Psychophysical and Social Functioning of Patients with Chronic Obstructive Lung Disease and Depression

The relationship between depression and chronic obstructive pulmonary disease (COPD) is not fully understood. The comorbidity rate ranges from 18 to 84%, and depression is closely related to chronic inflammation, which affects how patients and the people around them perceive their condition. This study aims to examine the relationship between the psychophysical and social functioning of COPD patients who have been diagnosed with depression and the therapeutic benefits of selective serotonin reuptake inhibitors (SSRIs). This prospective study enrolled primary care patients diagnosed with COPD and depression. The entire period of this research was 3 years. The research was conducted at the Primary Health Center, Kragujevac, Serbia, in 87 patients for 8 weeks. The Hamilton Depression Scale (HAM-D) and Questionnaire for Quality of Life and Life Satisfaction Short Form (Q-LES-Q-SF) were used for psychiatric assessment. A positive correlation was found between the psychophysical and social functioning of the participants after 8 weeks of treatment with SSRIs. Based on the value of the phi correlation coefficient (phi = 0.5) obtained using the χ2 test, a large influence was observed in terms of life satisfaction and physical health (p < 0.05). In terms of physical functioning by gender, based on the value of the Pearson's coefficient (r) obtained with the χ2 test, it was shown that physical functioning was superior in the female respondents (p < 0.05). Treatment was found to improve depression in COPD after 8 weeks of therapy.

Pharmacoeconomic aspects of hospital treatment of facial fractures - cost of illness study based on data from Balkan country with recent history of social and economic transition

Background/purpose: The incidence of facial fractures has a tendency to rise, which positively correlates with increasing total costs of treating this medical condition. The aim of this study was to identify the total costs of the hospital treatment of facial fractures and to analyze its main determinants. Materials and methods: This retrospective "cost-of-illness" study "from bottom to the top" approach was performed from the perspective of the Republic Health Insurance Fund. This study included 46 patients who were treated due to facial fractures at the Clinic for Maxillofacial Surgery at the Clinical Center Kragujevac in the period from the beginning of December 2017. to January 31, 2019. Results: The total costs of hospital treatment of all types of treated fractures amounted to 20,214.30€, and the average total cost per patient was estimated at 439.44±299.53€. The costs related to the length of hospitalization represented the largest part of the total direct costs, with a contribution of 31% and with a value of 6,329.30±80.18 €. Conclusions: Results of this pilot study pointed out that the total costs of treating facial fractures in the socio-economic sphere of Balkan countries are lower than in other health care systems, mostly due to differences in valuing medical services compared to countries within the European Union. Due to the rising incidence of injuries and obligatory hospital treatment of these conditions, this kind of pharmacoeconomic evaluation could contribute to the introduction of new therapeutic strategies for adequate allocation of resources within health systems.

Resource Use and Costs Related to Hematological Complications of Chemotherapy: Cost of Illness Study Based on Data from Balkan Country with Recent History of Socioeconomic Transition

Background

The administration of chemotherapy positively correlates with diverse adverse drug reactions, including the significant impact of hematological hazards such as anemia, leukopenia-neutropenia, thrombocytopenia, and pancytopenia. This pilot pharmacoeconomic study aimed to estimate the total direct costs of treating hematological toxicity induced by chemotherapy and its main determinants.

Methods

The study was conducted as a retrospective cost of illness study using the "from bottom to the top" approach from the perspective of the Republic Health Insurance Fund. This study included 88 patients treated due to developing at least one episode of one of the types of hematological complications of cytostatics in 2018 at the Oncology Clinic of the University Clinical Center Kragujevac, Kragujevac, the Republic of Serbia.

Results

Among cancer patients who developed haematological toxicity, treating pancytopenia was most demanding in a pharmacoeconomic manner compared to neutropenia and thrombocytopenia, with an estimated value of direct costs of 264,14, 178,19 and 157,76 euros per patient per year respectively. Regarding total direct costs, the main determinants were the costs of drugs, their parenteral administration, and costs due to hospitalization.

Conclusion

Due to the rising cancer incidence and obligatory hospital treatment of hematological toxicity induced by chemotherapy, the identification of the pharmacoeconomic aspects of the treatment of these complications is needed. Future research should focus on the development of new modalities of treatment regarding patient characteristics anticipating high costs.