Articles: health.
-
The comparison of the effectiveness of health technologies is not only laid down in German law (Social Code Book V, § 139 and § 35b) but also constitutes a central element of clinical guidelines and decision making in health care. Tools supporting decision making (e. g. Health Technology Assessments (HTA)) are therefore in need of a valid methodological repertoire for these comparisons. ⋯ Given the main prerequisite - a pool of homogenous and high-quality RCT - the results of head-to-head trials may be pre-estimated by an adjusted indirect comparison or a MTC. In the context of HTA and guideline development they are valuable tools if there is a lack of a direct comparison of the interventions of interest.
-
Pharmacists' roles are evolving from that of compounders and dispensers of medicines to that of experts on medicines within multidisciplinary health care teams. In the developing country context, the pharmacy is often the most accessible or even the sole point of access to health care advice and services. Because of their knowledge of medicines and clinical therapeutics, pharmacists are suitably placed for task shifting in health care and could be further trained to undertake functions such as clinical management and laboratory diagnostics. ⋯ A coordinated and multifaceted effort to advance workforce planning, training and education is needed in order to prepare an adequate number of well-trained pharmacists for such roles. Acknowledging that health care needs can vary across geography and culture, an international group of key stakeholders in pharmacy education and global health has reached unanimous agreement that pharmacy education must be quality-driven and directed towards societal health care needs, the services required to meet those needs, the competences necessary to provide these services and the education needed to ensure those competences. Using that framework, this commentary describes the Pharmacy Education Taskforce of the World Health Organization, United Nations Educational, Scientific and Cultural Organization and the International Pharmaceutical Federation Global Pharmacy and the Education Action Plan 2008-2010, including the foundation, domains, objectives and outcome measures, and includes several examples of current activities within this scope.
-
Baseline clinical and health-related quality of life (HRQoL) data from a phase 2, multi-site, international, randomized, controlled trial were analyzed to: (1) characterize the health status of patients with relapsing-remitting multiple sclerosis (RRMS), (2) explore cross-sectional relationships between HRQoL and clinical measures, and (3) evaluate differences in HRQoL scores for subsequent validation as minimally important differences (MID). ⋯ Clinical and HRQoL assessments documented health impairments in physical functioning, fatigue, and cognition among these RRMS patients with relatively short disease duration. HRQoL data varied with clinical measures and contributed new information regarding disease burden. The association between clinical and HRQoL measures was limited to cross-sectional analysis and requires confirmation in longitudinal datasets. These findings reflect an ambulatory, early-stage RRMS population that was mostly European in location or descent. The PAMSI also requires further validation as a measure of patient health status.
-
Int J Equity Health · Apr 2009
Beneficial impacts of a national smokefree environments law on an indigenous population: a multifaceted evaluation.
Smokefree environments legislation is increasingly being implemented around the world. Evaluations largely find that the legislation is popular, compliance is high and report improved air quality and reduced exposure to secondhand smoke (SHS). The impact of the legislation on disadvantaged groups, including indigenous peoples has not been explored. We present findings from a multifaceted evaluation of the impact of the smokefree workplace provisions of the New Zealand Smokefree Environments Amendment Act on Māori people in New Zealand. Māori are the indigenous people of New Zealand. The Smokefree Environments Amendment Act extended existing smokefree legislation to almost all indoor workplaces in December 2004 (including restaurants and pubs/bars). ⋯ The New Zealand Smokefree Environments Amendment Act had a range of positive effects, including reducing SHS exposure among Māori communities. If the experience is replicated in other countries with indigenous populations, it suggests that comprehensive smokefree environments legislation will have beneficial effects on the health of indigenous groups and could contribute to reducing inequalities in health within societies.