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  1. Article ; Online: Coste-efectividad de la vacunación universal infantil frente a la hepatitis A en España

    Cristina Valcárcel-Nazco / Esther Sanromá-Ramos / Lidia García-Pérez / Rafael Jacinto Villanueva-Micó / Clara Burgos-Simón / Javier Mar

    Gaceta Sanitaria, Vol 37, Iss , Pp 102292- (2023)

    un enfoque dinámico

    2023  

    Abstract: Resumen: Objetivo: Evaluar el coste-efectividad de diferentes estrategias de vacunación universal infantil frente a la hepatitis A en España. Método: A partir de un modelo dinámico y un árbol de decisión, se realizó un análisis de coste-efectividad para ... ...

    Abstract Resumen: Objetivo: Evaluar el coste-efectividad de diferentes estrategias de vacunación universal infantil frente a la hepatitis A en España. Método: A partir de un modelo dinámico y un árbol de decisión, se realizó un análisis de coste-efectividad para comparar tres estrategias de vacunación frente a la hepatitis A: no vacunación y vacunación universal infantil con una y dos dosis. La perspectiva del estudio escogida fue la del Sistema Nacional de Salud (SNS) y se consideró como horizonte temporal toda la vida del paciente. Tanto los costes como los efectos se descontaron al 3% anual. Los resultados en salud se midieron en años de vida ajustados por calidad (AVAC) y la medida de coste-efectividad utilizada es la razón de coste-efectividad incremental (RCEI). Además, se llevaron a cabo análisis de sensibilidad determinísticos por escenarios. Resultados: En el caso particular de España, con baja endemicidad de hepatitis A, las diferencias en resultados en salud entre las distintas estrategias de vacunación (con una o dos dosis) y la no vacunación son prácticamente inexistentes, en términos de AVAC. Además, las RCEI obtenidas son elevadas, superando los límites establecidos de disposición a pagar obtenidos en España (22.000-25.000 €/AVAC). El análisis de sensibilidad determinístico muestra que los resultados son sensibles a las variaciones de los parámetros clave, aunque en ningún caso resultan coste-efectivos. Conclusiones: La vacunación universal infantil frente a la hepatitis A no sería una opción coste-efectiva desde la perspectiva del SNS en España en la actualidad. Abstract: Objective: To evaluate the cost-effectiveness of infant universal vaccination against hepatitis A in Spain. Method: Using a dynamic model and decision tree model, a cost-effectiveness analysis was performed to compare three vaccination strategies against hepatitis A: non-vaccination strategy versus universal childhood vaccination of hepatitis A with one or two doses. The perspective of the study was that of the National Health System ...
    Keywords Cost-benefit analysis ; Hepatitis A vaccines ; Mass vaccination ; Infant ; Child ; Spain ; Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Health-Related Quality of Life and Perceived Burden of Informal Caregivers of Patients with Rare Diseases in Selected European Countries

    Cristina Valcárcel-Nazco / Yolanda Ramallo-Fariña / Renata Linertová / Juan Manuel Ramos-Goñi / Lidia García-Pérez / Pedro Serrano-Aguilar

    International Journal of Environmental Research and Public Health, Vol 19, Iss 8208, p

    2022  Volume 8208

    Abstract: Most of rare disease (RD) patients are assisted in their homes by their family as informal caregivers, causing a substantial burden among family members devoted to care. The role of informal caregivers has been associated with increased levels of stress, ...

    Abstract Most of rare disease (RD) patients are assisted in their homes by their family as informal caregivers, causing a substantial burden among family members devoted to care. The role of informal caregivers has been associated with increased levels of stress, poor physical/mental health and impaired HRQOL. The present study assessed the impact on HRQOL and perceived burden of long-term informal caregiving, as well as the inter-relationships of individuals affected by different RD in six European countries, taking advantage of the data provided by the BURQOL-RD project (France, Germany, Italy, Spain, Sweden and UK). Correlation analysis was used to explore the relation between caregiver HRQOL and caregiver burden (Zarit Burden Interview). Multinomial logistic regression models were used to explore the role of explanatory variables on each domain of caregivers HRQOL measured by EQ-5D. Caregivers’ HRQOL is inversely correlated with burden of caring. Mobility dimension of EQ-5D was significantly associated with patients age, time devoted to care by secondary caregivers, patient gender and patient utility index. Patients’ age, burden scores and patient utility index significantly predict the capacity of caregivers to perform activities of daily living. Employed caregivers are less likely of reporting ‘slight problems’ in pain/discomfort dimensions than unemployed caregivers. The EQ-5D instrument is sensitive to measure differences in HRQOL between caregivers with different levels of burden of care.
    Keywords health-related quality of life ; EQ-5D-5L ; caregivers ; rare diseases ; informal care ; caregiver burden ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2022-07-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Cost-effectiveness of pemetrexed in combination with cisplatin as first line treatment for patients with advanced non-squamous non-small-cell

    Jonathan González García / Fernando Gutiérrez Nicolás / Gloria Julia Nazco Casariego / Cristina Valcárcel Nazco / Jose Norberto Batista López / Juana Oramas Rodríguez

    Farmacia Hospitalaria, Vol 41, Iss 1, Pp 3-

    2017  Volume 13

    Abstract: Introduction: Lung cancer is the third most frequent neoplastic tumour in Spain, with around 27 000 new cases diagnosed per year; 80-95% of these are non-small-cell cancer (NSCLC), and the majority of cases are diagnosed in advanced stages of the disease, ...

    Abstract Introduction: Lung cancer is the third most frequent neoplastic tumour in Spain, with around 27 000 new cases diagnosed per year; 80-95% of these are non-small-cell cancer (NSCLC), and the majority of cases are diagnosed in advanced stages of the disease, and for this reason it is one of the oncologic conditions with higher mortality rates (21.4% mean survival at 5 years). The main treatment regimens used for first-line treatment of NSCLC are: isplatin/pemetrexed (cis/pem), cisplatin/gemcitabine/ bevacizumab (cis/gem/bev), and carboplatin/paclitaxel/ bevacizumab (carb/pac/bev). The objective of this study was to evaluate the cost-effectiveness ratio of antineoplastic 1st line NSCLC treatment regimens, from the point of view of hospital management. Methodology: A cost-efficacy mathematical model was prepared, based on a decision tree. The efficacy variable was Progression Free Survival, obtained from the PARAMOUNT, AVAIL and SAIL Phase III clinical trials. The study was conducted from the perspective of the hospital management, considering only the direct costs of drug acquisition. A deterministic sensitivity analysis was conducted to confirm the robustness of outcomes. Results: The PFS obtained in clinical trials with cis/pem, cis/ gem/bev and carb/pac/bev was: 6.9, 6.7 and 6.2 months, respectively. Based on our model, the mean cost of treatment per patient for these regimens was: 19 942 €, 15 594 € and 36 095 €, respectively. The incremental cost-effectiveness ratio per month of additional PFS between cis/pem and cis/gem/bev was 19 303 €. Estimating a 30% reduction in acquisition costs for pemetrexed (Alimta®Eli Lilly Nederland B.V.), due to the forthcoming launch of generic medications, the cis/pem treatment would become the predominant alternative for 1st line treatment of NSCLC patients, by offering the best health results at a lower cost.
    Keywords Non-small-cell lung cancer ; Cost-effectiveness ; Economic evaluation ; Cisplatin ; Pemetrexed ; Bevacizumab ; Medicine ; R ; Pharmacy and materia medica ; RS1-441
    Subject code 616 ; 610
    Language English
    Publishing date 2017-01-01T00:00:00Z
    Publisher Grupo Aula Médica
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: EVALUACIÓN ECONÓMICA BUSCA UMBRAL PARA APOYAR LA TOMA DE DECISIONES

    Borja García-Lorenzo / Laura Vallejo-Torres / María del Mar Trujillo-Martín / Lilisbeth Perestelo-Pérez / Cristina Valcárcel-Nazco / Pedro Serrano Aguilar

    Revista Española de Salud Pública, Vol 89, Iss 6, Pp 537-

    2015  Volume 544

    Keywords Medicine ; R ; Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2015-01-01T00:00:00Z
    Publisher Ministerio de Sanidad y Consumo
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Effectiveness, safety and costs of the FreeStyle Libre glucose monitoring system for children and adolescents with type 1 diabetes in Spain

    Lilisbeth Perestelo-Pérez / Amado Rivero-Santana / Cristina Valcárcel-Nazco / Yolanda Álvarez-Pérez / Pedro Serrano-Aguilar / Yolanda Ramallo-Fariña / Lidia García-Pérez / Miguel Angel García-Bello / Himar Gonzalez-Pacheco / Ariadna Campos Martorell / Amparo González Vergaz / Ana María Prado Carro / Anunciación Beisti Ortego / Atilano José Carcavilla Urqui / Cristina Amparo Del Castillo Villaescusa / Estela Gil Poch / Francisco Javier Arroyo Diez / Gemma Novoa Gómez / Isabel González Casado /
    Juncal Martínez Ibáñez / Laura Cuadrado Piqueras / Leticia Reis Iglesias / Lucia Garzón Lorenzo / Luis Salamanca Fresno / María Asunción Martínez Brocca / María Aurea Rodríguez Blanco / María Del Mar Martínez López / María Jesús Ferreiro Rodríguez / María Ruiz del Campo / Nerea Itza Martín / Patricia García Navas / Rebeca García García

    BMJ Open, Vol 13, Iss

    a prospective, uncontrolled, pre-post study

    2023  Volume 12

    Abstract: Objectives This study aimed to evaluate the effectiveness, safety and costs of FreeStyle Libre (FSL) glucose monitoring system for children and adolescents with type 1 diabetes mellitus (T1DM) in Spain.Design Prospective, multicentre pre-post study ... ...

    Abstract Objectives This study aimed to evaluate the effectiveness, safety and costs of FreeStyle Libre (FSL) glucose monitoring system for children and adolescents with type 1 diabetes mellitus (T1DM) in Spain.Design Prospective, multicentre pre-post study.Setting Thirteen Spanish public hospitals recruited patients from January 2019 to March 2020, with a 12-month follow-up.Participants 156 patients were included.Primary and secondary outcome measures Primary: glycated haemoglobin (HbA1c) change. Secondary: severe hypoglycaemic events (self-reported and clinical records), quality of life, diabetes treatment knowledge, treatment satisfaction, adverse events, adherence, sensor usage time and scans. Healthcare resource utilisation was assessed for cost analysis from the National Health System perspective, incorporating direct healthcare costs. Data analysis used mixed regression models with repeated measures. The intervention’s total cost was estimated by multiplying health resource usage with unit costs.Results In the whole sample, HbA1c increased significantly (0.32%; 95% CI 0.10% to 0.55%). In the subgroup with baseline HbA1c≥7.5% (n=88), there was a significant reduction at 3 months (−0.46%; 95% CI −0.69% to −0.23%), 6 months (−0.49%; 95% CI −0.73% to −0.25%) and 12 months (−0.43%; 95% CI −0.68% to –0.19%). Well-controlled patients had a significant 12-month worsening (0.32%; 95% CI 0.18% to 0.47%). Self-reported severe hypoglycaemia significantly decreased compared with the previous year for the whole sample (−0.37; 95% CI −0.62 to –0.11). Quality of life and diabetes treatment knowledge showed no significant differences, but satisfaction increased. Adolescents had lower sensor usage time and scans than children. Reduction in HbA1c was significantly associated with device adherence. No serious adverse effects were observed. Data suggest that use of FSL could reduce healthcare resource use (strips and lancets) and costs related to productivity loss.Conclusions The use of FSL in young patients with T1DM was associated ...
    Keywords Medicine ; R
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Effectiveness and cost-effectiveness of a virtual community of practice to improve the empowerment of patients with ischaemic heart disease

    Lilisbeth Perestelo-Pérez / Débora Koatz / Valeria Pacheco-Huergo / Vanesa Ramos-García / Alezandra Torres-Castaño / Amado Rivero-Santana / Ana Toledo-Chávarri / Cristina Valcárcel-Nazco / Juana Mateos-Rodilla / Juan Carlos Obaya-Rebollar / Javier García-García / Santiago Díaz-Sánchez / Luis Morales-Cobos / Josep María Bosch-Fontcuberta / Nuria Vallejo-Camazón / Ana Rodríguez-Almodovar / José Carlos del Castillo / Marcos Muñoz-Balsa / Yolanda del Rey-Granado /
    María-Eugenia Tello-Bernabé / Ana Belén Ramírez-Puerta

    BMJ Open, Vol 10, Iss

    study protocol of a randomised controlled trial

    2020  Volume 10

    Abstract: Introduction Virtual Communities of Practice (VCoP) or knowledge-sharing virtual communities offer ubiquitous access to information and exchange possibilities for people in similar situations, which might be especially valuable for the self-management of ...

    Abstract Introduction Virtual Communities of Practice (VCoP) or knowledge-sharing virtual communities offer ubiquitous access to information and exchange possibilities for people in similar situations, which might be especially valuable for the self-management of patients with chronic diseases. In view of the scarce evidence on the clinical and economic impact of these interventions on chronic conditions, we aim to evaluate the effectiveness and cost-effectiveness of a VCoP in the improvement of the activation and other patient empowerment measures in patients with ischaemic heart disease (IHD).Methods and analysis A pragmatic randomised controlled trial will be performed in Catalonia, Madrid and Canary Islands, Spain. Two hundred and fifty patients with a recent diagnosis of IHD attending the participating centres will be selected and randomised to the intervention or control group. The intervention group will be offered participation for 12 months in a VCoP based on a gamified web 2.0 platform where there is interaction with other patients and a multidisciplinary professional team. Intervention and control groups will receive usual care. The primary outcome will be measured with the Patient Activation Measure questionnaire at baseline, 6, 12 and 18 months. Secondary outcomes will include: clinical variables; knowledge (Questionnaire of Cardiovascular Risk Factors), attitudes (Self-efficacy Managing Chronic Disease Scale), adherence to the Mediterranean diet (Mediterranean Diet Questionnaire), level of physical activity (International Physical Activity Questionnaire), depression (Patient Health Questionnaire), anxiety (Hospital Anxiety Scale-A), medication adherence (Adherence to Refill Medication Scale), quality of life (EQ-5D-5L) and health resources use. Data will be collected from self-reported questionnaires and electronic medical records.Ethics and dissemination The trial was approved by Clinical Research Ethics Committee of Gregorio Marañón University Hospital in Madrid, Nuestra Señora de Candelaria University ...
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2020-10-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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