P Dilokthornsakul

The effects of metformin on ovarian cancer: a systematic review.

Objective The potential therapeutic effects of metformin on several cancers were reported. However, the evidence of the effects of metformin on ovarian cancer is still limited and inconclusive. This systematic review and meta-analysis study aims to summarize the existing evidence of the therapeutic effects of metformin on ovarian cancer. Methods We performed systematic searches using electronic databases including PubMed and EMBASE until December 2012. Key words included “metformin” AND (“ovarian cancer” OR “ovary tumor”). All human studies assessing the effects of metformin on ovarian cancer were eligible for inclusion. All articles were reviewed independently by 2 authors with a standardized approach for the purpose of study, study design, patient characteristics, exposure, and outcomes. The data were pooled using a random-effects model. Results Of 190 studies retrieved, only 3 observational studies and 1 report of 2 randomized controlled trials were included. Among those studies, 2 reported the effects of metformin on survival outcomes of ovarian cancer, whereas the other 2 reported the effects of metformin on ovarian cancer prevention. The findings of studies reporting the effects on survival outcomes indicated that metformin may prolong overall, disease-specific, and progression-free survival in ovarian cancer patients. The results of studies reporting the effects of metformin on ovarian cancer prevention were meta-analyzed. It indicated that metformin tended to decrease occurrence of ovarian cancer among diabetic patients with the pooled odds ratio of 0.57 (95% confidence interval, 0.16–1.99). Conclusions Our findings showed the potential therapeutic effects of metformin on survival outcomes of ovarian cancer and ovarian cancer prevention. However, most of the evidence was observational studies. There is a call for further well-conducted controlled clinical trials to confirm the effects of metformin on ovarian cancer survival and ovarian cancer prevention.

The Effects of Medication Supply on Hospitalizations and Health-Care Costs in Patients with Chronic Heart Failure

OBJECTIVES Use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers results in decreased morbidity among patients with chronic heart failure (CHF). Undersupply of medication could result in inadequate control of CHF, whereas oversupply of medication could increase health-care costs and risks of toxicities. This study aimed to determine the effects of medication supplies on health-care costs and hospitalizations in patients with CHF receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. METHODS We retrospectively examined the electronic database in a hospital in Thailand. Patients who were diagnosed with CHF and who received angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in the year 2003 were included. Medication supplies were assessed by using the medication possession ratio (MPR). The Cox proportional hazard model was used to determine the association of medication supply (appropriate supply: MPR 0.8-1.2, oversupply: MPR > 1.2, undersupply: MPR < 0.8) with CHF-related and all-cause hospitalizations. Health-care costs were compared by using multiple linear regressions. All analyses were adjusted for propensity score and other variables. RESULTS A total of 393 patients were included. Their mean age was 66 years, with 56% being females. Fifty-seven percent of the patients received an inappropriate -supply of medication. Undersupply of medication likely increased the risks of CHF-related hospitalization with an adjusted hazard ratio of 1.66 (95% confidence interval [CI] 0.80-3.46). The adjusted hazard ratio of undersupply and oversupply of medication for all-cause hospitalization was 1.13 (95% CI 0.74-1.73) and 3.19 (95%CI 0.66-15.47), respectively. The total health-care costs in the undersupply and oversupply groups were significantly greater than that in the appropriate-supply group:

Calendar time-specific propensity score analysis for observational data: a case study estimating the effectiveness of inhaled long-acting beta-agonist on asthma exacerbations.

49 (95% CI 32-66) and

Healthcare utilization and cost of Stevens-Johnson syndrome and toxic epidermal necrolysis management in Thailand.

103 (95% CI 32-173), respectively. CONCLUSIONS Inappropriate medication supplies could increase the risks of CHF-related and all-cause hospitalizations. Both undersupply and oversupply of medication had significantly higher health-care costs.

PCV11 EFFECTS OF MEDICATION SUPPLY ON HEALTH-CARE COSTS AND RE-HOSPITALIZATIONS IN PATIENTS WITH CHRONIC HEART FAILURE

Propensity scores (PS) are frequently used in observational studies. PS are usually estimated over the entire study period without consideration of the effect of changing patterns of the included variables over time. This study sought to compare PS estimated using the entire study period (conventional PS) and PS estimated for specific periods (calendar time‐specific PS (CTS‐PS)), and to determine whether there are differences in estimated treatment effects using these approaches.

Forecasting Lifetime Health Outcomes and Costs of Treatment for Non-Alcoholic Fatty Liver Disease

Background: Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are life-threatening dermatologic conditions. Although, the incidence of SJS/TEN in Thailand is high, information on cost of care for SJS/TEN is limited. This study aims to estimate healthcare resource utilization and cost of SJS/TEN in Thailand, using hospital perspective. Methods: A retrospective study using an electronic health database from a university-affiliated hospital in Thailand was undertaken. Patients admitted with SJS/TEN from 2002 to 2007 were included. Direct medical cost was estimated by the cost-to-charge ratio. Cost was converted to 2013 value by consumer price index, and converted to

Value of Antidrug Antibody Screening In Moderate-To-Severe Rheumatiod Arthritis Patients Who Failed Initial Tumor Necrosis Factor-Alpha Treatment.

US using 31 Baht/ 1

Comparison of Health Care Utilization and Costs for Patietns with Asthma by Severity and Health Insurance in Thailand: Using Generalized Linear Regression Model.

US. The healthcare resource utilization was also estimated. Results: A total of 157 patients were included with average age of 45.3±23.0 years. About 146 patients (93.0%) were diagnosed as SJS and the remaining (7.0%) were diagnosed as TEN. Most of the patients (83.4%) were treated with systemic corticosteroids. Overall, mortality rate was 8.3%, while the average length of stay (LOS) was 10.1±13.2 days. The average cost of managing SJS/TEN for all patients was

Strengthening Evidence Base for Traditional Medicine in Asean, Quality of Reporting of Randomised Controlled Trials of Herbal Interventions in Asean Plus Six Countries: A Systematic Review.

1,064±

Factors Predicting Medication Oversupply In Thailand: A Mixed Model Regression Analysis

2,558. The average cost for SJS patients was