Cost of long-term care and balancing caregiver wellbeing: a narrative review.

INTRODUCTION: Long-term care (LTC) refers to care and support services that are required by individuals who lack the ability to perform important daily routines and may be dependent on others for personal, social and medical needs over a sustained period of time. LTC may be broadly categorized into formal and informal care, where formal care is provided by professionals who are compensated to provide these services and informal care captures the care services provided without compensation by family members, friends, or other unpaid individuals. AREAS COVERED: In this narrative review, we identify and synthesize evidence to evaluate the cost of long-term care while balancing the needs of caregivers. We searched Embase and EconLit for studies published from 2010 to November 2023. Our search strategy used a combination of keywords such as 'long-term care,' 'caregiver burden,' 'caregiver support,' 'cost of care,' and 'caregiver wellbeing.' We include both formal and informal LTC, as well as predictors of caregiver wellbeing. EXPERT COMMENTARY: The review highlights the global variability in LTC costs and the significant burden on caregivers, emphasizing the need for policy interventions and comprehensive insurance schemes. Future research should focus on standardized assessment tools, intervention effectiveness, and integrating caregiver support into healthcare models, ensuring holistic and sustainable LTC solutions.

Income disparities in COVID-19 vaccine and booster uptake in the United States: An analysis of cross-sectional data from the Medical Expenditure Panel Survey.

COVID-19 vaccination has significantly decreased morbidity, hospitalizations, and death during the pandemic. However, disparities in vaccination uptake threatens to stymie the progress made in safeguarding the health of Americans. Using a nationally representative adult (≥18 years old) sample from the 2021 Medical Expenditure Panel Survey (MEPS), we aimed to explore disparities in COVID-19 vaccine and booster uptake by income levels. To reflect the nature of the survey, a weighted logistic regression analysis was used to explore factors associated with COVID-19 vaccine and booster uptake. A total of 241,645,704 (unweighted n = 21,554) adults were included in the analysis. Average (SD) age of the population was 49 (18) years old, and 51% were female. There were disparities in COVID-19 vaccine and booster uptake by income groups. All other income groups were less likely to receive COVID-19 vaccines and booster shot than those in the high-income group. Those in the poor income group had 55% lower odds of being vaccinated for COVID-19 (aOR = 0.45, p<0.01). Considering the female population only, women with lower incomes may have greater disparities in access to COVID-19 vaccines than do males with lower incomes. Disparities in COVID-19 vaccination by income may have even greater implications as the updated vaccines are rolled out in the US without the government covering the cost as before.

Pharmacy Benefit Manager Pricing and Spread Pricing for High-Utilization Generic Drugs.

This cross-sectional study uses Medicare Part D claims for high-utilization generic drugs to analyze gross profits accumulated by pharmacy benefit managers, pharmacies, wholesalers, and manufacturers in the pharmaceutical supply chain.

Assessment of public knowledge and attitude toward antibiotics use and resistance: a community pharmacy-based survey.

BACKGROUND: Antimicrobial resistance is a public health challenge affecting all aspects of healthcare systems. Policies to reduce antimicrobial resistance should be implemented and monitored in community pharmacies, because they are patients' first point of care. Public awareness of relevant knowledge and attitudes on antimicrobials is a feasible strategy to mitigate the spread of antimicrobial resistance by exploiting the relationship between pharmacists and patients in the community pharmacy setting. The study evaluated and determined predictors of antibiotic knowledge and attitudes toward antibiotic use and resistance in community pharmacy patients. METHODS: A cross-sectional design was used to retrieve data in five randomly selected community pharmacies in Lagos and Abuja using a self-administered questionnaire. Descriptive and inferential statistics were utilized for characterizing and determining the associations between predictors and outcomes at p < 0.05. Logistic regression was used to identify predictors of patients' knowledge and attitude to antibiotic use. RESULTS: A total of 964 clients participated in the study: 526(54.7%) were females, and 358(37.3%) were aged 25-34. chlorpheniramine-maleate and levonorgestrel were wrongly identified as antibiotics by 621 (64%) and 490 (50%) respondents, respectively. Many respondents, 448(46.5%), strongly agree that antibiotic creams should be mixed with body creams. The result of the multivariable logistic regression showed secondary education [Odds Ratio (OR): 0.31, 95% CI 0.10-0.97, p value: 0.044], urban residence (OR: 1.45, 95% CI 1.01-2.08, p value: 0.043) and age 34 (OR: 1.55, 95% CI 1.01-2.37, p value: 0.045) were strong predictors of knowledge on antibiotics, while community pharmacy location (OR: 5.48, 95% CI 3.45-8.70, p value: ≤ 0.001), urban residence (OR: 2.57, 95% CI 1.67-3.96, p value: ≤ 0.001), and antibiotic recommender (OR: 0.55, 95% CI 0.35-0.85, p value: 0.008) were predictors of respondents' attitude to antibiotic use. CONCLUSIONS: The study established that sociodemographic factors could impact community pharmacy clients' knowledge and attitude toward antibiotic use and resistance and should be considered when developing policies to curb the spread of resistant microbes. Community pharmacies should educate community pharmacy clients on the dangers associated with the misuse of antibiotics with stringent antibiotic stewardship programs and restrict access to antibiotics over-the-counter.