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[PMID]:28453758
[Au] Autor:Daperno M; Comberlato M; Bossa F; Armuzzi A; Biancone L; Bonanomi AG; Cosintino R; Lombardi G; Mangiarotti R; Papa A; Pica R; Grassano L; Pagana G; D'Incà R; Orlando A; Rizzello F; IGIBDEndo Group
[Ad] Endereço:Gastroenterology Unit, AO Ordine Mauriziano, Torino, TO, Italy.
[Ti] Título:Training Programs on Endoscopic Scoring Systems for Inflammatory Bowel Disease Lead to a Significant Increase in Interobserver Agreement Among Community Gastroenterologists.
[So] Source:J Crohns Colitis;11(5):556-561, 2017 May 01.
[Is] ISSN:1876-4479
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and Aims: Endoscopic outcomes are increasingly used in clinical trials and in routine practice for inflammatory bowel disease [IBD] in order to reach more objective patient evaluations than possible using only clinical features. However, reproducibility of endoscopic scoring systems used to categorize endoscopic activity has been reported to be suboptimal. The aim of this study was to analyse the inter-rated agreement of non-dedicated gastroenterologists on IBD endoscopic scoring systems, and to explore the effects of a dedicated training programme on agreement. Methods: A total of 237 physicians attended training courses on IBD endoscopic scoring systems, and they independently scored a set of IBD endoscopic videos for ulcerative colitis [with Mayo endoscopic subscore], post-operative Crohn's disease [with Rutgeerts score] and luminal Crohn's disease (with the Simple Endoscopic Score for Crohn's Disease [SESCD] and Crohn's Endoscopic Index of Severity [CDEIS]). A second round of scoring was collected after discussion about determinants of discrepancy. Interobserver agreement was measured by means of the Fleiss' kappa [kappa] or intraclass correlation coefficient [ICC] as appropriate. Results: The inter-rater agreement increased from kappa 0.51 (95% confidence interval [95% CI] 0.48-0.55) to 0.76 [95% CI 0.72-0.79] for the Mayo endoscopic subscore, and from 0.45 [95% CI 0.40-0.50] to 0.79 [0.74-0.83] for the Rutgeerts score before and after the training programme, respectively, and both differences were significant [P < 0.0001]. The ICC was 0.77 [95% CI 0.56-0.96] for SESCD and 0.76 [0.54- 0.96] for CDEIS, respectively, with only one measurement. Discussion: The basal inter-rater agreement of inexperienced gastroenterologists focused on IBD management is moderate; however, a dedicated training programme can significantly impact on inter-rater agreement, increasing it to levels expected among expert central reviewers.
[Mh] Termos MeSH primário: Colonoscopia/educação
Gastroenterologistas/educação
Doenças Inflamatórias Intestinais/diagnóstico
[Mh] Termos MeSH secundário: Colite Ulcerativa/diagnóstico
Colite Ulcerativa/patologia
Doença de Crohn/diagnóstico
Doença de Crohn/patologia
Educação Médica Continuada/métodos
Gastroenterologistas/estatística & dados numéricos
Seres Humanos
Doenças Inflamatórias Intestinais/patologia
Variações Dependentes do Observador
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/ecco-jcc/jjw181


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[PMID]:29369224
[Au] Autor:Kaplan DE; Mehta R; D'Addeo K; Valderrama A; Taddei TH; Sorafenib for Hepatocellular carcinomA in VEterans (SHAVE) Study Investigators
[Ad] Endereço:Department of Medicine, University of Pennsylvania.
[Ti] Título:Sorafenib prescribed by gastroenterologists and hepatologists for hepatocellular carcinoma: A retrospective, multi-institutional cohort study.
[So] Source:Medicine (Baltimore);97(4):e9757, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Sorafenib is the only Food and Drug Administration (FDA)-approved first-line therapy shown to have survival benefit for patients with advanced hepatocellular carcinoma (HCC). Patients with advanced HCC are often but not exclusively transferred from non-oncologists to oncologists to initiate systemic therapy. The objective of this study was to assess whether sorafenib prescribing by non-oncologists has any impact on utilization, adverse effects, cost or outcome.This was a retrospective cohort study utilizing data from patients prescribed sorafenib for HCC within Veterans Health Administration hospitals with 100% chart abstraction to confirm HCC diagnosis, identify prescribing provider specialty (oncology versus gastroenterology/hepatology), and obtain data required for cancer staging by the Barcelona Clinic Liver Cancer (BCLC) system. The primary outcome was overall survival from the time of sorafenib prescription.A total of 4903 patients who prescribed sorafenib for HCC were identified, for whom 340 patients (6.9%) were prescribed drug by a non-oncologist (Onc). BCLC Stage, age, Child-Turcotte-Pugh score, and comorbidity indices were similar between patients prescribed sorafenib by oncologists and non-oncologists. Oncologists more often discontinued sorafenib due to progression, whereas non-oncologists were more likely to continue sorafenib until death resulting in greater pill utilization and cost. Overall survival in both unadjusted and multivariable models showed no significant impact of prescriber type on survival (222 vs 217 days, P = .96), confirmed with propensity-matched subcohorts.Similar survival outcomes were observed for patients with HCC prescribed sorafenib by non-oncologists and oncologists, suggesting that non-oncologists with expertise in the management of HCC can safely and effectively administer sorafenib.
[Mh] Termos MeSH primário: Antineoplásicos/uso terapêutico
Carcinoma Hepatocelular/tratamento farmacológico
Neoplasias Hepáticas/tratamento farmacológico
Niacinamida/análogos & derivados
Compostos de Fenilureia/uso terapêutico
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Idoso
Antineoplásicos/economia
Custos de Medicamentos
Prescrições de Medicamentos/estatística & dados numéricos
Feminino
Gastroenterologistas/estatística & dados numéricos
Seres Humanos
Masculino
Oncologia/estatística & dados numéricos
Meia-Idade
Niacinamida/economia
Niacinamida/uso terapêutico
Compostos de Fenilureia/economia
Estudos Retrospectivos
Estados Unidos
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Phenylurea Compounds); 25X51I8RD4 (Niacinamide); 9ZOQ3TZI87 (sorafenib)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009757


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[PMID]:27770471
[Au] Autor:Garcia-Tsao G
[Ad] Endereço:Digestive Diseases Section, Yale University School of Medicine, New Haven, CT.
[Ti] Título:Empowering women: Perspective from a hepatologist.
[So] Source:Hepatology;64(6):1831-1833, 2016 12.
[Is] ISSN:1527-3350
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Gastroenterologistas
Médicas
Poder (Psicologia)
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Caracteres Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE
[do] DOI:10.1002/hep.28875


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[PMID]:28815353
[Au] Autor:Kumar NL; Perencevich ML; Trier JS
[Ad] Endereço:Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. nlkumar@partners.org.
[Ti] Título:Perceptions of the Inpatient Training Experience: A Nationwide Survey of Gastroenterology Program Directors and Fellows.
[So] Source:Dig Dis Sci;62(10):2631-2647, 2017 Oct.
[Is] ISSN:1573-2568
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Inpatient training is a key component of gastroenterology (GI) fellowship programs nationwide, yet little is known about perceptions of the inpatient training experience. AIM: To compare the content, objectives and quality of the inpatient training experience as perceived by program directors (PD) and fellows in US ACGME-accredited GI fellowship programs. METHODS: We conducted a nationwide, online-based survey of GI PDs and fellows at the conclusion of the 2016 academic year. We queried participants about (1) the current models of inpatient training, (2) the content, objectives, and quality of the inpatient training experience, and (3) the frequency and quality of educational activities on the inpatient service. We analyzed five-point Likert items and rank assessments as continuous variables by an independent t test and compared proportions using the Chi-square test. RESULTS: Survey response rate was 48.4% (75/155) for PDs and a total of 194 fellows completed the survey, with both groups reporting the general GI consult team (>90%) as the primary model of inpatient training. PDs and fellows agreed on the ranking of all queried responsibilities of the inpatient fellow to develop during the inpatient service. However, fellows indicated that attendings spent less time teaching and provided less formal feedback than that perceived by PDs (p < 0.0001). PDs rated the overall quality of the inpatient training experience (p < 0.0001) and education on the wards (p = 0.0003) as better than overall ratings by fellows. CONCLUSION: Although GI fellows and PDs agree on the importance of specific fellow responsibilities on the inpatient service, fellows report experiencing less teaching and feedback from attendings than that perceived by PDs. Committing more time to education and assessment may improve fellows' perceptions of the inpatient training experience.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Educação de Pós-Graduação em Medicina/métodos
Docentes de Medicina/psicologia
Gastroenterologistas/educação
Gastroenterologistas/psicologia
Gastroenterologia/educação
Conhecimentos, Atitudes e Prática em Saúde
Pacientes Internados
Internato e Residência
Percepção
[Mh] Termos MeSH secundário: Distribuição de Qui-Quadrado
Competência Clínica
Bolsas de Estudo
Feminino
Feedback Formativo
Seres Humanos
Masculino
Avaliação de Programas e Projetos de Saúde
Inquéritos e Questionários
Carga de Trabalho
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1007/s10620-017-4711-y


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[PMID]:28785771
[Au] Autor:Kattakuzhy S; Gross C; Emmanuel B; Teferi G; Jenkins V; Silk R; Akoth E; Thomas A; Ahmed C; Espinosa M; Price A; Rosenthal E; Tang L; Wilson E; Bentzen S; Masur H; Kottilil S; and the ASCEND Providers
[Ad] Endereço:From University of Maryland School of Medicine, Baltimore, Maryland; Unity Health Care and Family and Medical Counseling Services, Washington, DC; and National Institutes of Health, Bethesda, Maryland.
[Ti] Título:Expansion of Treatment for Hepatitis C Virus Infection by Task Shifting to Community-Based Nonspecialist Providers: A Nonrandomized Clinical Trial.
[So] Source:Ann Intern Med;167(5):311-318, 2017 Sep 05.
[Is] ISSN:1539-3704
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection has resulted in high rates of disease cure; however, not enough specialists currently are available to provide care. Objective: To determine the efficacy of HCV treatment independently provided by nurse practitioners (NPs), primary care physicians (PCPs), or specialist physicians using DAA therapy. Design: Nonrandomized, open-label clinical trial initiated in 2015. (ClinicalTrials.gov: NCT02339038). Setting: 13 urban, federally qualified health centers (FQHCs) in the District of Columbia. Patients: A referred sample of 600 patients, of whom 96% were black, 69% were male, 82% were treatment naive, and 20% had cirrhosis. Seventy-two percent of the patients had HCV genotype 1a infection. The baseline characteristics of patients seen by each provider type were similar. Intervention: Patients were assigned in a nonrandomized but specified manner to receive treatment from 1 of 5 NPs, 5 PCPs, or 6 specialists. All providers underwent an identical 3-hour training session based on guidelines. Patients received treatment with ledipasvir-sofosbuvir, which was provided on site, according to U.S. Food and Drug Administration labeling requirements. Measurements: Sustained virologic response (SVR). Results: 516 patients achieved SVR, a response rate of 86% (95% CI, 83.0% to 88.7%), with no major safety signals. Response rates were consistent across the 3 provider types: NPs, 89.3% (CI, 83.3% to 93.8%); PCPs, 86.9% (CI, 80.6% to 91.7%); and specialists, 83.8% (CI, 79.0% to 87.8%). Patient loss to follow-up was the major cause of non-SVR. Limitation: Nonrandomized patient distribution; possible referral bias. Conclusion: In a real-world cohort of patients at urban FQHCs, HCV treatment administered by nonspecialist providers was as safe and effective as that provided by specialists. Nurse practitioners and PCPs with compact didactic training could substantially expand the availability of community-based providers to escalate HCV therapy, bridging existing gaps in the continuum of care for patients with HCV infection. Primary Funding Source: National Institutes of Health and Gilead Sciences.
[Mh] Termos MeSH primário: Antivirais/uso terapêutico
Serviços de Saúde Comunitária/organização & administração
Hepatite C Crônica/tratamento farmacológico
Profissionais de Enfermagem
Médicos de Atenção Primária
[Mh] Termos MeSH secundário: Antivirais/efeitos adversos
Serviços de Saúde Comunitária/métodos
Serviços de Saúde Comunitária/normas
District of Columbia
Feminino
Gastroenterologistas
Infecções por HIV/complicações
Hepatite C Crônica/complicações
Seres Humanos
Infectologia
Cirrose Hepática/complicações
Masculino
Adesão à Medicação
Meia-Idade
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE IV; JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Antiviral Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170809
[St] Status:MEDLINE
[do] DOI:10.7326/M17-0118


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[PMID]:28686048
[Au] Autor:Anderson L
[Ad] Endereço:Nutrition Nurse Specialist, Nutrition and Dietetics Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust.
[Ti] Título:Nutrition teams: what are they and why do we need them?
[So] Source:Br J Community Nurs;22(Sup7):S8-S10, 2017 Jul 01.
[Is] ISSN:1462-4753
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Gastroenterologistas
Enfermeiras Especialistas
Apoio Nutricional
Nutricionistas
Equipe de Assistência ao Paciente/organização & administração
[Mh] Termos MeSH secundário: Seres Humanos
Medicina Estatal
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170708
[St] Status:MEDLINE
[do] DOI:10.12968/bjcn.2017.22.Sup7.S8


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[PMID]:28482818
[Au] Autor:Yoshioka N; Okumura A; Yamamoto Y; Yamaguchi K; Kaga A; Yamada K; Hirosaki T; Ishikawa D; Kunii S; Watanabe K; Utsunomiya S; Hayashi K; Ishigami M; Goto H; Hirooka Y
[Ad] Endereço:Department of Gastroenterology, The Aichi Prefectural Federation of Agricultural Cooperatives for Health and Welfare Kainan Hospital, 396 Minamihonden, Maegasu-cho, Yatomi, Aichi, 498-8502, Japan. town_court_2@yahoo.co.jp.
[Ti] Título:Promoting notification and linkage of HBs antigen and anti-HCV antibody-positive patients through hospital alert system.
[So] Source:BMC Infect Dis;17(1):330, 2017 May 08.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In Japan, approximately 0.9% and 1% of the whole population are infected with HBV and HCV, respectively. Doctors from departments other than gastroenterology often order viral hepatitis tests before an invasive examination or an operation. However, the notification of positive results to the patients and linkage to care is not appropriately performed. The in-hospital alert system was constructed to promote the notification and referral to gastroenterologists for patients with positive viral hepatitis tests, and its efficacy was evaluated. METHODS: The patients who tested HBsAg and anti-HCV antibody by chemiluminescent enzyme immunoassays and chemiluminescent immunoassays were investigated for whether they were notified of the positive results and if they were referred to gastroenterologists at our hospital. The notification and referral rate was compared before (from January to December 2014) and after the introduction of the alert system (from February to September 2016). RESULTS: HBsAg-positive rate was 1.1% (69/6543) before the introduction of the alert system and 0.8% (41/5403) after it. The notification rate has significantly improved from 46% to 73% (p = 0.0061) and the referral rate has improved from 16% to 27%, while not significant. Positive rate of anti-HCV antibody was 2.1% (139/6481) before the introduction of the alert system and 2.4% (128/5322) after it. The rate of notification and referral has significantly improved from 35% to 62% (p < 0.0001) and from 6% to 23% (p < 0.0001), respectively. CONCLUSIONS: The in-hospital alert system increased the rates of notification and referral of the patients with positive viral hepatitis tests. Enlightenment of doctors other than gastroenterologists on viral hepatitis and cooperation of medical staffs would be helpful to improve the notification and referral rates.
[Mh] Termos MeSH primário: Hepatite B/diagnóstico
Hepatite C/diagnóstico
Sistemas de Comunicação no Hospital/organização & administração
[Mh] Termos MeSH secundário: Gastroenterologistas
Hepatite B/epidemiologia
Antígenos de Superfície da Hepatite B/sangue
Hepatite C/epidemiologia
Anticorpos Anti-Hepatite C/sangue
Administração Hospitalar/métodos
Hospitais
Seres Humanos
Japão/epidemiologia
Encaminhamento e Consulta/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hepatitis B Surface Antigens); 0 (Hepatitis C Antibodies)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170510
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2438-1


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[PMID]:28441679
[Au] Autor:Ruhnke GW; Manning WG; Rubin DT; Meltzer DO
[Ad] Endereço:G.W. Ruhnke is assistant professor, Section of Hospital Medicine, Department of Medicine, University of Chicago Medicine, Chicago, Illinois.W.G. Manning was professor, Department of Health Studies, and professor, Public Policy Studies and Public Health Sciences, Harris School of Public Policy Studies, University of Chicago, Chicago, Illinois.D.T. Rubin is professor of medicine and section chief, Gastroenterology, Hepatology and Nutrition, Department of Medicine, Pritzker School of Medicine, University of Chicago Medicine, Chicago, Illinois.D.O. Meltzer is section chief, Hospital Medicine, Fanny L. Pritzker Professor of Medicine, and director, Center for Health and the Social Sciences, Pritzker School of Medicine, and professor, Harris School of Public Policy Studies, University of Chicago, Chicago, Illinois.
[Ti] Título:The Drivers of Discretionary Utilization: Clinical History Versus Physician Supply.
[So] Source:Acad Med;92(5):703-708, 2017 May.
[Is] ISSN:1938-808X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Because the effect of physician supply on utilization remains controversial, literature based on non-Medicare populations is sparse, and a physician supply expansion is under way, the potential for physician-induced demand across diverse populations is important to understand. A substantial proportion of gastrointestinal endoscopies may be inappropriate. The authors analyzed the impact of physician supply, practice patterns, and clinical history on esophagogastroduodenoscopy (EGD, defined as discretionary) among patients hospitalized with lower gastrointestinal bleeding (LGIB). METHOD: Among 34,344 patients hospitalized for LGIB from 2004 to 2009, 43.1% and 21.3% had a colonoscopy or EGD, respectively, during the index hospitalization or within 6 months after. Linking to the Dartmouth Atlas via patients' hospital referral region, gastroenterologist density and hospital care intensity (HCI) index were ascertained. Adjusting for age, gender, comorbidities, and race/education indicators, the association of gastroenterologist density, HCI index, and history of upper gastrointestinal disease with EGD was estimated using logistic regression. RESULTS: EGD was not associated with gastroenterologist density or HCI index, but was associated with a history of upper gastrointestinal disease (OR 2.30; 95% CI 2.17-2.43), peptic ulcer disease (OR 4.82; 95% CI 4.26-5.45), and liver disease (OR 1.34; 95% CI 1.18-1.54). CONCLUSIONS: Among patients hospitalized with LGIB, large variation in gastroenterologist density did not predict EGD, but relevant clinical history did, with association strengths commensurate with risk for upper gastrointestinal bleeding. In the scenario studied, no evidence was found that specialty physician supply increases will result in more discretionary care within commercially insured populations.
[Mh] Termos MeSH primário: Doenças do Colo/diagnóstico
Colonoscopia/utilização
Endoscopia do Sistema Digestório/utilização
Gastroenterologistas/provisão & distribuição
Hemorragia Gastrointestinal/terapia
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Gerenciamento Clínico
Feminino
Serviços de Saúde/utilização
Seres Humanos
Modelos Logísticos
Masculino
Uso Excessivo de Produtos e Serviços de Saúde/estatística & dados numéricos
Meia-Idade
Análise Multivariada
Médicos/provisão & distribuição
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170426
[St] Status:MEDLINE
[do] DOI:10.1097/ACM.0000000000001500


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[PMID]:28410403
[Au] Autor:Sullivan E; Piercy J; Waller J; Black CM; Kachroo S
[Ad] Endereço:Adelphi Real World, Manchester, United Kingdom.
[Ti] Título:Assessing gastroenterologist and patient acceptance of biosimilars in ulcerative colitis and Crohn's disease across Germany.
[So] Source:PLoS One;12(4):e0175826, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: This study examined gastroenterologists' motivation for prescribing biosimilars, assessed their treatment preferences in relation to prescribing behaviour, and explored patient attitudes to biosimilars. METHODS: Data were taken from the Adelphi Real World Biosimilars Programme, a real-world, cross-sectional study undertaken in 2015-2016 with German gastroenterologists and patients with ulcerative colitis or Crohn's disease. Gastroenterologists provided data on their prescribing behaviour and attitudes towards biosimilars, and invited the next eight eligible consecutive consulting patients to complete a detailed questionnaire. For analysis, gastroenterologists were split into 'Investigative', 'Conservative', and 'Other' groups. RESULTS: Overall, 25 gastroenterologists and 136 patients participated. Biosimilars accounted for <15% of all biologic therapies and >80% of gastroenterologists would prescribe a bio-originator rather than biosimilar as 1st line therapy if unrestricted. Patients showed some reluctance to accept biosimilars, although of those receiving biosimilars, 79% were satisfied with the current treatment of their condition, and 69% were satisfied with the control of symptoms. Although at least 35% of patients in each analysis group reported no concerns when starting treatment with a bio-originator or biosimilar, 41% of previously biologic-naïve patients prescribed a biosimilar indicated potential side effects and potential long-term problems, and 24% not knowing enough about the drug, as concerns. CONCLUSION: Results demonstrate that there is reluctance from patients to accept biosimilars and the need to further educate patients who are unsure to allow them to be involved in decision making, highlighting the importance of patient and physician communication. There remains a need for further research into non-clinical switching and the long term impact of prescribing biosimilars.
[Mh] Termos MeSH primário: Anticorpos Monoclonais/uso terapêutico
Medicamentos Biossimilares/uso terapêutico
Colite Ulcerativa/tratamento farmacológico
Doença de Crohn/tratamento farmacológico
Gastroenterologistas/psicologia
Satisfação do Paciente
[Mh] Termos MeSH secundário: Atitude
Estudos Transversais
Prescrições de Medicamentos
Alemanha
Seres Humanos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Biosimilar Pharmaceuticals)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170504
[Lr] Data última revisão:
170504
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170415
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0175826


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[PMID]:28365918
[Au] Autor:Hirten R; Sands BE; Cohen BL
[Ad] Endereço:The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at The Mount Sinai Hospital, 1468 Madison Avenue, Box 1069, New York, NY, 10029-6574, USA. robert.hirten@mountsinai.org.
[Ti] Título:The Whys and Hows of Fourth-Year Inflammatory Bowel Disease Fellowships.
[So] Source:Dig Dis Sci;62(5):1116-1118, 2017 05.
[Is] ISSN:1573-2568
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Bolsas de Estudo/métodos
Gastroenterologistas/educação
Doenças Inflamatórias Intestinais
Internato e Residência/métodos
[Mh] Termos MeSH secundário: Bolsas de Estudo/tendências
Gastroenterologistas/tendências
Seres Humanos
Doenças Inflamatórias Intestinais/diagnóstico
Doenças Inflamatórias Intestinais/terapia
Internato e Residência/tendências
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171027
[Lr] Data última revisão:
171027
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170403
[St] Status:MEDLINE
[do] DOI:10.1007/s10620-017-4555-5



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