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  1. Article ; Online: Cost-effectiveness analysis of percutaneous coronary intervention for single-vessel coronary artery disease

    Christopher Rajkumar

    BMJ Open, Vol 11, Iss

    an economic evaluation of the ORBITA trial

    2021  Volume 2

    Abstract: Objective To evaluate the cost-effectiveness of percutaneous coronary intervention (PCI) compared with placebo in patients with single-vessel coronary artery disease and angina despite anti-anginal therapy.Design A cost-effectiveness analysis comparing ... ...

    Abstract Objective To evaluate the cost-effectiveness of percutaneous coronary intervention (PCI) compared with placebo in patients with single-vessel coronary artery disease and angina despite anti-anginal therapy.Design A cost-effectiveness analysis comparing PCI with placebo. A Markov model was used to measure incremental cost-effectiveness, in cost per quality-adjusted life-years (QALYs) gained, over 12 months. Health utility weights were estimated using responses to the EuroQol 5-level questionnaire, from the Objective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina trial and UK preference weights. Costs of procedures and follow-up consultations were derived from Healthcare Resource Group reference costs and drug costs from the National Health Service (NHS) drug tariff. Probabilistic sensitivity analysis was undertaken to test the robustness of results to parameter uncertainty. Scenario analyses were performed to test the effect on results of reduced pharmaceutical costs in patients undergoing PCI, and the effect of patients crossing over from placebo to PCI due to refractory angina within 12 months.Setting Five UK NHS hospitals.Participants 200 adult patients with stable angina and angiographically severe single-vessel coronary artery disease on anti-anginal therapy.Interventions At recruitment, patients received 6 weeks of optimisation of medical therapy for angina after which they were randomised to PCI or a placebo procedure.Outcome measures Incremental cost-effectiveness ratio (ICER) expressed as cost (in £) per QALY gained for PCI compared with placebo.Results The estimated ICER is £90 218/QALY gained when using PCI compared with placebo in patients receiving medical treatment for angina due to single-vessel coronary artery disease. Results were robust under sensitivity analyses.Conclusions The ICER for PCI compared with placebo, in patients with single-vessel coronary artery disease and angina on anti-anginal medication, exceeds the threshold of £30 000 used by ...
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2021-02-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Prevalence of multimorbidity among adults attending primary health care centres in Qatar

    Fathima Shezoon Mohideen / Prince Christopher Rajkumar Honest / Mohamed Ahmed Syed / Kirubah Vasandhi David / Jazeel Abdulmajeed / Neelima Ramireddy

    Journal of Family Medicine and Primary Care, Vol 10, Iss 5, Pp 1823-

    A retrospective cross-sectional study

    2021  Volume 1828

    Abstract: Context: Multimorbidity (MM) is a global concern following the increase in life expectancy, the conquering of major infectious diseases, and the advances in the management of chronic illnesses. It places a substantial burden on patients and healthcare ... ...

    Abstract Context: Multimorbidity (MM) is a global concern following the increase in life expectancy, the conquering of major infectious diseases, and the advances in the management of chronic illnesses. It places a substantial burden on patients and healthcare systems. Aims: This study aims to describe the prevalence and pattern of MM in adults among primary healthcare users in Qatar. Settings and Design: A retrospective cross-sectional study design. Methods and Material: Data were extracted from the electronic health records of patients aged 18 years and above who registered for care with 27 primary health centres in Qatar from 1st January 2017 to 30th June 2020. The distribution of MM among age groups, gender and nationality was analysed. Results: In the study population of 7,96,427, the prevalence of MM was found to be 22.1%. MM was more prevalent in females (51.2%) than males (48.8%). The prevalence of MM showed an increasing trend with increasing age, with a peak of 25.8% found in the 46–55 age group. Qatari nationals accounted for 32.7% of MM, Southeast Asians for 28.3%, North Africans for 16.7% and individuals from other Middle Eastern countries for 14.1%. The five most common long-term chronic conditions were type-2 diabetes mellitus, hypertension, dyslipidaemia, obesity and eczema, with the first three being the most prevalent disease clusters. Conclusions: Our findings confirm that MM is common in Qatar's primary care centres. While the prevalence of MM was found to increase with increasing age, the largest proportion of patients with MM were those aged 46–55 years. This information adds to the available data on MM and directs health policymakers towards tailoring the management for the same.
    Keywords comorbidity ; multi-morbidity ; prevalence ; primary health care ; qatar ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Effect of BATHE interview technique on patient satisfaction in an ambulatory family medicine centre in South India

    Navnee Chengappa / Prince Christopher Rajkumar Honest / Kirubah David / Ruby Angeline Pricilla / Sajitha MF Rahman / Grace Rebecca

    Family Medicine and Community Health, Vol 8, Iss

    2020  Volume 4

    Abstract: Objective The objective of the study is to determine the effect of background, affect, trouble, handling and empathy (BATHE) versus usual interview technique on patient satisfaction during regular consultation with family physicians in ambulatory care ... ...

    Abstract Objective The objective of the study is to determine the effect of background, affect, trouble, handling and empathy (BATHE) versus usual interview technique on patient satisfaction during regular consultation with family physicians in ambulatory care.Design The research design was a prospective, randomised control trial.Setting The trial took place in a family practice unit in South India, which was one of the clinical service units of the academic Department of Family Medicine of a tertiary hospital.Participant The eligible participants were adults above the age of 18 years, who did not have any acute presenting illness. The participants should have given consent and also not have any cognitive disability. A total of 138 participants took part in the trial, 70 in BATHE group and 68 in the non-BATHE group. All participants entering the trial completed the questionnaire.Result The BATHE group had a significantly higher mean score for questions grouped under professional satisfaction. This included questions on whether the patient felt that the physician treated them as a person and also whether they felt the appropriate clinical examination was communicated to them. The questionnaire used for scoring satisfaction had 18 questions with a maximum possible score of 90. When taking a cut-off of 75% (68) from the total possible score of 90, 72.9% (51) of the participants for whom the BATHE consultation technique was used were satisfied as compared with only 55.9% (30) for whom the routine consultation was carried out. This was statistically significant (χ2=11.15, p value=0.0006)Conclusion The study suggests that using BATHE in this family practice centre is beneficial in improving the perception of person centeredness in the consultation. However, further studies ruling out all possible bias are needed in our setting before the range of probable benefits of the BATHE technique can be fully gauged.
    Keywords Medicine (General) ; R5-920
    Subject code 616
    Language English
    Publishing date 2020-12-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Characteristics, types and causes of chest pain in an urban family practice secondary care center in South India

    Yeshvanth Kumar G.S. / Prince Christopher Rajkumar Honest / Apoorva Subramanian / Ranjit Abraham / Saran Teja Velaga / Ruby Angeline Pricilla / Kirubah Vasandhi David / Sunil Abraham

    Family Medicine & Primary Care Review, Vol 19, Iss 4, Pp 377-

    2017  Volume 381

    Abstract: Background . Chest pain is a common diagnostic problem faced by primary and emergency care physicians. We are taught to consider the cardiac cause of chest pain as the usual cause from our undergraduate textbooks. Though the cardiac cause of chest pain ... ...

    Abstract Background . Chest pain is a common diagnostic problem faced by primary and emergency care physicians. We are taught to consider the cardiac cause of chest pain as the usual cause from our undergraduate textbooks. Though the cardiac cause of chest pain is one of the more serious causes, it may not be the common one. There was a paucity of data available concerning this common problem in the Indian context. We present an observational study of causes of chest pain in 254 adults presenting to an ambulatory secondary care unit. Material and methods . All consecutive adults (over 18 years of age) presenting with chest pain to the urban family health center were administered a questionnaire documenting location, severity, characteristic and cause of chest pain as diagnosed by relevant clinical examination and appropriate investigations. This was done in the time period from September 2014 to July 2016. Results . A total of 254 adults with chest pain were studied, among whom 73.6% (187) were female. The most common diagnosis as to the cause of chest pain made by the treating physician was of a gastro-esophageal cause (41.3%, 105). A cardiac origin of chest pain was diagnosed in 18.5% (47) of the patients. Conclusions . The causes of chest pain in adults vary with the setting and the target population. It is mostly non-cardiac in ambulatory care practices in primary and secondary care units. However, we need to be clinically vigilant and apply a robust approach in diagnosing chest pain.
    Keywords chest pain ; family practice ; secondary care ; India ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2017-12-01T00:00:00Z
    Publisher Continuo
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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