Breaking News
September 19, 2018 - Sensor array may detect de novo Parkinson’s disease in breath
September 19, 2018 - A roadmap for the future of electronic health records
September 19, 2018 - Surprising research showing peptide adaptability may pave way to develop immunotherapies
September 19, 2018 - Amyloid β protein makes comeback as therapeutic target for Alzheimer’s disease
September 19, 2018 - Alcon expands its global support of eye care professionals through Alcon Experience Academy
September 19, 2018 - Study gives new insights into how cells leverage GPCRs to control inflammation
September 19, 2018 - Automatic relevance detection in ophthalmic surgery videos
September 19, 2018 - UNIST to accelerate discovery, development of new medicines for incurable diseases
September 19, 2018 - Novel clinical trial to examine cannabis as potential treatment for essential tremor
September 19, 2018 - Salsa dancers have lower injury rates than Spanish, aerobic or Zumba dancers
September 19, 2018 - Bristol-Myers Squibb’s Novel, Oral, Selective TYK2 Inhibitor Delivered Significant Skin Clearance in Patients with Moderate to Severe Plaque Psoriasis in Phase 2 Trial
September 19, 2018 - Can work stress contribute to Parkinson’s disease risk?
September 19, 2018 - Global Climate Action Summit: A focus on kids and climate
September 19, 2018 - Vitamin D may reduce breast cancer mortality in women with lower BMI
September 19, 2018 - Targeted Lung Denervation procedure significantly reduces COPD problems
September 19, 2018 - FDA-approved ‘safe’ daily BPA exposure may contribute to insulin resistance
September 19, 2018 - Research finds physical connection between the brain’s fluid reservoirs and meningeal lymphatics
September 19, 2018 - UCalgary study could help physicians make better treatment decisions for stroke
September 19, 2018 - Biomedical review finds failure rates in some surgical mesh treatments to be unacceptably high
September 19, 2018 - Researchers develop more accurate measure of body fat
September 19, 2018 - Doctors and students rally to support gun violence research, education
September 19, 2018 - LEO Pharma and MorphoSys announce expansion of strategic alliance to develop peptide-derived drugs
September 19, 2018 - Seniors in pain hop aboard the canna-bus
September 19, 2018 - New compound could prevent malaria parasites from maturing inside mosquito
September 19, 2018 - Scientists find alterations in blood flow in response to body position change
September 19, 2018 - UNC Health Care extends free access to virtual care service in the aftermath of Hurricane Florence
September 19, 2018 - Opioid Refills Rare After Rhinoplasty
September 19, 2018 - Corn, obesity, and navigating healthy eating choices as a parent
September 19, 2018 - Journal editor aims to prompt thoughtful review of ethics in precision health
September 19, 2018 - Researchers identify key step in how plant cells respond to pathogens
September 18, 2018 - Researchers analyze how exposure to silver nanoparticles affects zebrafish
September 18, 2018 - Study shows air pollution may be bad for the fetus
September 18, 2018 - Coffee May Have Another Perk for Kidney Patients
September 18, 2018 - Tongue-in-cheek Nobels honor nutritional analysis of cannibalism, roller-coaster kidney stones treatment
September 18, 2018 - Progress, priorities, challenges are focus of State of Stanford Medicine | News Center
September 18, 2018 - Established Alzheimer’s Risk Gene Has a New Role
September 18, 2018 - Hospitalization after antibiotic initiation found to be higher for people with Alzheimer’s disease
September 18, 2018 - Many children with special healthcare needs do not have access to ‘PCMH-concordant’ care
September 18, 2018 - Investigational nasal influenza vaccine tested in children and teens
September 18, 2018 - Lymphatic vessels surrounding the brain play crucial role in multiple sclerosis, research suggests
September 18, 2018 - New fiber laser-based ultrasound sensor may have potential applications in medical diagnostics
September 18, 2018 - Protect your heart and health during ‘dog days’ of summer
September 18, 2018 - Faculty receive awards for promise in biomedical research, clinical care | News Center
September 18, 2018 - Digital games for CVD-related self-management improve exercise capacity and energy expenditure
September 18, 2018 - Aluminum inclusions help enhance adsorption of chemo drugs onto active carbon delivery capsule
September 18, 2018 - Adding PET scans to CT imaging can change treatment for women with cervical cancer
September 18, 2018 - UCSF awarded $20 million grant to study impacts of new, emerging tobacco products
September 18, 2018 - Human brains may be wired to prefer lying on the couch, suggests research
September 18, 2018 - Zika virus vaccine shows promise for treatment of fatal glioblastoma
September 18, 2018 - Theravance Biopharma and Mylan to Report New Data from Phase 3 Studies of Yupelri (revefenacin) in Oral Presentation at European Respiratory Society International Congress 2018
September 18, 2018 - INSiGHT identifies unique retinal regulatory genes
September 18, 2018 - Diversity, science leadership grants awarded to student-faculty pairs | News Center
September 18, 2018 - Many parents blame electronics for sleep problems among teens
September 18, 2018 - Researchers study neuronal activity in brain that prevents individuals from doing physical activity
September 18, 2018 - Purifying Proteins from Mammalian Cell Culture
September 18, 2018 - Researchers map 3D structure of toxic proteins used by Pseudomonas aeruginosa to trigger infection
September 18, 2018 - Outcome of ACL reconstruction related to the way you move post-surgery
September 18, 2018 - Study aims to investigate risk factors for PPCs in surgical patients with gastric cancer
September 18, 2018 - Ardelyx Submits New Drug Application for Tenapanor for IBS-C
September 18, 2018 - Sociodemographic disparities in eyeglass use among elderly
September 18, 2018 - New Drug Shows Promise for Progressive Form of MS
September 18, 2018 - Babies exposed to higher levels of organochlorine compounds in womb may have worse lung function
September 18, 2018 - Women exposed to trauma in their lives gave birth to underweight male infants
September 18, 2018 - Probiotic supplementation may reduce use of antibiotics, scientific analysis shows
September 18, 2018 - Resveratrol decreases pain severity and levels of inflammatory biomarkers in osteoarthritis patients
September 18, 2018 - Research shows pollution is reaching the placenta
September 18, 2018 - KAIST researchers develop heart-targeting drug delivery technology using tannin acid
September 18, 2018 - Muscle relaxants used during general anesthesia can increase risk of pulmonary complications
September 18, 2018 - Silicone breast implants may increase risk of rare adverse outcomes in women
September 18, 2018 - Pediatricians Have a Role in Encouraging Play Among Children
September 18, 2018 - California’s Medicaid program hits ‘print’ when the feds need info
September 18, 2018 - Genes, environment and schizophrenia—new study finds the placenta is the missing link
September 18, 2018 - Boehringer Ingelheim announces study results of COPD patients treated with Spiolto Respimat
September 18, 2018 - PAREXEL launches Patient Innovation Center to improve drug development process
September 18, 2018 - Children’s National and NIAID launch pediatric clinical research partnership
September 18, 2018 - Researchers may be overlooking complexities in social relations of primates
September 18, 2018 - Key signaling molecule that helps stem cells make healthy bone declines as we age
September 18, 2018 - More women veterans with chronic pain use CIH therapies than men
September 18, 2018 - As Earth Warms, Heat-Related Deaths Will Multiply
September 18, 2018 - Labetalol use up for patients with preeclampsia and asthma
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