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Article: Metabolic complications of antiretroviral therapy.

Sweet, Donna E

Topics in HIV medicine : a publication of the International AIDS Society, USA

2005 Volume 13, Issue 2, Page(s) 70–74

Abstract: ... and changes in risk factors. This article summarizes a presentation by Donna E. Sweet, MD ...

Abstract	HIV-infected patients receiving long-term antiretroviral treatment experience a number of metabolic abnormalities, including lipid abnormalities, dysregulation of glucose metabolism, body-fat redistribution, mitochondrial abnormalities, and bone abnormalities, as well as the sequelae of these disorders. These complications can be severe and life threatening, disrupt adherence to antiretroviral therapy, limit options in therapy, and profoundly affect quality of life. Risk for such complications should be considered in selection of antiretroviral therapy, and patients should be monitored for the occurrence of abnormalities and changes in risk factors. This article summarizes a presentation by Donna E. Sweet, MD, on the metabolic complications of long-term antiretroviral therapy at the IAS-USA course in New York in March 2005.
MeSH term(s)	Anti-HIV Agents/adverse effects ; Blood Glucose/drug effects ; Bone Diseases/chemically induced ; Coronary Disease/etiology ; HIV Infections/complications ; HIV Infections/drug therapy ; HIV-Associated Lipodystrophy Syndrome/chemically induced ; Humans ; Hyperlipidemias/chemically induced ; Mitochondrial Diseases/chemically induced
Chemical Substances	Anti-HIV Agents ; Blood Glucose
Language	English
Publishing date	2005-06
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ISSN	1542-8826
ISSN	1542-8826
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Cost-Effectiveness of Single- Versus Generic Multiple-Tablet Regimens for Treatment of HIV-1 Infection in the United States.

Sweet, Donna E / Altice, Frederick L / Cohen, Calvin J / Vandewalle, Björn

PloS one

2016 Volume 11, Issue 1, Page(s) e0147821

Abstract: Background: The possibility of incorporating generics into combination antiretroviral therapy and breaking apart once-daily single-tablet regimens (STRs), may result in less efficacious medications and/or more complex regimens with the expectation of ... ...

Abstract	Background: The possibility of incorporating generics into combination antiretroviral therapy and breaking apart once-daily single-tablet regimens (STRs), may result in less efficacious medications and/or more complex regimens with the expectation of marked monetary savings. A modeling approach that assesses the merits of such policies in terms of lifelong costs and health outcomes using adherence and effectiveness data from real-world U.S. settings. Methods: A comprehensive computer-based microsimulation model was developed to assess the lifetime health (life expectancy and quality adjusted life-years--QALYs) and economic outcomes in HIV-1 infected patients initiating STRs compared with multiple-table regimens including generic medications where possible (gMTRs). The STRs considered included tenofovir disoproxil fumarate/emtricitabine and efavirenz or rilpivirine or elvitegravir/cobicistat. gMTRs substitutions included each counterpart to STRs, including generic lamivudine for emtricitabine and generic versus branded efavirenz. Results: Life expectancy is estimated to be 1.301 years higher (discounted 0.619 QALY gain) in HIV-1 patients initiating a single-tablet regimen in comparison to a generic-based multiple-table regimen. STRs were associated with an average increment of $26,547.43 per patient in medication and $1,824.09 in other medical costs due to longer survival which were partially offset by higher inpatients costs ($12,035.61) with gMTRs treatment. Overall, STRs presented incremental lifetime costs of $16,335.91 compared with gMTRs, resulting in an incremental cost-effectiveness ratio of $26,383.82 per QALY gained. Conclusions: STRs continue to represent good value for money under contemporary cost-effectiveness thresholds despite substantial price reductions of generic medications in the U. S.
MeSH term(s)	Adult ; Anti-HIV Agents/administration & dosage ; Anti-HIV Agents/economics ; CD4 Lymphocyte Count ; Drug Administration Schedule ; Female ; HIV Infections/drug therapy ; HIV-1 ; Humans ; Male ; Middle Aged ; Quality-Adjusted Life Years ; Tablets ; United States ; Viral Load
Chemical Substances	Anti-HIV Agents ; Tablets
Language	English
Publishing date	2016-01-25
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0147821
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Initial Antiretroviral Therapy: When and With What to Begin.

Sweet, Donna E.

Topics in HIV medicine : a publication of the International AIDS Society, USA

2002 Volume 10, Issue 5, Page(s) 4–9

Abstract: At the International AIDS Society-USA course in Denver in May 2002, Donna E. Sweet, MD, discussed ...

Abstract	At the International AIDS Society-USA course in Denver in May 2002, Donna E. Sweet, MD, discussed issues related to the ongoing question of when to initiate antiretroviral therapy in HIV-infected individuals and factors in selecting an initial drug regimen. Current treatment guidelines offer some consensus on the question of timing. Selection of the initial therapy focuses on the choice between regimens based on nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, or protease inhibitors.
Language	English
Publishing date	2002-11
Publishing country	United States
Document type	Journal Article
ISSN	2161-5845
ISSN (online)	2161-5845
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: An assessment of ten popular pregnancy applications (Apps) available for women in Australia.

Wanni Arachchige Dona, Sithara / Angeles, Mary Rose / Nguyen, Dieu / Cooper, Paul / Sweet, Linda / Peeters, Anna

International journal of medical informatics

2024 Volume 184, Page(s) 105354

Abstract: ... within Australia were assessed using the Deakin Health E-technologies Assessment Lab (HEAL) framework ...

Abstract	Objective: Given the growing popularity of health Apps, this study aimed to evaluate popular pregnancy Apps among Australian women. Design: Ten popular pregnancy mobile device Apps accessible within Australia were assessed using the Deakin Health E-technologies Assessment Lab (HEAL) framework, the Australian Privacy Principles (APP) and other context-specific criteria. Results: Most Apps were robust in use and user-friendly in terms of design. Based on the HEAL assessment, all the Apps scored between 70 and 89 out of 120. Only two of the ten Apps were locally hosted and operated. Only one App could search local health services using Victorian postcodes. All ten Apps were aligned with various privacy policy guidelines, but only one was reported to be fully aligned with the APP as it is locally hosted and operated. None of the Apps had accessibility features such as for visual or hearing difficulties. Only one App could be assessed as able to interface with the electronic medical record system in Australia due to a lack of publicly available information on this capability. Conclusions: Due to privacy concerns, pregnancy Apps accessible in Australia should be used with caution unless care is taken to select an App that fully complies with local requirements or international equivalents. All Apps were subjectively rated as moderate in quality, and more attention to accessibility and privacy features by App developers is recommended, along with the focus on integration with Australian digital health services.
MeSH term(s)	Humans ; Female ; Pregnancy ; Australia ; Telemedicine ; Mobile Applications ; Confidentiality ; Privacy
Language	English
Publishing date	2024-02-02
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	1466296-6
ISSN	1872-8243 ; 1386-5056
ISSN (online)	1872-8243
ISSN	1386-5056
DOI	10.1016/j.ijmedinf.2024.105354
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Article ; Online: Cost-Effectiveness of Single- Versus Generic Multiple-Tablet Regimens for Treatment of HIV-1 Infection in the United States.

Donna E Sweet / Frederick L Altice / Calvin J Cohen / Björn Vandewalle

PLoS ONE, Vol 11, Iss 1, p e

2016 Volume 0147821

Abstract: BACKGROUND:The possibility of incorporating generics into combination antiretroviral therapy and breaking apart once-daily single-tablet regimens (STRs), may result in less efficacious medications and/or more complex regimens with the expectation of ... ...

Abstract	BACKGROUND:The possibility of incorporating generics into combination antiretroviral therapy and breaking apart once-daily single-tablet regimens (STRs), may result in less efficacious medications and/or more complex regimens with the expectation of marked monetary savings. A modeling approach that assesses the merits of such policies in terms of lifelong costs and health outcomes using adherence and effectiveness data from real-world U.S. settings. METHODS:A comprehensive computer-based microsimulation model was developed to assess the lifetime health (life expectancy and quality adjusted life-years--QALYs) and economic outcomes in HIV-1 infected patients initiating STRs compared with multiple-table regimens including generic medications where possible (gMTRs). The STRs considered included tenofovir disoproxil fumarate/emtricitabine and efavirenz or rilpivirine or elvitegravir/cobicistat. gMTRs substitutions included each counterpart to STRs, including generic lamivudine for emtricitabine and generic versus branded efavirenz. RESULTS:Life expectancy is estimated to be 1.301 years higher (discounted 0.619 QALY gain) in HIV-1 patients initiating a single-tablet regimen in comparison to a generic-based multiple-table regimen. STRs were associated with an average increment of $26,547.43 per patient in medication and $1,824.09 in other medical costs due to longer survival which were partially offset by higher inpatients costs ($12,035.61) with gMTRs treatment. Overall, STRs presented incremental lifetime costs of $16,335.91 compared with gMTRs, resulting in an incremental cost-effectiveness ratio of $26,383.82 per QALY gained. CONCLUSIONS:STRs continue to represent good value for money under contemporary cost-effectiveness thresholds despite substantial price reductions of generic medications in the U. S.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Principles for Patient and Family Partnership in Care: An American College of Physicians Position Paper.

Nickel, Wendy K / Weinberger, Steven E / Guze, Phyllis A / Carney, Jan / Ende, Jack / Hoy, Elizabeth / Myerson, Sandra / Rothholz, Mitchel / Sands, Danny / Schneider, Doron / Sweeney, Jennifer M / Sweet, Donna E

Annals of internal medicine

2018 Volume 169, Issue 11, Page(s) 796–799

Abstract: In this position paper, the American College of Physicians (ACP) examines the rationale for patient and family partnership in care and reviews outcomes associated with this concept, including greater adherence to care plans, improved satisfaction, and ... ...

Abstract	In this position paper, the American College of Physicians (ACP) examines the rationale for patient and family partnership in care and reviews outcomes associated with this concept, including greater adherence to care plans, improved satisfaction, and lower costs. The paper also explores and acknowledges challenges associated with implementing patient- and family-centered models of care. On the basis of a comprehensive literature review and a multistakeholder vetting process, the ACP's Patient Partnership in Healthcare Committee developed a set of principles that form the foundation for authentic patient and family partnership in care. The principles position patients in their rightful place at the center of care while acknowledging the importance of partnership between the care team and patient in improving health care and reducing harm. The principles state that patients and families should be treated with dignity and respect, be active partners in all aspects of their care, contribute to the development and improvement of health care systems, and be partners in the education of health care professionals. This paper also recommends ways to implement these principles in daily practice.
MeSH term(s)	Humans ; Patient Care Team ; Patient Compliance ; Patient Participation ; Patient Satisfaction ; Patient-Centered Care/organization & administration ; Patient-Centered Care/standards ; Physician-Patient Relations ; Professional-Family Relations
Language	English
Publishing date	2018-11-27
Publishing country	United States
Document type	Journal Article ; Practice Guideline ; Research Support, Non-U.S. Gov't
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/M18-0018
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Article: Prevalence of communication disorders in HIV-infected adults.

Kallail, K James / Downs, David / Scherz, Julie / Sweet, Donna / Zackula, Rosalee E

Journal of the International Association of Providers of AIDS Care

2014 Volume 13, Issue 1, Page(s) 8–11

Abstract: Few adult patients with HIV/AIDS are evaluated for communication disorders. A broad inventory of the communication disorders was obtained in a convenience sample of 82 adult HIV/AIDS patients who presented for medical appointments. Each participant ... ...

Abstract	Few adult patients with HIV/AIDS are evaluated for communication disorders. A broad inventory of the communication disorders was obtained in a convenience sample of 82 adult HIV/AIDS patients who presented for medical appointments. Each participant underwent a head and neck exam and a communications skills evaluation. Speech, language, and cognition were assessed using a 10-item test battery. A 14-item hearing test battery was conducted in a separate session. The primary outcomes were the presence and degree of communication disorders. Head and neck exams revealed 40% with ear-related issues. Only 2 participants showed normal findings on all 24 communication skills assessments. Four demonstrated normal findings on all speech-language-cognitive assessments, whereas 8 had normal findings on the complete hearing test battery. A relatively high prevalence of cognitive and language deficits and central auditory disturbances were found. Clinicians must recognize the potential for communication deficits even in a relatively healthy patient with HIV.
MeSH term(s)	Adult ; Aged ; Communication Disorders/virology ; Cross-Sectional Studies ; Female ; HIV Infections/physiopathology ; Hearing Loss/virology ; Humans ; Male ; Middle Aged ; Prevalence
Language	English
Publishing date	2014-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2709037-1
ISSN	2325-9582 ; 2325-9574
ISSN (online)	2325-9582
ISSN	2325-9574
DOI	10.1177/2325957413510608
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: A clinical practice guideline from the American College of Physicians.

Qaseem, Amir / Hopkins, Robert H / Sweet, Donna E / Starkey, Melissa / Shekelle, Paul

Annals of internal medicine

2013 Volume 159, Issue 12, Page(s) 835–847

Abstract: Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the screening, monitoring, and treatment of adults with stage 1 to 3 chronic kidney disease.: Methods: This ...

Abstract	Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the screening, monitoring, and treatment of adults with stage 1 to 3 chronic kidney disease. Methods: This guideline is based on a systematic evidence review evaluating the published literature on this topic from 1985 through November 2011 that was identified by using MEDLINE and the Cochrane Database of Systematic Reviews. Searches were limited to English-language publications. The clinical outcomes evaluated for this guideline included all-cause mortality, cardiovascular mortality, myocardial infarction, stroke, chronic heart failure, composite vascular outcomes, composite renal outcomes, end-stage renal disease, quality of life, physical function, and activities of daily living. This guideline grades the evidence and recommendations by using ACP's clinical practice guidelines grading system. Recommendation 1: ACP recommends against screening for chronic kidney disease in asymptomatic adults without risk factors for chronic kidney disease. (Grade: weak recommendation, low-quality evidence) Recommendation 2: ACP recommends against testing for proteinuria in adults with or without diabetes who are currently taking an angiotensin-converting enzyme inhibitor or an angiotensin II-receptor blocker. (Grade: weak recommendation, low-quality evidence) Recommendation 3: ACP recommends that clinicians select pharmacologic therapy that includes either an angiotensin-converting enzyme inhibitor (moderate-quality evidence) or an angiotensin II-receptor blocker (high-quality evidence) in patients with hypertension and stage 1 to 3 chronic kidney disease. (Grade: strong recommendation) Recommendation 4: ACP recommends that clinicians choose statin therapy to manage elevated low-density lipoprotein in patients with stage 1 to 3 chronic kidney disease. (Grade: strong recommendation, moderate-quality evidence).
MeSH term(s)	Adult ; Angiotensin Receptor Antagonists/adverse effects ; Angiotensin Receptor Antagonists/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/adverse effects ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Antihypertensive Agents/adverse effects ; Antihypertensive Agents/therapeutic use ; Asymptomatic Diseases/therapy ; Disease Progression ; Drug Therapy, Combination ; Gemfibrozil/adverse effects ; Gemfibrozil/therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Hypolipidemic Agents/adverse effects ; Hypolipidemic Agents/therapeutic use ; Kidney/physiopathology ; Mass Screening ; Monitoring, Physiologic ; Proteinuria/diagnosis ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/drug therapy ; Renal Insufficiency, Chronic/physiopathology ; Risk Factors
Chemical Substances	Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Antihypertensive Agents ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypolipidemic Agents ; Gemfibrozil (Q8X02027X3)
Language	English
Publishing date	2013-10-18
Publishing country	United States
Document type	Journal Article ; Practice Guideline ; Research Support, Non-U.S. Gov't
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/0003-4819-159-12-201312170-00726
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Article ; Online: Oral pharmacologic treatment of type 2 diabetes mellitus: a clinical practice guideline from the American College of Physicians.

Qaseem, Amir / Humphrey, Linda L / Sweet, Donna E / Starkey, Melissa / Shekelle, Paul

Annals of internal medicine

2012 Volume 156, Issue 3, Page(s) 218–231

Abstract: Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the comparative effectiveness and safety of type 2 diabetes medications.: Methods: This guideline is based ... ...

Abstract	Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the comparative effectiveness and safety of type 2 diabetes medications. Methods: This guideline is based on a systematic evidence review evaluating literature published on this topic from 1966 through April 2010 that was identified by using MEDLINE (updated through December 2010), EMBASE, and the Cochrane Central Register of Controlled Trials. Searches were limited to English-language publications. The clinical outcomes evaluated for this guideline included all-cause mortality, cardiovascular morbidity and mortality, cerebrovascular morbidity, neuropathy, nephropathy, and retinopathy. This guideline grades the evidence and recommendations by using the American College of Physicians clinical practice guidelines grading system. RECOMMENDATION 1: ACP recommends that clinicians add oral pharmacologic therapy in patients diagnosed with type 2 diabetes when lifestyle modifications, including diet, exercise, and weight loss, have failed to adequately improve hyperglycemia (Grade: strong recommendation; high-quality evidence). RECOMMENDATION 2: ACP recommends that clinicians prescribe monotherapy with metformin for initial pharmacologic therapy to treat most patients with type 2 diabetes (Grade: strong recommendation; high-quality evidence). RECOMMENDATION 3: ACP recommends that clinicians add a second agent to metformin to treat patients with persistent hyperglycemia when lifestyle modifications and monotherapy with metformin fail to control hyperglycemia (Grade: strong recommendation; high-quality evidence).
MeSH term(s)	Administration, Oral ; Age Factors ; Cause of Death ; Comparative Effectiveness Research ; Diabetes Complications/mortality ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Diet, Reducing ; Drug Therapy, Combination ; Exercise Therapy ; Glycated Hemoglobin A/metabolism ; Humans ; Hyperglycemia/drug therapy ; Hypoglycemic Agents/administration & dosage ; Hypoglycemic Agents/adverse effects ; Hypoglycemic Agents/therapeutic use ; Lipids/blood ; Metformin/administration & dosage ; Metformin/adverse effects ; Metformin/therapeutic use ; Treatment Outcome ; Weight Loss
Chemical Substances	Glycated Hemoglobin A ; Hypoglycemic Agents ; Lipids ; Metformin (9100L32L2N)
Language	English
Publishing date	2012-02-07
Publishing country	United States
Document type	Journal Article ; Practice Guideline ; Research Support, Non-U.S. Gov't
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/0003-4819-156-3-201202070-00011
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Article ; Online: Screening for colorectal cancer: a guidance statement from the American College of Physicians.

Qaseem, Amir / Denberg, Thomas D / Hopkins, Robert H / Humphrey, Linda L / Levine, Joel / Sweet, Donna E / Shekelle, Paul

Annals of internal medicine

2012 Volume 156, Issue 5, Page(s) 378–386

Abstract: Description: Colorectal cancer is the second leading cause of cancer-related deaths for men and women in the United States. The American College of Physicians (ACP) developed this guidance statement for clinicians by assessing the current guidelines ... ...

Abstract	Description: Colorectal cancer is the second leading cause of cancer-related deaths for men and women in the United States. The American College of Physicians (ACP) developed this guidance statement for clinicians by assessing the current guidelines developed by other organizations on screening for colorectal cancer. When multiple guidelines are available on a topic or when existing guidelines conflict, ACP believes that it is more valuable to provide clinicians with a rigorous review of the available guidelines rather than develop a new guideline on the same topic. Methods: The authors searched the National Guideline Clearinghouse to identify guidelines developed in the United States. Four guidelines met the inclusion criteria: a joint guideline developed by the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology and individual guidelines developed by the Institute for Clinical Systems Improvement, the U.S. Preventive Services Task Force, and the American College of Radiology. GUIDANCE STATEMENT 1: ACP recommends that clinicians perform individualized assessment of risk for colorectal cancer in all adults. GUIDANCE STATEMENT 2: ACP recommends that clinicians screen for colorectal cancer in average-risk adults starting at the age of 50 years and in high-risk adults starting at the age of 40 years or 10 years younger than the age at which the youngest affected relative was diagnosed with colorectal cancer. GUIDANCE STATEMENT 3: ACP recommends using a stool-based test, flexible sigmoidoscopy, or optical colonoscopy as a screening test in patients who are at average risk. ACP recommends using optical colonoscopy as a screening test in patients who are at high risk. Clinicians should select the test based on the benefits and harms of the screening test, availability of the screening test, and patient preferences. GUIDANCE STATEMENT 4: ACP recommends that clinicians stop screening for colorectal cancer in adults over the age of 75 years or in adults with a life expectancy of less than 10 years.
MeSH term(s)	Adult ; Aged ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/prevention & control ; Early Detection of Cancer/methods ; Early Detection of Cancer/standards ; Female ; Humans ; Male ; Mass Screening/methods ; Mass Screening/standards ; Middle Aged ; Risk Factors ; United States
Language	English
Publishing date	2012-03-06
Publishing country	United States
Document type	Journal Article ; Practice Guideline ; Research Support, Non-U.S. Gov't
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/0003-4819-156-5-201203060-00010
Database	MEDical Literature Analysis and Retrieval System OnLINE

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