Breaking News
July 21, 2018 - Parents say intense gun violence in PG-13 movies appropriate for teens 15 and older
July 21, 2018 - FAU researchers find possible cause of Parkinson’s disease in the patients’ immune system
July 21, 2018 - Protective qualities of ‘good cholesterol’ reduce after menopause
July 21, 2018 - Researchers develop new way to uncover hidden breast cancer tumors
July 21, 2018 - FDA approves first drug for treatment of adult AML patients with specific genetic mutation
July 21, 2018 - Top AI companies join hands to discover novel drugs for DMD
July 21, 2018 - Ferring announces FDA approval of ZOMACTON for injection in four new pediatric indications
July 20, 2018 - Researchers design proteins that can self-assemble into complex structures
July 20, 2018 - AVITA Medical expands management team to support launch of RECELL device to treat burns
July 20, 2018 - FDA Approves Tibsovo (ivosidenib) for Relapsed or Refractory Acute Myeloid Leukemia with an IDH1 Mutation
July 20, 2018 - Developmental screening and surveillance rates remain low, new study suggests
July 20, 2018 - TGen opens tissue donation portal to advance DIPG research
July 20, 2018 - Health impact of highly processed summertime staples
July 20, 2018 - Exergaming can improve health in overweight and obese children, study shows
July 20, 2018 - Postmenopausal factors may impact heart-protective qualities of ‘good cholesterol’
July 20, 2018 - MRI and blood test combination results in improved prostate cancer diagnosis
July 20, 2018 - Update Health Professional and Consumer on Recent Recalled Products
July 20, 2018 - Researchers trace Parkinson’s damage in the heart
July 20, 2018 - Wearable device designed to measure cortisol in sweat
July 20, 2018 - Scientists demonstrate a new regulation mechanism for skeletal muscles
July 20, 2018 - Exposure to mobile phone radiation may negatively impact memory performance in adolescents
July 20, 2018 - SUSU scientists find alternative method to treat post-traumatic stress disorder syndrome
July 20, 2018 - Gestational diabetes may increase offspring’s heart disease risk
July 20, 2018 - New vaccine could protect unborn babies from Zika virus
July 20, 2018 - Researchers find high mercury and methylmercury concentrations in traditional Tibetan medicine
July 20, 2018 - Brief Safety Plan Intervention in ER Can Cut Suicidal Behavior
July 20, 2018 - Toward a better understanding of Parkinson’s disease
July 20, 2018 - Med school communications office wins four national awards | News Center
July 20, 2018 - Professional baseball players with faster hand-eye coordination may have better batting performance
July 20, 2018 - Study looks into mechanisms that control sleep and wakefulness
July 20, 2018 - Scientists identify melanoma biomarkers that could help tailor immunotherapy treatments
July 20, 2018 - Research reveals long-term efficacy of drug used to treat common cause of kidney failure
July 20, 2018 - Timing of dinner associated with breast and prostate cancer risks
July 20, 2018 - Health Tip: Performing the Heimlich Maneuver
July 20, 2018 - Nearly all adolescents have eating, activity or weight-related issues
July 20, 2018 - Sage launches new web-based tool that helps explore curated genomic analyses of Alzheimer’s
July 20, 2018 - High-performance porous polymeric material for chromatography applications
July 20, 2018 - New molecule shows great promise for future treatment of many cancers
July 20, 2018 - New research project investigates alternative treatments for eye infections
July 20, 2018 - Immune T cells are built to react as fast as possible, shows study
July 20, 2018 - ZHX2 protein could offer a new treatment strategy for kidney cancer
July 20, 2018 - EKF’s Quo-Lab POC HbA1c analyzer meets international quality targets for diabetes testing
July 20, 2018 - Health burdens of very high risk drinking are potentially large, study reveals
July 20, 2018 - Using miniature drug-filled nanocarriers to target headaches and tumors
July 20, 2018 - Researchers uncover cause for progression of prostate cancer to incurable stage
July 20, 2018 - Studies highlight issues regarding black lung, opioid overdose, police violence and more
July 20, 2018 - AbbVie submits supplemental NDA to FDA for venetoclax to treat acute myeloid leukemia
July 20, 2018 - Researchers are one step closer to developing eye drops to treat age-related macular degeneration (AMD)
July 20, 2018 - Patients maintain muscle mass five years after surgically induced weight loss
July 20, 2018 - AMSBIO introduces new, powerful CRISPR/Cas9 gene editing kits
July 20, 2018 - PureTech Health collaborates with Roche to advance oral administration of antisense oligonucleotides
July 20, 2018 - Analysis reveals disparities in cancer death rates among minority groups
July 20, 2018 - Dr Maddy Parsons receives Royal Microscopical Society Life Science Medal
July 20, 2018 - Study finds link between DNA methylation and non-alcoholic fatty liver disease
July 20, 2018 - Military personnel with head trauma and football players with suspected CTE show similar brain changes
July 20, 2018 - Vidac Pharma Announces Initiation of Phase 2b Clinical Trial of VDA-1102 Ointment in Patients with Actinic Keratosis
July 20, 2018 - KKR is buying Envision Healthcare in a nearly $10B deal
July 20, 2018 - Older people with broken bones face higher risk of death for up to 10 years
July 20, 2018 - A simple pill for meth addicts on the cards
July 20, 2018 - UA researchers to repurpose ketamine to reduce side effects in Parkinson’s patients
July 20, 2018 - Child psychiatrist available on call to help assess separated immigrant children
July 20, 2018 - High bitter-taste sensitivity linked to increased risk of cancer
July 20, 2018 - Falling temperatures may lead to rise in numbers of deaths from stroke
July 20, 2018 - Supplemental oxygen prevents rise in morning blood pressure in OSA patients
July 20, 2018 - High fruit and vegetable intake linked to reduced risk of breast cancer
July 20, 2018 - Careful patient selection may help achieve good outcomes for vaginal mesh surgery
July 20, 2018 - Researchers raise viability of cloned mice using somatic cell nuclear transfer method
July 20, 2018 - 3HP for Latent TB Infection Treatment | 2018 | Newsroom | NCHHSTP
July 20, 2018 - An orange a day keeps macular degeneration away: 15-year study
July 20, 2018 - Researchers elucidate how the brain drives trial-by-trial adaptation to compensate for errors
July 20, 2018 - Understanding triple-negative breast cancer to develop better treatments
July 20, 2018 - Study compares outpatient antibiotic prescribing with traditional medical, retail clinic settings
July 20, 2018 - Immediate Monitoring With ECG Patch Ups A-Fib Diagnosis Rate
July 20, 2018 - KHN’s ‘What the Health?’ Drug prices and unicorns
July 20, 2018 - Scientists seek to better protect the eye from glaucoma
July 20, 2018 - Football training could improve bone mineral density in prostate cancer patients
July 20, 2018 - Single genetic change in gut bacteria can lead to obesity
July 20, 2018 - Research uncovers new target for therapeutic intervention in breast cancer
July 20, 2018 - WFN to highlight clean air for brain health on World Brain Day 2018
July 20, 2018 - Health Highlights: July 17, 2018
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