This qualitative study of travel-related risk behaviours of Slovene injection drug users was based on interviews with individuals enrolled in drug addiction treatment programmes run by three regional centres for prevention and treatment of drug addiction. The primary objective of the study was to analyse behaviour patterns and practices of injection drug users during travel.MethodsTravel-related problems of Slovene injection drug users were identified on the basis of data obtained by 25 in-depth interviews. A semi-structured questionnaire with 13 open-ended questions was developed after a preliminary study and review of the literature, and on the basis of experience with the treatment of drug addiction in Slovenia.ResultsThe sample comprised 25 individuals, 18 men and seven women, aged 25 to 53 years. The interviews were 10 to 30 minutes long. The results obtained were presented as identified risk behaviours. Five categories were generated, providing information on the following topics: procurement of illicit drugs, criminal acts/environment, HIV and hepatitis B and C infections, storage and transport of substitution medication and pre-travel health protection. The first three categories comprise the injection drug users' risk behaviours that are most frequently explored in the literature. The other two categories - storage and transport of medication across the border and pre-travel health protection - reflect national specificities and the effectiveness of substitution treatment programmes. The majority of participants denied having shared needles and other injecting equipment when travelling. Participants who had no doctor's certificate had recourse to various forms of risk behaviour, finding a number of ways to hide the medication at the border.ConclusionThis qualitative study provides insight into potential travel-related risk behaviour of injection drug users from two Slovene regions - central and coastal. The potential value of this qualitative study is primarily in the identification of potential risk behaviour of Slovene injection drug users travelling abroad. The study shows that injection drug users' experiences can contribute to better and more efficient treatment of drug addiction in Slovenia.

Izhodišče: Kazalniki predpisovanja zdravil so izbrani podatki, ki delno osvetljujejo zdravnikovo delo na področju predpisovanja zdravil. Zavod za zdravstveno zavarovanje Slovenije (ZZZS) je v sodelovanju s predstavniki pediatrične stroke pripravil nabor kazalnikov kakovosti predpisovanja zdravil na področju pediatrije. Pripravljena je analiza kazalnikov za petletno obdobje od leta 2014 – 2018.Metode: V retrospektivni, opazovalni raziskavi so bili analizirani podatki o predpisanih zdravilih otrokom do 19. leta starosti v Sloveniji in območnih enotah ZZZS (OE). Vir podatkov je Baza ambulantno predpisanih zdravil na ZZZS in na Nacionalnem inštitutu za javno zdravje. V analizo so bili vključeni podatki o ambulantno predpisanih zdravilih na zelenih in belih receptih. Poraba zdravil je prikazana glede na razvrstitev po anatomsko-terapevtsko-kemijski (ATC) klasifikaciji v definiranih dnevnih odmerkih (DDD). Pregledane so bile tudi podskupine zdravil znotraj ATC skupin. Podatki so prikazani tabelarično.Rezultati: Število izdanih receptov za standardizirano populacijo otrok v letih 2014 do 2018 se je v Sloveniji zmanjšalo za 3 %, ob tem pa je bilo predpisanih 9 % več DDD. Najvišji odstotek oseb, ki so prejele vsaj en recept za zdravila za sistemsko zdravljenje bakterijskih infekcij, je bil v OE Murska Sobota, 35 %. Sledijo OE Krško s 34,1 %, OE Ravne s 33,2 % in OE Novo mesto z 32 %. Najmanj oseb je zdravila prejelo v OE Nova Gorica – 21,1 %. Kazalnik KKP1, ki kaže povprečno ceno enote DDD vseh predpisanih zdravil v EUR, kaže padajoč trend za Slovenijo in velike razlike med OE. Glede na izhodiščno leto je v Sloveniji prišlo do zmanjšanja deleža otrok, ki so prejeli recept za antibiotik za 14 %. V OE Nova Gorica je to zmanjšanje kar 33 %.Zaključek: Predstavljeni kazalniki kažejo izboljšanje kakovosti predpisovanja zdravil pri otrocih zlasti na področju sistemskih antibiotikov. Menimo, da so kazalniki koristni tako za posamezne zdravnike kot za odločanje na nacionalni ravni in da lahko prispevajo k nadaljnjemu obvladovanju porabe protimikrobnih zdravil pri otrocih, kar je njihov osnovni namen.

No abstract

und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) assesses the benefits and harms of new drugs. IQWiG's guidelines specify that ratings of individual outcomes are based on the upper limit of confidence intervals thresholds of hazard ratio. In oncology, benefit in mortality typically drives the overall benefit, but other outcomes may also impact IQWIG's overall benefit rating. The objective was to identify what additional clinical outcomes may impact IQWIG's HTA decision-making in oncology. Oncology drug assessments from 2011-2018 were identified through the IQWiG website. Reported outcomes were reviewed in line with IQWiG's categorization overall survival (OS), safety, morbidity and HRQoL. The extent of benefit or harm of each individual outcome was correlated by category and subsequently to the overall benefit rating. 92 IQWIG oncology drug assessments covering 168 different subgroups were identified. In 116 of 168, the overall benefit rating matched the mortality benefit rating. For the 52 subgroups where overall ratings did not match mortality benefit rating, data on safety, morbidity and/or HRQoL drove a higher or lower benefit rating (18 and 34 subgroups, respectively). 'Major clinical benefits' in these outcome categories were correlated with a higher overall benefit rating as seen in 12 of the 18 subgroups with higher benefit ratings. Only for 1 subgroup did a 'major clinical benefit' not translate in a higher overall rating. In 5 out of 6 subgroups receiving a higher overall benefit rating without 'major clinical benefits', some extent of benefit in safety outcomes were identified. Mortality remains the main decision driver in IQWiG overall benefit rating for oncology. When no OS benefit can be demonstrated, or when additional data is available, a major benefit in safety, morbidity or HRQoL, is likely to lead a more favorable overall IQWiG rating.

No abstract