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  1. Article ; Online: A Scoping Review of the Application of BREAST-Q in Surgical Research.

    Arora, Nikita / Patel, Ruchit / Sohi, Gursharan / Merchant, Shaila / Martou, Glykeria

    JPRAS open

    2023  Volume 37, Page(s) 9–23

    Abstract: Background: Collection of patient-reported outcome (PRO) data can facilitate cost-effective, evidence-based, and patient-centered care. The BREAST-Q has become the gold standard tool to measure PRO data in breast surgery. The last review of its ... ...

    Abstract Background: Collection of patient-reported outcome (PRO) data can facilitate cost-effective, evidence-based, and patient-centered care. The BREAST-Q has become the gold standard tool to measure PRO data in breast surgery. The last review of its application indicated that it was underutilized. Considering the evolution in breast surgery, the purpose of this study was to perform a scoping review of BREAST-Q application since 2015 and identify emerging trends and potential persistent gaps to guide patient-centered practice and future research in breast surgery.
    Methods: We performed an electronic literature review to identify publications published in English that used the BREAST-Q to assess patient outcomes. We excluded validation studies, review papers, conference abstracts, discussions, comments, and/or responses to previously published papers.
    Results: We identified 270 studies that met our inclusion criteria. Specific data was extracted to examine the evolution of the BREAST-Q application and examine clinical trends and research gaps.
    Discussion: Despite a significant increase in BREAST-Q studies, gaps in the understanding of the patient experience remain. The BREAST-Q is uniquely designed to measure quality of life and satisfaction with outcome and care. The prospective collection of center-specific data for every type of breast surgery will generate important information for the provision of patient-centered and evidence-based care.
    Language English
    Publishing date 2023-05-09
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2834721-3
    ISSN 2352-5878 ; 2352-5878
    ISSN (online) 2352-5878
    ISSN 2352-5878
    DOI 10.1016/j.jpra.2023.04.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Strategies to reduce out-of-pocket medication costs for Canadians with peripheral arterial disease.

    McClure, Graham R / McIntyre, William F / Belesiotis, Peter / Kaplovitch, Eric / Chan, Noel / Bhagirath, Vinai / Chahill, Gurneet / Hayes, Abigail / Sohi, Gursharan / Bordman, Wendy / Whitlock, Richard P / Anand, Sonia S / Belley-Côté, Emilie P

    Canadian journal of surgery. Journal canadien de chirurgie

    2024  Volume 67, Issue 1, Page(s) E1–E6

    Abstract: Background: Given that peripheral arterial disease (PAD) disproportionately affects people of lower socioeconomic status, out-of-pocket expenses for preventive medications are a major barrier to their use. We carried out a cost comparison of drug ... ...

    Abstract Background: Given that peripheral arterial disease (PAD) disproportionately affects people of lower socioeconomic status, out-of-pocket expenses for preventive medications are a major barrier to their use. We carried out a cost comparison of drug therapies for PAD to identify prescribing strategies that minimize out-of-pocket expenses for these medications.
    Methods: Between March and June 2019, we contacted outpatient pharmacies in Hamilton, Ontario, Canada, to assess pricing of pharmacologic therapies at dosages included in the 2016 American College of Cardiology/American Heart Association guideline for management of lower extremity PAD. We also gathered pricing information for supplementary charges, including delivery, pill splitting and blister packaging. We calculated prescription prices with and without dispensing fees for 30-day brand-name and generic prescriptions, and 90-day generic prescriptions.
    Results: Twenty-four pharmacies, including hospital-based, independent and chain, were included in our sample. In the most extreme scenario, total 90-day medication costs could differ by up to $1377.26. Costs were affected by choice of agent within a drug class, generic versus brand-name drug, quantity dispensed, dispensing fee and delivery cost, if any.
    Conclusion: By opting for prescriptions for 90 days or as long as possible, selecting the lowest-cost generic drugs available in each drug class, and identifying dispensing locations with lower fees, prescribers can minimize out-of-pocket patient medication expenses. This may help improve adherence to guideline-recommended therapies for the secondary prevention of vascular events in patients with PAD.
    MeSH term(s) Humans ; Costs and Cost Analysis ; Drugs, Generic/economics ; Ontario ; Peripheral Arterial Disease/drug therapy ; United States ; Health Expenditures ; Drug Costs
    Chemical Substances Drugs, Generic
    Language English
    Publishing date 2024-01-03
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 410651-9
    ISSN 1488-2310 ; 0008-428X
    ISSN (online) 1488-2310
    ISSN 0008-428X
    DOI 10.1503/cjs.003722
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 221: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Nonopioid drug combinations for cancer pain: protocol for a systematic review.

    Sohi, Gursharan / Caraceni, Augusto / Moulin, Dwight E / Zimmermann, Camilla / Herx, Leonie / Gilron, Ian

    Pain reports

    2020  Volume 5, Issue 6, Page(s) e856

    Abstract: Introduction: Pain related to cancer, and its treatment, is common, may severely impair quality of life, and imposes a burden on patients, their families and caregivers, and society. Cancer-related pain is often challenging to manage, with limitations ... ...

    Abstract Introduction: Pain related to cancer, and its treatment, is common, may severely impair quality of life, and imposes a burden on patients, their families and caregivers, and society. Cancer-related pain is often challenging to manage, with limitations of analgesic drugs including incomplete efficacy and dose-related adverse effects.
    Objectives: Given problems with, and limitations of, opioid use for cancer-related pain, the identification of nonopioid treatment strategies that could improve cancer pain care is an attractive concept. The hypothesis that combinations of mechanistically distinct analgesic drugs could provide superior analgesia and/or fewer adverse effects has been tested in several pain conditions, including in cancer-related pain. Here, we propose to review trials of nonopioid analgesic combinations for cancer-related pain.
    Methods: Using a predefined literature search strategy, trials-comparing the combination of 2 or more nonopioid analgesics with at least one of the combination's individual components-will be searched on the PubMed and EMBASE databases from their inception until the date the searches are run. Outcomes will include pain intensity or relief, adverse effects, and concomitant opioid consumption.
    Results/conclusions: This review is expected to synthesize available evidence describing the efficacy and safety of nonopioid analgesic combinations for cancer-related pain. Furthermore, a review of this literature will serve to identify future research goals that would advance our knowledge in this area.
    Language English
    Publishing date 2020-10-27
    Publishing country United States
    Document type Journal Article
    ISSN 2471-2531
    ISSN (online) 2471-2531
    DOI 10.1097/PR9.0000000000000856
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Nonopioid drug combinations for cancer pain: a systematic review.

    Sohi, Gursharan / Lao, Nicholas / Caraceni, Augusto / Moulin, Dwight E / Zimmermann, Camilla / Herx, Leonie / Gilron, Ian

    Pain reports

    2021  Volume 7, Issue 2, Page(s) e995

    Abstract: Pain is highly prevalent in patients with cancer-nearly 40% report moderate-severe pain, which is commonly treated with opioids. Increasing cancer survivorship, opioid epidemics in some regions of the world, and limited opioid access in other regions ... ...

    Abstract Pain is highly prevalent in patients with cancer-nearly 40% report moderate-severe pain, which is commonly treated with opioids. Increasing cancer survivorship, opioid epidemics in some regions of the world, and limited opioid access in other regions have focused attention on nonopioid treatments. Given the limitations of monotherapy, combining nonopioids-such as antiepileptics and antidepressants-have shown promise in noncancer pain. This review seeks to evaluate efficacy of nonopioid combinations for cancer-related pain. Systematic searches of PubMed, EMBASE, and Cochrane CENTRAL were conducted for double-blind, randomized, controlled trials comparing a nonopioid combination with at least one of its components and/or placebo. This search yielded 4 randomized controlled trials, published between 1998 and 2019 involving studies of (1) imipramine + diclofenac; (2) mitoxantrone + prednisone + clodronate; (3) pentoxifylline + tocopherol + clodronate; and (4) duloxetine + pregabalin + opioid. In the first 3 of these trials, trends favouring combination efficacy failed to reach statistical significance. However, in the fourth trial, duloxetine + pregabalin + opioid was superior to pregabalin + opioid. This review illustrates recognition for the need to evaluate nonopioid drug combinations in cancer pain, although few trials have been published to date. Given the growing practice of prescribing more than 1 nonopioid for cancer pain and the need to expand the evidence base for rational combination therapy, more high-quality trials in this area are needed.
    Language English
    Publishing date 2021-03-02
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2471-2531
    ISSN (online) 2471-2531
    DOI 10.1097/PR9.0000000000000995
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The cost of chemotherapy administration: a systematic review and meta-analysis.

    Sohi, Gursharan K / Levy, Jordan / Delibasic, Victoria / Davis, Laura E / Mahar, Alyson L / Amirazodi, Elmira / Earle, Craig C / Hallet, Julie / Hammad, Ahmed / Shah, Rajan / Mittmann, Nicole / Coburn, Natalie G

    The European journal of health economics : HEPAC : health economics in prevention and care

    2021  Volume 22, Issue 4, Page(s) 605–620

    Abstract: Purpose: Cancer treatment is a significant driver of healthcare costs worldwide, however, the economic impact of treating patients with anti-neoplastic agents is poorly elucidated. We conducted a systematic review and meta-analysis to estimate the ... ...

    Abstract Purpose: Cancer treatment is a significant driver of healthcare costs worldwide, however, the economic impact of treating patients with anti-neoplastic agents is poorly elucidated. We conducted a systematic review and meta-analysis to estimate the direct costs associated with administering intravenous chemotherapy in an outpatient setting.
    Methods: We systematically searched four databases from 2010 to present and extracted hourly administration costs and the respective components of each estimate. Separate analyses were conducted of Canadian and United States (US) studies, respectively, to address a priori hypotheses regarding heterogeneity amongst estimates. The Drummond checklist was used to assess risk-of-bias. Data were summarized using medians with interquartile ranges and five outliers were identified; costs were presented in 2019 USD.
    Results: Forty-four studies were analyzed, including sub-analyses of 19 US and seven Canadian studies. 26/44 studies were of moderate-high quality. When components of administration cost were evaluated, physician costs were reported most frequently (24 studies), followed by lab tests (13) and overhead costs (9). The median estimate (excluding outliers) was $142/hour (IQR = $103-166). The median administration cost in the US was $149/hour (IQR = $118-158), and was $128/hour (IQR = $102-137) in Canada.
    Conclusions: There is currently a paucity of literature addressing the costs of chemotherapy administration, and existing studies utilize a patchwork of reporting methodologies which renders direct comparison challenging. Our results demonstrate that the cost of administering chemotherapy is approximately $125-150/hour, globally. This value is dependent upon the region of analysis, inclusiveness of cost subcomponents as well as the methodology used to estimate unit prices, as described here.
    MeSH term(s) Antineoplastic Agents ; Canada ; Cost-Benefit Analysis ; Health Care Costs ; Humans ; United States
    Chemical Substances Antineoplastic Agents
    Language English
    Publishing date 2021-03-09
    Publishing country Germany
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 2045253-6
    ISSN 1618-7601 ; 1618-7598
    ISSN (online) 1618-7601
    ISSN 1618-7598
    DOI 10.1007/s10198-021-01278-0
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5475: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: Strategies to Reduce Out-of-Pocket Medication Costs for Canadians Living with Heart Failure.

    McIntyre, William F / Belesiotis, Peter / McClure, Graham R / Demers, Catherine / Chahill, Gurneet / Hayes, Abigail / Sohi, Gursharan / Bordman, Wendy / Whitlock, Richard P / Belley-Côté, Emilie P

    Cardiovascular drugs and therapy

    2020  Volume 35, Issue 5, Page(s) 1009–1023

    Abstract: Introduction: Daily medication is the cornerstone of evidence-based therapy to reduce mortality and morbidity in patients with heart failure (HF). Up to 20% of Canadian patients pay for medications out of pocket. We sought to identify strategies that ... ...

    Abstract Introduction: Daily medication is the cornerstone of evidence-based therapy to reduce mortality and morbidity in patients with heart failure (HF). Up to 20% of Canadian patients pay for medications out of pocket. We sought to identify strategies that patients and prescribers can employ to reduce these costs.
    Methods: We collected data from outpatient pharmacies in Hamilton, Ontario. We determined prices for different medications in each of the drug classes recommended for HF with reduced ejection fraction in the Canadian Cardiovascular Society's guidelines. We examined differences in dispensing and delivery fees and inquired about other cost-saving strategies.
    Results: We collected data from 24 different pharmacies, including a selection of hospital-based, independent, and larger chain pharmacies. In the most extreme scenario (i.e., 90-day prescription instead of a 30-day prescription and the least expensive generic drug instead of the most expensive brand name drug), total medication costs can differ by up to $495.56 per month. Costs were affected by choice of agent within a drug class, generic versus brand-name drug, quantity dispensed, dispensing fee, and delivery cost.
    Conclusions: Prescription content, dispensing practice, and pharmacy choice can remarkably impact out-of-pocket costs for HF medications. Prescribers can reduce costs by writing 90-day prescriptions and choosing the lowest-cost generic drugs in each therapeutic class. Patients should consider the services received for their pharmacy dispensing fees, use free delivery services where needed, and request inexpensive generic drugs. Pharmacists can facilitate cost minimization without compromising therapeutic efficacy.
    MeSH term(s) Canada ; Cardiovascular Agents/economics ; Cardiovascular Agents/therapeutic use ; Drugs, Generic/economics ; Drugs, Generic/therapeutic use ; Heart Failure/drug therapy ; Humans ; Prescription Fees/statistics & numerical data
    Chemical Substances Cardiovascular Agents ; Drugs, Generic
    Keywords covid19
    Language English
    Publishing date 2020-08-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639068-7
    ISSN 1573-7241 ; 0920-3206
    ISSN (online) 1573-7241
    ISSN 0920-3206
    DOI 10.1007/s10557-020-07046-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.B 3057: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  7. Article: Strategies to Reduce Out-of-Pocket Medication Costs for Canadians Living with Heart Failure

    McIntyre, William F / Belesiotis, Peter / McClure, Graham R / Demers, Catherine / Chahill, Gurneet / Hayes, Abigail / Sohi, Gursharan / Bordman, Wendy / Whitlock, Richard P / Belley-Côté, Emilie P

    Cardiovasc. drugs ther

    Abstract: INTRODUCTION: Daily medication is the cornerstone of evidence-based therapy to reduce mortality and morbidity in patients with heart failure (HF). Up to 20% of Canadian patients pay for medications out of pocket. We sought to identify strategies that ... ...

    Abstract INTRODUCTION: Daily medication is the cornerstone of evidence-based therapy to reduce mortality and morbidity in patients with heart failure (HF). Up to 20% of Canadian patients pay for medications out of pocket. We sought to identify strategies that patients and prescribers can employ to reduce these costs. METHODS: We collected data from outpatient pharmacies in Hamilton, Ontario. We determined prices for different medications in each of the drug classes recommended for HF with reduced ejection fraction in the Canadian Cardiovascular Society's guidelines. We examined differences in dispensing and delivery fees and inquired about other cost-saving strategies. RESULTS: We collected data from 24 different pharmacies, including a selection of hospital-based, independent, and larger chain pharmacies. In the most extreme scenario (i.e., 90-day prescription instead of a 30-day prescription and the least expensive generic drug instead of the most expensive brand name drug), total medication costs can differ by up to $495.56 per month. Costs were affected by choice of agent within a drug class, generic versus brand-name drug, quantity dispensed, dispensing fee, and delivery cost. CONCLUSIONS: Prescription content, dispensing practice, and pharmacy choice can remarkably impact out-of-pocket costs for HF medications. Prescribers can reduce costs by writing 90-day prescriptions and choosing the lowest-cost generic drugs in each therapeutic class. Patients should consider the services received for their pharmacy dispensing fees, use free delivery services where needed, and request inexpensive generic drugs. Pharmacists can facilitate cost minimization without compromising therapeutic efficacy.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #32803405
    Database COVID19

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