {2},

number = {5},

pages = {325--336},

address = {Netherlands},

abstract = {BACKGROUND: Hepatitis C virus (HCV) is a leading cause of 

 liver-related morbidity and mortality worldwide. In the European 

 Union (EU), treatment and cure of HCV with direct-acting 

 antiviral therapies began in 2014. WHO targets are to achieve a 

 65% reduction in liver-related deaths, a 90% reduction of new 

 viral hepatitis infections, and 90% of patients with viral 

 hepatitis infections being diagnosed by 2030. This study assessed 

 the prevalence of HCV in the EU and the level of intervention 

 required to achieve WHO targets for HCV elimination. METHODS: We 

 populated country Markov models for the 28 EU countries through a 

 literature search of PubMed and Embase between Jan 1, 2000, and 

 March 31, 2016, and a Delphi process to gain expert consensus and 

 validate inputs. We aggregated country models to create a 

 regional EU model. We used the EU model to forecast HCV disease 

 progression (considering the effect of immigration) and developed 

 a strategy to acehive WHO targets. We used weighted average 

 sustained viral response rates and fibrosis restrictions to model 

 the effect of current therapeutic guidelines. We used the EU 

 model to forecast HCV disease progression (considering the effect 

 of immigration) under current screening and therapeutic 

 guidelines. Additionally, we back-calculated the total number of 

 patients needing to be screened and treated to achieve WHO 

 targets. FINDINGS: We estimated the number of viraemic HCV 

 infections in 2015 to be 3 238 000 (95% uncertainty interval 

 [UI] 2 106 000-3 795 000) of a total population of 509 868 000 in 

 the EU, equating to a prevalence of viraemic HCV of 0·64% (95% 

 UI 0·41-0·74). We estimated that 1 180 000 (95% UI 1 003 000-1 

 357 000) people were diagnosed with viraemia (36·4%), 150 000 

 (12 000-180 000) were treated (4·6% of the total infected 

 population or 12·7% of the diagnosed population), 133 000 (106 

 000-160 000) were cured (4·1%), and 57 900 (43 900-67 300) were 

 newly infected (1·8%) in 2015. Additionally, 30 400 (26 600-42 

 500) HCV-positive immigrants entered the EU. To achieve WHO 

 targets, unrestricted treatment needs to increase from 150 000 

 patients in 2015 to 187 000 patients in 2025 and diagnosis needs 

 to increase from 88 800 new cases annually in 2015 to 180 000 in 

 2025. INTERPRETATION: Given its advanced health-care 

 infrastructure, the EU is uniquely poised to eliminate HCV; 

 however, expansion of screening programmes is essential to 

 increase treatment to achieve the WHO targets. A united effort, 

 grounded in sound epidemiological evidence, will also be 

 necessary. FUNDING: Gilead Sciences.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Petrakis2017-wm,

title = {Losing a foot versus losing a dollar; a systematic review of cost  studies in diabetic foot complications},

author = {Ioannis Petrakis and Ilias Kyriopoulos and Alexandros Ginis and Kostas Athanasakis},

year  = {2017},

date = {2017-03-01},

urldate = {2017-03-01},

journal = {Expert Rev Pharmacoecon Outcomes Res},

volume = {17},

number = {2},

pages = {165--180},

address = {England},

abstract = {Diabetes mellitus is a chronic disease with high prevalence 

 worldwide and a range of serious related complications. Amongst 

 them, diabetic foot is one of the most disabling, posing a 

 substantial health and economic burden on patients and healthcare 

 systems. Areas covered: According to projections, the expected 

 lower limb morbidity is about to increase - in this light the 

 present review aimed at identifying cost-of-illness studies on 

 the management and treatment of conditions related to the 

 diabetic foot, in an aim to provide a body of evidence for an 

 increasing health care burden. Expert commentary: Recent 

 literature review surfaced a plethora of cost studies. Despite 

 heterogeneity of foot complications and geographic variations, 

 the search methodology revealed substantial costs and further 

 healthcare burden for people with diabetes. Amputations due to 

 suboptimally treated foot infections contribute to the already 

 high rates of hospitalizations and readmissions. The cost of 

 amputation ranges between $35,000 and $45,000 in the developed 

 countries, however it largely depends on the amputation type. 

 Moreover, the findings suggest that the cost of amputation in the 

 US is generally higher compared to the cost in European 

 countries. The cost of amputation in developing countries is 

 substantially lower, as it approximates $5,000.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Charonis2017,

title = {Subjective social status, social network and health disparities: empirical evidence from Greece},

author = {Antonios Charonis and Ilias-Ioannis Kyriopoulos and Manos Spanakis and Dimitris Zavras and Kostas Athanasakis and Elpida Pavi and John Kyriopoulos},

url = {https://doi.org/10.1186/s12939-017-0533-y},

doi = {10.1186/s12939-017-0533-y},

year  = {2017},

date = {2017-02-01},

journal = {International Journal for Equity in Health},

volume = {16},

number = {1},

publisher = {Springer Science and Business Media LLC},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Intas2017,

title = {Information-Seeking Behavior of Greek Nursing Students},

author = {George Intas and Petros Kostagiolas and Dimitris Zavras and Eleftheria Chalari and Pantelis Stergiannis and Georgia Toylia and Dimitris Niakas},

url = {https://doi.org/10.1097/cin.0000000000000294},

doi = {10.1097/cin.0000000000000294},

year  = {2017},

date = {2017-02-01},

journal = {CIN: Computers, Informatics, Nursing},

volume = {35},

number = {2},

pages = {109--114},

publisher = {Ovid Technologies (Wolters Kluwer Health)},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Konerding2017-yy,

title = {The impact of travel distance, travel time and waiting time on 

 health-related quality of life of diabetes patients: An 

 investigation in six European countries},

author = {Uwe Konerding and Tom Bowen and Sylvia G Elkhuizen and Raquel Faubel and Paul Forte and Eleftheria Karampli and Mahdi Mahdavi and Tomi Malmström and Elpida Pavi and Paulus Torkki},

year  = {2017},

date = {2017-02-01},

journal = {Diabetes Res Clin Pract},

volume = {126},

pages = {16--24},

address = {Ireland},

abstract = {AIMS: The effects of travel distance and travel time to the 

 primary diabetes care provider and waiting time in the practice 

 on health-related quality of life (HRQoL) of patients with type 2 

 diabetes are investigated. RESEARCH DESIGN AND METHODS: Survey 

 data of 1313 persons with type 2 diabetes from six regions in 

 England (274), Finland (163), Germany (254), Greece (165), the 

 Netherlands (354), and Spain (103) were analyzed. Various 

 multiple linear regression analyses with four different EQ-5D-3L 

 indices (English, German, Dutch and Spanish index) as target 

 variables, with travel distance, travel time, and waiting time in 

 the practice as focal predictors and with control for study 

 region, patient's gender, patient's age, patient's education, 

 time since diagnosis, thoroughness of provider-patient 

 communication were computed. Interactions of regions with the 

 remaining five control variables and the three focal predictors 

 were also tested. RESULTS: There are no interactions of regions 

 with control variables or focal predictors. The indices decrease 

 with increasing travel time to the provider and increasing 

 waiting time in the provider's practice. CONCLUSIONS: HRQoL of 

 patients with type 2 diabetes might be improved by decreasing 

 travel time to the provider and waiting time in the provider's 

 practice.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Charonis2017-cm,

title = {Subjective social status, social network and health disparities: 

 empirical evidence from Greece},

author = {Antonios Charonis and Ilias-Ioannis Kyriopoulos and Manos Spanakis and Dimitris Zavras and Kostas Athanasakis and Elpida Pavi and John Kyriopoulos},

year  = {2017},

date = {2017-02-01},

journal = {Int J Equity Health},

volume = {16},

number = {1},

pages = {40},

abstract = {BACKGROUND: Several studies suggest that socioeconomic status 

 affects (SES) affects self-rated health (SRH), both in Greece and 

 internationally. However, prior research mainly uses objective 

 measures of SES, instead of subjective evaluations of 

 individuals' social status. Based on this, this paper aims to 

 examine (a) the impact of the economic dowturn on SRH in Greece 

 and (b) the relationship between subjective social status (SSS), 

 social network and SRH. METHODS: The descriptive analysis is 

 based on four cross-sectional surveys conducted by the National 

 School of Public Health, Athens, Greece (2002, 2006, 2011, 2015), 

 while the data for the empirical investigation were derived from 

 the 2015 survey (Health + Welfare Survey GR). The empirical 

 strategy is based on an ordinal logistic regression model, aiming 

 to examine how several variables affect SRH. Size of social 

 network and SSS are among the independent variables employed for 

 the empirical analysis RESULTS: According to our findings, 

 average SRH has deteriorated, and the percentage of the 

 population that reports very good/good SRH has also decreased. 

 Moreover, our empirical analysis suggests that age, existence of 

 a chronic disease, size of social network and SSS affect SRH in 

 Greece. CONCLUSION: Our findings are consistent with the existing 

 literature and confirm a social gradient in health. According to 

 our analysis, health disparities can be largely attributed to 

 socioeconomic inequalities. The adverse economic climate has 

 impact on socioeconomic differences which in turn affect health 

 disparities. Based on these, policy initiatives are necessasy in 

 order to mitigate the negative impact on health and the 

 disparities caused by economic dowturn and the occuring 

 socioeconomic inequalities.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Athanasakis2017-hv,

title = {The Socioeconomic Effects of Uncontrolled Hypertension},

author = {Kostas Athanasakis},

year  = {2017},

date = {2017-01-01},

journal = {Curr Vasc Pharmacol},

volume = {16},

number = {1},

pages = {5--9},

address = {United Arab Emirates},

abstract = {BACKGROUND: Hypertension (HT), albeit a modifiable risk factor of 

 cardiovascular morbidity and mortality, remains one of the main 

 contributors to the total disease burden internationally and, 

 thus, inevitably one of the basic cost drivers in healthcare 

 systems. CONCLUSION: Taking the above into account, this brief 

 narrative review aims at presenting the main findings of the 

 international health economics literature on HT with regards to 

 four key areas: a) the costs attributable to HT, b) the effects 

 of HT on patient well-being, c) the cost-effectiveness of 

 pharmaceutical interventions against high blood pressure, and, d) 

 the costs and benefits of preventive measures against HT. Bearing 

 in mind the available evidence on disease costs and the 

 efficiency of interventions, HT must constitute a primary 

 objective of modern health policy, internationally.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Balasopoulos2017-rx,

title = {Why do generic drugs fail to achieve an adequate market share in  Greece? Empirical findings and policy suggestions},

author = {T Balasopoulos and A Charonis and Kostas Athanasakis and John Kyriopoulos and Elpida Pavi},

year  = {2017},

date = {2017-01-01},

urldate = {2017-01-01},

journal = {Health Policy},

volume = {121},

number = {3},

pages = {265--272},

address = {Ireland},

abstract = {OBJECTIVES: Since 2010, the memoranda of understanding were 

 implemented in Greece as a measure of fiscal adjustment. Public 

 pharmaceutical expenditure was one of the main focuses of this 

 implementation. Numerous policies, targeted on pharma spending, 

 reduced the pharmaceutical budget by 60.5%. Yet, generics' 

 penetration in Greece remained among the lowest among OECD 

 countries. This study aims to highlight the factors that affect 

 the perceptions of the population on generic drugs and to suggest 

 effective policy measures. METHODOLOGY: The empirical analysis is 

 based on a national cross-sectional survey that was conducted 

 through a sample of 2003 individuals, representative of the 

 general population. Two ordinal logistic regression models were 

 constructed in order to identify the determinants that affect the 

 respondents' beliefs on the safety and the effectiveness of 

 generic drugs. FINDINGS: The empirical findings presented a 

 positive and statistically significant correlation with income, 

 bill payment difficulties, safety and effectiveness of drugs, 

 prescription and dispensing preferences and the views toward 

 pharmaceutical companies. Also, age and trust toward medical 

 community have a positive and statistically significant 

 correlation with the perception on the safety of generic drugs. 

 Policy interventions are suggested on the bases of the empirical 

 results on 3 major categories; (a) information campaigns, (b) 

 incentives to doctors and pharmacists and (c) to strengthen the 

 bioequivalence control framework and the dissemination of 

 results.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Konerding2016-vh,

title = {Investigating burden of informal caregivers in England, Finland 

 and Greece: an analysis with the short form of the Burden Scale 

 for Family Caregivers (BSFC-s)},

author = {Uwe Konerding and Tom Bowen and Paul Forte and Eleftheria Karampli and Tomi Malmström and Elpida Pavi and Paulus Torkki and Elmar Graessel},

year  = {2016},

date = {2016-10-01},

journal = {Aging Ment Health},

volume = {22},

number = {2},

pages = {280--287},

address = {England},

abstract = {OBJECTIVES: The burden of informal caregivers might show itself 

 in different ways in different cultures. Understanding these 

 differences is important for developing culture-specific measures 

 aimed at alleviating caregiver burden. Hitherto, no findings 

 regarding such cultural differences between different European 

 countries were available. In this paper, differences between 

 English, Finnish and Greek informal caregivers of people with 

 dementia are investigated. METHODS: A secondary analysis was 

 performed with data from 36 English, 42 Finnish and 46 Greek 

 caregivers obtained with the short form of the Burden Scale for 

 Family Caregivers (BSFC-s). The probabilities of endorsing the 

 BSFC-s items were investigated by computing a logit model with 

 items and countries as categorical factors. Statistically 

 significant deviation of data from this model was taken as 

 evidence for country-specific response patterns. RESULTS: The 

 two-factorial logit model explains the responses to the items 

 quite well (McFadden's pseudo-R-square: 0.77). There are, 

 however, also statistically significant deviations (p < 0.05). 

 English caregivers have a stronger tendency to endorse items 

 addressing impairments in individual well-being; Finnish 

 caregivers have a stronger tendency to endorse items addressing 

 the conflict between the demands resulting from care and demands 

 resulting from the remaining social life and Greek caregivers 

 have a stronger tendency to endorse items addressing impairments 

 in physical health. CONCLUSION: Caregiver burden shows itself 

 differently in English, Finnish and Greek caregivers. 

 Accordingly, measures for alleviating caregiver burden in these 

 three countries should address different aspects of the 

 caregivers' lives.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}