BackgroundThe European eHealthMonitor project (eHM) developed a user-sensitive and interactive web portal for dementia care: the eHM Dementia Portal (eHM-DP). It aims to provide targeted and personalized support for informal caregivers of people with dementia in a home-based care setting. The objective of the pilot study was to obtain feedback on the eHM-DP from two user perspectives (caregivers and medical professionals), focusing on caregiver empowerment, decision aid, and the perceived benefits of the eHM-DP.MethodsThe study on the eHM-DP was conducted from March 2014 to June 2014. The methodological approach followed a user-participatory design with a total number of 42 participants. The study included caregivers of people with dementia and medical professionals (MPs) from the metropolitan region of Erlangen-Nürnberg (Bavaria, Germany). Study participants were interviewed face-to-face with semi-structured, written interviews.ResultsCaregivers indicated a high degree of perceived support by the eHM-DP and of provided decision aid. In total, 89 % of caregivers and 54 % of MPs would use the eHM-DP if access were provided. The primary benefits participants perceived were the acquisition of individualized information, computerized interaction between caregivers and MPs, empowerment in health-related decisions and comprehensive insights into the progress of the disease. Major recommendations for improving the eHM-DP encompassed: an active search functionality based on predefined terms, the implementation of a chatroom for caregivers, an upload function and alerts for MPs, as well as the overall design.ConclusionsOur study is the first to have provided new insights and results on an interactive and needs-oriented web portal, endeavouring towards empowerment and assistance in decision making for caregivers as well as MPs within the realm of caring for patients with dementia. The acceptance and willingness to use the eHM-DP emphasizes the potential of eHealth services for community-based dementia care settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-015-0182-2) contains supplementary material, which is available to authorized users.
Objectives: Estimating resource use [RU] in real life is an important part of health economic evaluations. RU data should reflect how patients are actually treated. In MDD, RU data are mostly obtained from expert opinion. Variability in RU may lead to uncertainty in health economic evaluations, but few published studies report these data in the detail needed. The present analysis reports RU data by depression health state from an observational study. MethOds: PERFORM (Prospective Epidemiological Research on Functioning Outcomes Related to Major depressive disorder) is a 2-year prospective observational study conducted in 5 Western-European countries. Two-and six-month RU were estimated by health state: remitters, non-remitters, patients in relapse or not. RU included visits to different health care professionals, hospitalization and sick leave. Results are reported for the whole study population and are also available by country (including the UK, for which EQ5-D-derived utilities are also available) and for subgroups (e. g., patients who switched antidepressants at baseline). Results: Of the 819 analysable patients at 2 months, 29% were in remission. Among patients with at least one visit, the frequency of visits to general practitioners, psychiatrists and psychotherapists was consistently lower for remitters versus non-remitters (1.8 vs. 2.4, 2.2 vs. 2.4 and 2.6 vs. 3.1 respectively). Fourteen patients had at least one hospitalisation. Sick leave was less frequent (14% vs. 27%) and shorter (34 vs. 41 days) for remitters versus non-remitters respectively. At 6 months, 19.3% of patients relapsed. RU were higher with more visits to psychiatrists, psychotherapists (4.0 vs. 2.7, 7.8 vs. 5.5) for relapsed versus non-relapsed patients. cOnclusiOns: This first analysis provides European RU data in MDD. More information is expected at completion of the two-year follow-up and this study offers the possibility to describe RU by health states, countries and subgroups and assess their transferability to other countries.
Objectives: To describe medication use patterns and adherence rates for schizophrenia patients after initiating antipsychotic treatment in Tianjin, China. MethOds: Data were extracted from the Tianjin Urban Employee Basic Medical Insurance database (2008-2010). Adult patients with a schizophrenia diagnosis, newly initiating or restarting antipsychotics (no antipsychotics during previous 90 days) with 12-month continuous enrollment after their first observed antipsychotic prescription were included. Patients' medication prescribing patterns and antipsychotic adherence are described. Results: A total of 1216 patients were identified, with a mean (SD) age of 51.43 (12.48) years, 54.11% female. 83.14% of patients initiated with one antipsychotic and 16.86% with ≥ 2 antipsychotics. 37.99% of patients were initiated on typical antipsychotics, 52.06% on atypicals, and 9.95% on both. A higher portion of typical initiators were co-prescribed antianxiety and anticholinergic medications than atypical starters (both p< 0.001). During the following 12 months, the majority of patients remained on medications from their initial antipsychotic class (80.74% of typical initiators vs. 86.41% of atypical initiators) or the same medication (66.45% of typical initiators vs. 70.93% of atypical initiators). More typical initiators switched to, or augmented with, atypical antipsychotics than atypical initiators to/with typical antipsychotics (19.26% vs. 13.59%, P= 0.011). During the following 3, 6 and 12 months, antipsychotic continuation rates (≤ 30 days gap) were 50.33%, 23.60%, and 8.88%, respectively. Medication Possession Ratios were low, with means (SD) of 0.58 (0.32), 0.44 (0.30), and 0.34 (0.27) for the 3, 6 and 12 months, respectively. cOnclusiOns: More individuals with schizophrenia were treated with atypicals rather than typical antipsychotics. The majority of patients tended to stay with one antipsychotic drug class or the same medication. Patients' adherence to prescribed antipsychotics was low. This study highlights the importance of selecting an effective medication when starting antipsychotic therapy in China. However much could be done to improve treatment adherence. MUscUlar-skeletal disorders-clinical outcomes studies PMs1 tHe iMPact of coMorbidities on Utility cHanges in lower-liMb osteoartHritis : kHoala stUdy
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