ABSTRACT
@#Schizophrenia is a chronic, debilitating illness affecting around 21 million people globally. It is a severe form of mental health problem, affecting more individuals aged 15-35 years (late adolescence to early adulthood) and commonly found among males 1 • It is thought to result from a combination of genetic, environmental and psychosocial factors. In the Philippines, schizophrenia is the leading cause for mental health consultation and treatment in hospitals2 • Based from the Philippine Health Information System on Mental Health data gathered from 2014 to 2015 in 14 health facilities, around 42% out of 2,562 patients on record were diagnosed with schizophrenia. From this data, it is estimated that 1 % or around 1 million of the country's total population are affected by this disorder. Poor adherence to medication is a major cause of poor outcomes in patients with schizophrenia, with non-adherence as high as 50-74% in the initial phase of treatment3 - 5 • Nonadherence is associated with relapse, re-hospitalization and poor quality of life among individuals with the illness3 • While remission and ultimately, recovery, is the goal, the foundation of successful treatment is appropriate medication prescription and good adherence. The use of new generation, long-acting injectable (LAI) antipsychotic medications is one of the ways to improve patient's adherence to treatment by reducing frequency of administration and improving the consistency of drug delivery as well as bioavailability in the circulation 6.On January 25, 2018, Johnson and Johnson Philippines organized a symposium on LAI treatment during the 2018 International Congress of the Asian Federation of Psychiatric Associations (AFPA) and 44th Philippine Psychiatric Association Annual Convention at the Philippine International Convention Center, Pasay City. The purpose of the symposium was to discuss the role of long-acting antipsychotic medications in a comprehensive treatment approach for schizophrenia. A total of almost 300 psychiatrists and psychologists attended the activity. The aim of this special report is to present the discussion of the guest speaker Dr. Allan Tasman, and weigh the pros and cons of using long-acting injectable (LAI) antipsychotics as part of treatment for Filipino patients with schizophrenia. Dr. Tasman is an internationally known psychiatrist and advocate of integrative biopsychosocial treatment model within a comprehensive, collaborative system of care and innovation for psychiatric education and clinical services. He is currently professor and emeritus chairman of the Department of Psychiatry and Behavioral Sciences at the University of Louisville, and Schwab Endowed Chair in Social and Community Psychiatry. The primary objectives of Dr. Tasman's presentation were to: (1) review comprehensive treatment approaches in schizophrenia, keeping in mind up-to-date medication management as the foundation of treatment; and (2) use evidence-based practice in maximizing the likelihood of recovery in patients with schizophrenia.
Subject(s)
SchizophreniaABSTRACT
BACKGROUND@#Multiple myeloma is a malignant proliferation of plasma cells that accumulate in the bone marrow and results in several organ dysfunctions that are debilitating and fatal. For the past 20 years, advances in the understanding of genetic abnormalities, interactions in the bone marrow microenvironment, developments in the diagnosis and staging in myeloma and introduction and incorporation of novel agents early in the disease course have been pivotal in the clinical treatment and management of patients with multiple myeloma. However, the burden associated with the disease, including treatment costs, is significant for Filipino patients as it is still incurable. In the Philippines, the introduction of bortezomib in the market in the last decade have brought hope to many patients by expanding the availability of treatment options, improving quality of life and extending survival. @*METHODS@#This paper documents the proceedings of a forum on multiple myeloma conducted last March 2018 at Makati City. The purpose of the forum was to discuss the major clinical presentations of the disease as well as treatment and management of selected patients. Speakers were hematology and medical oncology experts in the Philippines.@*RESULTS@#Five cases of multiple myeloma with different clinical presentations and management were discussed: (1) renal insufficiency, (2) easy fatigability, (3) bone pain, (4) autologous stem cell/bone marrow transplantation and (5) coagulopathy. Short videos of selected patients (or their family members) after each presentation was showed, describing their treatment journey with myeloma. Other patients with multiple myeloma who were treated with bortezomib were present in the forum and briefly shared their experiences.@*CONCLUSION@#As multiple myeloma is a highly heterogeneous molecular disease, approaches and provision of care will need to be individualized for each patient. Because of its impressive performance, bortezomib is likely to continue being an important part of the clinical treatment and management of Filipino patients with myeloma.