582 research outputs found
Iolascon G, Capaldo A, Orlando V, Menditto E. Persistence with antiosteoporotic drugs: a retrospective population-based color study
No full textThe study of adherence to therapy is a field of study of particular relevant today. In chronic conditions, the adherence to therapy is never greater than 50% Which leads to an increase in both morbidity and mortality. The use of administrative databases represents an excellent tool for indirect measurement of levels of persistence to evaluate the effectiveness of therapy. Osteoporosis is a major cause of disability with high costs to the health service. Persistence to drug therapy of less than 6 months has absolutely no benefit to the patient. The analysis performed in Campania region by using retrospective health administrative databases confirms inadeguate persistence of therapy: about 70% of patients interrupt treatment at 6 months and only 14% are persistent after 1 year. Moreover, half of incident users are spot therapy. The greatest factor which influences persistence is the complexity of administration: Ibandronate and Risedronate which are taken monthly are the most compliant
Le strade della cittadinanza. Una riflessione tra benessere e migrazioni
No full textQuesto capitolo vuole articolare due riflessioni parallele sulla
cittadinanza, prima attraverso una disamina storica sul peso che il benessere e l’accesso
ai consumi hanno giocato a livello di legittimazione politica nell’Europa del
secondo dopoguerra; successivamente, con un’analisi di un discorso politico ufficiale
inerente al rapporto tra cittadini, immigrazione e criminalità. L’intento è di
complicare la relazione Stato-cittadini, facendo emergere l’intersezione tra il piano
economico-culturale in cui il benessere viene discusso e rinegoziato tra vari attori
sociali, e quello più apertamente politico legato al controllo di una parte della popolazione,
costituita dai residenti stranieri (illegittimi) e dalle relazioni conflittuali
che intercorrono tra questi, la comunità dei cittadini e le istituzioni statali
THU0474 Utilisation of anti-osteoporotic drugs in real-world data: an analysis of persistence to therapy and risk of fracture
No full textBackground Osteoporosis is a chronic progressive disease characterised by low bone mass and deterioration of bone structure, leading to an increate risk of fractures. It is a major public health problem, affecting hundreds of millions of people worldwide. The primary aim of pharmaceutical therapy is to reduce the risk of osteoporotic fractures. However, long-term adherence to therapy is requie for optimal therapeutic benefit for patients with osteoporosis. Poor adherence is considered to be one primary reason for suboptimal clinical benefit.
Objectives The aim of this study was to investigate the determinants of non-persistence and impact of persistence on the risk of fractures by using administrative databases.
Methods We conducted a retrospective cohort study using administrative data from four local health authorities in the Abruzzo Region (Central Italy), which comprise about 9 00 000 inhabitants (68% of the overall regional population). The final cohort consisted of a total of 7862 patients, aged ≥60 years, identified through records of filled prescriptions for an antiosteoporotic drug between January 1, 2006 to December 31, 2006. The primary outcome of this study was persistence at one year. Persistence was defined as the length of time (in days) from the date of the index prescription to the date of discontinuation therapy.
Results Kaplan – Meier analysis showed that 3733 patients (47.5%) were persistent with antiosteoporotic drugs after 1 year. An adjusted analysis showed that there is a big difference in persistence between women and men: women are more likely to be non-persistent than men (HR:1.94). Switcher patients were more likely to be non-persistent (HR:1.22). The odds of fracture were significantly higher for patients with previous fractures in comparison with those without previous fractures [OR, 1.70, (95% CI, 1.12–2.59)] (table 1)
Table 1 Logistic regression model: impact of persistence and other factors on the risk fracture
Conclusions Persistence with antiosteoporotic drugs is a significant predictor of incurring a fracture. For these reason, improving osteoporosis treatment compliance and persistence represents one of a major challenge for the future.
References [1] Casula M, Filippi A, Flacco E, Gambera M, Manzoli L, Menditto E, Orlando V, Piccinelli R, Tragni E, Catapano A. Assessment and potential determinats of compliance and persistence to anti-osteoporosis therapy in Italy. Am J Manag Care2014;20(5):e138-e145.
[2] Iolascon G, Gimigliano F, Orlando V, Capaldo A, Di Somma C, Menditto E. Osteoporosis drugs in real-world clinical practice: an analysis of persistence. Aging Clin Exp Res2013Oct;25 Suppl 1:S137–41
Calcium uptake in human spermatozoa: characterization and mechanisms
No full textBasal 45Ca2+ influx was analyzed in human seminal spermatozoa using a method that allows these highly reactive cells to be easily and safely handled. The uptake was a time-dependent process, with its maximum at 400 s. The kinetics of 45Ca2+ transport was saturating as a function of extracellular Ca2+ concentration with a Km of 429 μM and a V(max) of 1.6 nmol 45Ca2+/mg protein/2.5 min. Depolarizing conditions and the calcium channel blocker verapamil did not affect the uptake; based on this, the presence of operating calcium channels in seminal spermatozoa is excluded. The independence of 45Ca2+ uptake on external concentration of both Na+ and Ca2+ suggests that Na+/Ca2+ exchange does not occur in these cells. The anticalmodulin drug trifluoperazine, the mitochondrial inhibitor antimycin A, and the SH reagents N-ethylmaleimide and mersalyl all inhibited the ion transport. A calmodulin-regulated, energy-requiring, proteinaceous Ca2+ transporter seems to be the main operating mechanism of calcium uptake in human seminal gametes
Attività di monitoraggio delle prescrizioni farmaceutiche: la collaborazione tra il settore farmaceutico della Regione Campania e il Centro di Ricerca in Farmacoeconomia e Farmacoutilizzazione
No full textUTILIZATION OF ANTI-OSTEOPOROTIC DRUGS IN REAL-WORLD DATA: AN ANALYSIS OF PERSISTENCE TO THERAPY AND RISK OF FRACTURE
No full textBackground: Osteoporosis is a chronic progressive disease characterized by low bone mass and deterioration of bone structure,
leading to an increate risk of fractures. It is a major public health problem, affecting hundreds of millions of people worldwide. The
primary aim of pharmaceutical therapy is to reduce the risk of osteoporotic fractures. However, long-term adherence to therapy is
requie for optimal therapeutic benefit for patients with osteoporosis. Poor adherence is considered to be one primary reason for
suboptimal clinical benefit.
Objectives: The aim of this study was to investigate the determinants of non-persistence and impact of persistence on
the risk of fractures by using administrative databases.
Methods: We conducted a retrospective cohort study using administrative data from four local health authorities in the Abruzzo
Region (Central Italy), which comprise about 900,000 inhabitants (68% of the overall regional population). The final cohort consisted
of a total of 7,862 patients, aged >60 years, identified through records of filled prescriptions for an antiosteoporotic drug between
January 1, 2006 to December 31, 2006. The primary outcome of this study was persistence at one year. Persistence was defined as
the length of time (in days) from the date of the index prescription to the date of discontinuation therapy.
Results: Kaplan – Meier analysis showed that 3,733 patients (47.5%) were persistent with antiosteoporotic drugs after 1 year. An
adjusted analysis showed that there is a big difference in persistence between women and men: women are more likely to be nonpersistent
than men (HR:1.94). Switcher patients were more likely to be non-persistent (HR:1.22) . The odds of fracture were
significantly higher for patients with previous fractures in comparison with those without previous fractures [OR, 1.70, (95% CI, 1.12-
2.59)] (Table 1)
Image/graph:
Conclusions: Persistence with antiosteoporotic drugs is a significant predictor of incurring a fracture. For these reason, improving
osteoporosis treatment compliance and persistence represents one of a major challenge for the future.
References: Casula M, Filippi A, Flacco E, Gambera M, Manzoli L, Menditto E, Orlando V, Piccinelli R, Tragni E, Catapano A.
Assessment and potential determinats of compliance and persistence to anti-osteoporosis therapy in Italy. Am J Manag Care.
2014;20(5):e138-e145
Iolascon G, Gimigliano F, Orlando V, Capaldo A, Di Somma C, Menditto E. Osteoporosis drugs in real-world clinical practice: an
analysis of persistence. Aging Clin Exp Res. 2013 Oct;25 Suppl 1:S137-41
Disclosure of Interest: None declare
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