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2.
Article in English | MEDLINE | ID: mdl-23300348

ABSTRACT

INTRODUCTION: Venous thromboembolism (VTE) is a well-known complication of total hip replacement (THR) and total knee replacement (TKR). Various drugs have been introduced in an attempt to reduce the mortality as well as the short-term and long-term morbidity associated with the development of VTE. The aim of this study was to analyze drug utilization for thromboprophylaxis and the cost of illness in real clinical practice in patients with THR or TKR. MATERIALS AND METHODS: A multicenter, retrospective, observational cohort study based on local health unit administrative databases was conducted. All patients (≥18 years old) discharged for THR/TKR procedures between January 1, 2007 and December 31, 2008 were included in the study. The date of first hospital discharge was the index date; patients were followed up for a period of 12 months. RESULTS: A total of 10,389 patients were included: 3516 males (33.8%, 69.4 ± 10.4 years) and 6873 females (66.2%, 71.7 ± 9.0 years), of which 5483 (52.8%) were discharged for THR and 4906 (47.2%) for TKR. First antithrombotic treatments after discharge were enoxaparin (3937, 37.9%), heparin (3752, 36.1%), antiplatelet agents (658, 6.3%), vitamin K antagonists (276, 2.7%), fondaparinux (136, 1.3%), combinations (185, 1.8%), and no therapy (1445, 13.9%). Overall, we observed 2347 (22.6%) treatment changes; median duration of antithrombotic treatment was 23 days (range 11-47) for THR and 22 days (range 11-46) for TKR. During the follow-up period, we observed 129 cases of VTE (120 per 10,000 patients), five post-thrombotic syndrome (4.8 per 10,000 patients), and three heparin-induced thrombocytopenia (2.9 per 10,000 patients). Median cost for both THR and TKR was €9052.00 (range €8063.00-€9084.96), with a median length of stay of 9.0 days (range 6.0-12.0).

3.
J Exp Clin Cancer Res ; 31: 91, 2012 Nov 01.
Article in English | MEDLINE | ID: mdl-23116062

ABSTRACT

BACKGROUND: In recent decades, melanoma incidence has been increasing in European countries; in 2006, there were approximately 60,000 cases leading to 13,000 deaths. Within Europe there is some geographical variation in the incidence of melanoma, with the highest rates reported in Scandinavia (15 cases per 100,000 inhabitants per year) and the lowest in the Mediterranean countries (5 to 7 cases per 100,000 inhabitants per year). METHODS: The present article is based on the information collected in the MELODY study (MELanoma treatment patterns and Outcomes among patients with unresectable stage III or stage IV Disease: a retrospective longitudinal survey).In that study, the medical charts of patients were reviewed to document current treatment patterns and to analyse information on patients, disease characteristics and healthcare resource utilization related to the treatment of advanced melanoma regarding patients who presented with a diagnosis of malignant melanoma (stage I to IV) at participating sites between 01 July, 2005 and 30 June, 2006. RESULTS: Summarizing, though the length of the follow-up period varies among sample patients, an amount of the yearly cost per patient can be estimated, dividing the average per patient total cost (€ 5.040) by the average follow-up duration (17.5 months) and reporting to one year; on these grounds, unresectable stage III or stage IV melanoma in Italy would cost € 3,456 per patient per year.


Subject(s)
Health Care Costs , Melanoma , Skin Neoplasms , Aged , Europe , Female , Humans , Italy , Longitudinal Studies , Male , Melanoma/economics , Melanoma/epidemiology , Melanoma/pathology , Melanoma/surgery , Middle Aged , Neoplasm Staging , Retrospective Studies , Scandinavian and Nordic Countries , Skin Neoplasms/economics , Skin Neoplasms/epidemiology , Skin Neoplasms/pathology , Skin Neoplasms/surgery , Survival Rate
4.
J Nephrol ; 25(3): 325-31, 2012.
Article in English | MEDLINE | ID: mdl-21748718

ABSTRACT

BACKGROUND: Albuminuria is a powerful predictor of renal and cardiovascular outcomes in type 2 diabetes and a good indicator of the evolution of renal disease. Our aim was to obtain information concerning the identification of albuminuria as well as the utilization of antihypertensive, lipid-lowering and antiplatelet drugs in patients with diabetes. METHODS: Subjects were enrolled from individuals registered with 3 Italian local health units by querying the drugs reimbursable, hospital laboratory investigation and hospital discharge databases. The determination of albumin to creatinine ratio (ACR) throughout 2007 and 2008 was defined as the index date. Patients who received at least 2 prescriptions of hypoglycemic drugs in the 12 months before the index date were classified as diabetics. We looked also for prescriptions of antihypertensive, lipid-lowering and antiplatelet drugs. RESULTS: Among a population of 701,133 subjects, we identified 29,350 patients with diabetes (4.2% of the cohort). ACR had been determined in 5,644 diabetic subjects (19.2% of that cohort). The prevalence of determination of ACR in nontreated subjects was 16.0%, while in treated subjects, it ranged from 13.6% to 34.9% according to different schedules of treatment. Drugs acting on the renin-angiotensin system were prescribed in more then 80% of diabetics. The ratio of angiotensin receptor blockers to angiotensin-converting enzyme inhibitors regimen was 0.64 in subjects without determination of ACR, 0.88 in subjects with normal albuminuria, 1.02 in subjects with microalbuminuria and 1.43 in subjects with macroalbuminuria. CONCLUSIONS: Our methodology can easily be applied to obtain an epidemiological view of albuminuria and pharmacological treatments of diabetics in a general population.


Subject(s)
Albuminuria/drug therapy , Attitude of Health Personnel , Awareness , Diabetes Mellitus, Type 2/drug therapy , Diabetic Nephropathies/drug therapy , Health Knowledge, Attitudes, Practice , Hypoglycemic Agents/therapeutic use , Adult , Aged , Aged, 80 and over , Albuminuria/diagnosis , Albuminuria/epidemiology , Analysis of Variance , Antihypertensive Agents/therapeutic use , Chi-Square Distribution , Cohort Studies , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Diabetic Nephropathies/diagnosis , Diabetic Nephropathies/epidemiology , Disease Progression , Drug Prescriptions , Female , Humans , Hypolipidemic Agents/therapeutic use , Italy/epidemiology , Male , Middle Aged , Platelet Aggregation Inhibitors/therapeutic use , Prevalence , Retrospective Studies , Time Factors
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