Breaking News
November 14, 2018 - Health Tip: Limit Fat, Sugar and Salt in Your Child’s Diet
November 14, 2018 - CA 19-9 Blood Test (Pancreatic Cancer): MedlinePlus Lab Test Information
November 14, 2018 - Old drug could have new use helping sick premature babies
November 14, 2018 - Surgery, not antibiotics, should remain first-line treatment for appendicitis | News Center
November 14, 2018 - Researchers to develop sports-specific classification system for blind football
November 14, 2018 - Preschool children show awake responses to naptime nonsense words
November 14, 2018 - Survey shows negative effect of vulvovaginal atrophy symptoms on quality of life for women
November 14, 2018 - Study sheds light on mechanisms that prevent autoimmune attack
November 14, 2018 - Sleep quality found to be worse for women who undergo surgical menopause
November 14, 2018 - New study provides deeper insight into chromosome segregation during mitosis
November 14, 2018 - Inhibition of one protein clears toxic clumps seen in Parkinson’s disease, study finds
November 14, 2018 - Appendix removal is linked to lower risk of Parkinson’s
November 14, 2018 - Lifting weights for less than an hour a week may reduce cardiovascular disease risk
November 14, 2018 - Pulmonary rehabilitation rarely received by hospitalized COPD patients despite health benefits
November 14, 2018 - New anti-HER2 drug shows promising anti-tumor activity in gullet, stomach and bowel cancers
November 14, 2018 - Regular head circumference assessment of preterm babies can help identify long-term IQ problems
November 14, 2018 - Brigham investigators examine opioid use among Massachusetts adolescents, prescription trends
November 14, 2018 - Study defines biomarker in response to treatment of castration-resistant prostate cancer
November 14, 2018 - Study identifies potential therapeutic strategy for patients with clear cell renal cancer
November 14, 2018 - Bausch Health Announces U.S. Launch of Bryhali (halobetasol propionate) Lotion, 0.01%, for Plaque Psoriasis In Adults
November 14, 2018 - Alpha Fetoprotein (AFP) Tumor Marker Test: MedlinePlus Lab Test Information
November 14, 2018 - Researchers evaluate controversial treatment for Parkinson’s disease psychosis
November 14, 2018 - AI could help veterinarians code their notes
November 14, 2018 - Pre-schoolers with autism thrive in mainstream classroom settings
November 14, 2018 - Individual and work-related factors may help promote hospital physician engagement, finds study
November 14, 2018 - Complementary and alternative medicine is widely used by general population in England
November 14, 2018 - Study reveals link between tobacco availability and smoking during pregnancy
November 14, 2018 - Purdue researchers develop translucent base for silicon patches to deliver exact doses of biomolecules
November 14, 2018 - New technology based on moths and magnets could help treat genetic diseases
November 14, 2018 - Concussion-Related Biomarkers Vary Based on Sex, Race
November 14, 2018 - One more year of high school may shape waistlines later in life
November 14, 2018 - Dissecting high drug costs – Scope
November 14, 2018 - Study shows novel strategy to reduce breast cancer bone metastasis
November 14, 2018 - Empowering the NHS through Industry Partnerships
November 14, 2018 - One size does not fit all in obesity treatment, study finds
November 14, 2018 - Seeking ways to prevent ‘secondary cataracts’
November 14, 2018 - Change Within the Eye May Be Early Warning for Macular Degeneration
November 14, 2018 - Study of 500,000 people clarifies the risks of obesity
November 14, 2018 - Ultrasound releases drug to alter activity in targeted brain areas in rats | News Center
November 14, 2018 - Umass Amherst researchers battle against youth suicide in rural Alaska Native communities
November 14, 2018 - Cancer stem cells depend on amino acid metabolism, and it’s proving to be their Achilles’ heel
November 14, 2018 - Epigenetic link found between prenatal exposure to maternal smoking and offspring’s cardio-metabolic health
November 14, 2018 - Meditation, music may change biomarkers of cellular aging and Alzheimer’s disease in older adults
November 14, 2018 - Multidisciplinaryresearch teams selected to study age-related brain disorders
November 14, 2018 - The Current issue of “The view from here” is concerned with Informatics
November 14, 2018 - Researchers identify tool to help transgender women have a more authentic voice
November 14, 2018 - Four faculty members appointed to endowed professorships | News Center
November 13, 2018 - Research finds strongest evidence yet that obesity causes depression
November 13, 2018 - Researchers compare stools of breastfed and formula-fed infants
November 13, 2018 - Entasis Therapeutics Announces Zoliflodacin Phase 2 Results Published in The New England Journal of Medicine
November 13, 2018 - Gene changes driving myopia reveal new focus for drug development
November 13, 2018 - $6 million grant to support study of preeclampsia, atherosclerosis links | News Center
November 13, 2018 - Beneficial gut microbes metabolize high-fiber diet to improve heart health in mouse model
November 13, 2018 - Excessive use of social media through visual postings linked to increase in narcissistic traits
November 13, 2018 - Study finds why obesity both fuels cancer growth and helps immunotherapy to kill tumors
November 13, 2018 - Women prefer and invest more in daughters, while men favor sons
November 13, 2018 - With hospitalization losing favor, judges order outpatient mental health treatment
November 13, 2018 - Transgenic rat model may provide new insights into cerebral amyloid angiopathy
November 13, 2018 - Study identifies factors tied to greater risk of advanced liver disease in cystic fibrosis patients
November 13, 2018 - Risk of blindness among premature babies with low levels of blood platelets
November 13, 2018 - A new strategy for combatting antibiotic-resistant infections
November 13, 2018 - Study aims to find which outreach method is more effective at improving cancer screening rates
November 13, 2018 - Insufficient sleep duration linked with unhealthy lifestyle profile among children
November 13, 2018 - IIASA researchers introduce new, simple measure for human wellbeing
November 13, 2018 - Magnetic nanosprings used as targeted drug delivery agents for anticancer therapy
November 13, 2018 - Scientists examine FCMs containing silver nanoparticles
November 13, 2018 - Failed DNA repair triggers chromosomal chaos
November 13, 2018 - Study shows new emerging role of osteopontin in HCV-related hepatocellular carcinoma
November 13, 2018 - Food insecurity during pregnancy linked to severity of neonatal abstinence syndrome
November 13, 2018 - Majority of Americans are concerned about health threat posed by antibiotic resistance
November 13, 2018 - Addition of Elotuzumab Ups PFS in Refractory Multiple Myeloma
November 13, 2018 - Study finds women with pregnancy-related nausea, vomiting use marijuana more
November 13, 2018 - Lethal heart rhythm more likely to be found in patients with common heart failure
November 13, 2018 - Study provides new clues to origin and development of multiple sclerosis
November 13, 2018 - Climate change could pose threat to male fertility
November 13, 2018 - Researchers discover how mitochondria deploy a powerful punch against disease-causing bacteria
November 13, 2018 - AHA: Traumatic Childhood Could Increase Heart Disease Risk in Adulthood
November 13, 2018 - Feeling the Burn? | NIH News in Health
November 13, 2018 - Women’s birth canals in Kenya, Korea, Kansas not the same: study
November 13, 2018 - Fecal microbiota transplantation effective against ICI-associated colitis
New study focuses on best, cost effective practices to bridge treatment gap for brain disorders

New study focuses on best, cost effective practices to bridge treatment gap for brain disorders

image_pdfDownload PDFimage_print

Up to eight out of ten patients with a brain disorder remain untreated or inadequately treated. But what is the best practice – and above all, most cost effective – healthcare interventions to bridge the treatment gap? This was the focus of the European Brain Council’s study entitled The Value of Treatment which was discussed at the Congress of the European Academy of Neurology in Lisbon.

Up to eight out of ten people living with a brain disorder remain untreated or inadequately treated, even though effective therapies exist. What are the barriers to optimal treatment? Is it really unaffordable to grant people with brain disorders access to the best medical and psychosocial care? These questions were at the heart of the Value of Treatment study of the European Brain Council (EBC) which has been under discussion at the 4th Congress of the European Academy of Neurology (EAN) in Lisbon.

“The Value of Treatment puts a valuable resource in the hands of political decision-makers that contains the background information they need to reach conclusions on and analyze the return on investment for various treatments – as well as pinpointing cost-effective policy recommendations for treating brain disorders in their countries,” explained Prof Wolfgang Oertel (Marburg), Vice President of the EBC, who participated in the study. But it is not only a case of diagnosis and treatment of certain brain disorders, the study also sets out a vision for a more patient-centered and seamless, integrated care model for these conditions.

Brain disorders cost 800 billion a year

According to the European Brain Council brain disorders – including both neurological and psychiatric conditions – currently affect around one third of all European citizens or 179 million people, with steadily increasing numbers. And the costs of these conditions are enormous: the European Brain Council estimates the total at EUR 800 billion a year in Europe, with around 40 percent accounted for indirect costs such as incapacity, and lost earnings and tax revenues. But the huge amounts of money invested in treatment are often failing to deliver the desired outcomes, as Prof Oertel explained: “Healthcare and welfare systems are often inadequately organized and have trouble keeping up with the rapid pace of medical advances.”

Long-term misdiagnosis and inadequate treatment are the best examples of this. If a patient is unlucky, they can end up waiting a very long time before receiving specialist care. Many treatments have only been studied for a few years in neurological diseases a patient may suffer from for decades and may waste precious resources. At the same time, valuable time is lost – and particularly in the case of neurological disorders: ‘time is brain’. “When it comes to many brain disorders, the medical profession is increasingly pushing up against its limits. However, early recognition, starting treatment as soon as possible and preventive measures would serve to minimize the risks or may even in some instances slow the progression of the disease,” reported Prof Oertel.

Recommendations for patient-centered care

Following two years of research, The Value of Treatment (VoT) delivers recommendations to provide better and more cost-effective care for people with brain disorders. It contains nine case studies, which look into the situation regarding Alzheimer’s disease, epilepsy, headache, multiple sclerosis, normal pressure hydrocephalus, Parkinson’s disease, restless legs syndrome, schizophrenia and stroke. Hundreds of experts from representing European professional societies such as the EAN, EPA, ECNP, ENSA, FENS and patients’ associations like EFNA and GAMIAN which are all members of the European Brain Council were involved in the study which was based on data sets from different countries of the WHO Europe region, including the Czech Republic, France, Germany, Great Britain, Italy, Luxembourg, Russia, Sweden, Switzerland and Spain. The report used clinical indicators and patient data to assess the value of individual treatments for specific patient groups. This involved comparing the best possible treatment with the standard treatment offered or – if applicable – non-treatment and analyzed the health, social and economic costs. “We clearly saw that an early start to treatment and optimal care costs the least over the long term. Non-treatment is the most expensive variant for diseases such as restless legs syndrome or multiple sclerosis and epilepsy, which affect people from a young age,” said Prof Maura Pugliatti (Ferrara).

Case management instead of acute treatment alone

The Value of Treatment uses case studies to value specific healthcare interventions – and identifies where they often fall short of what they set out to achieve. In one such case study, a stroke patient in the prime of her life describes how she felt abandoned after receiving acute therapy. Nobody talked to her or her relatives about what should happen next. No steps were taken to initiate a course of rehabilitation or find out more about her situation at home and in the workplace. “This is something that simply wouldn’t happen with better case management,” noted Prof Oertel. “Everything possible would have been done to get this lady back on her feet and provide her with the necessary support. Perhaps she would have even been able to keep her job. But it is a time-consuming processes. That said, in overall economic terms it is still more cost effective than early retirement and permanent incapacity at the age of 45.”

Other case studies analyzed the situation of patients suffering from restless leg syndrome (RLS), a highly prevalent neurological disease. Around 2,7 percent of the European population suffer from moderate to severe forms of this uncontrollable urge to move the legs due to pain-like sensations, leading to chronic sleep deprivation. “RLS is among the five most important disorders with respect to economic disease burden”, Prof Oertl reported. The report describes a 67-year old RLS patient who received the diagnosis only after years of suffering. Subsequently medication was given at a too high dosage as a consequence of which her symptoms further worsened. “When translating RLS costs and the impact of RLS inadequate treatment to the general population, we foresee substantial economic impacts well beyond what may be anticipated from current epidemiological figures in the literature”, said Vinciane Quoidbach, a research associate at EBC herself strongly involved in the VoT study. Joke Jaarsma from Amsterdam, herself a sufferer of RLS and the president of EFNA added: “Education about RLS is urgently needed to increase expertise of health care professionals on how to diagnose and manage RLS. Also the search into the causes of RLS and for new treatment strategies has to be intensified.”

Another example from the VoT study looked at the issues surrounding the care gap: a migraine patient had been creeping out to her garage at night for years to scream so that her children would not be affected by her cries of pain. “This clearly illustrates the consequences of a lack of specialist facilities and a lack of defined treatment paths for certain diseases and patient groups, and shows what happens when insufficient social support is put in place for patients and their relatives,” said Prof. Oertel. But it is specialist outpatient clinics that are likely to fall victim to cost cutting measures in times of financial austerity. “The ongoing economic and financial crises have seen an overall deterioration in access to neurological care in some cities and rural areas due to cut backs or the introduction of excesses payable by patients. It often takes too long to come up with the right diagnosis and initiate personalised therapies – if at all,” concluded Prof Oertel. But this is a false economic strategy. As a fact-based study, The Value of Treatment highlights how important prevention and early detection are, while showing that an early start to treatment makes sense both from a healthcare and an economic point of view: “Measurable health gains are linked to early intervention such as better survival rates, fewer complications, lower incidence of disability, improved quality of life and, ultimately, lower treatment costs – all of that would be possible!” Prof Oertel explained. Given the right medication, 70 percent of epilepsy patients could lead fit-free lives without any restrictions, and the remaining 30 percent could be offered access to other viable treatment options including surgical intervention. “But that calls for suitable treatment from the occurrence of the first fit onwards – by a suitably qualified specialist. And this is where there are major – yet surmountable – treatment gaps to be filled. We have a humanitarian duty to bridge them to the best of our ability when it comes to neurological conditions.

Source:

Home

Tagged with:

About author

Related Articles