Rungpetch Sakulbumrungsil

Health Utilities in Patients with HIV/AIDS in Thailand

OBJECTIVES We measured health utility (HU) in Thai HIV/AIDS patients using visual analog scale (VAS), EuroQOL (EQ-5D), and standard gamble (SG), determine the relationships between these HU measures and health-related quality of life (HRQOL) measures of HIV and patient characteristics, and assess the feasibility of the HU methods. METHODS A sample of 120 HIV/AIDS patients was identified at Bamrasnaradura Infectious Disease Institute, Thailand, during September to December, 2004. Face-to-face interviews included VAS, SG, and EQ-5D, HRQOL assessment using the Thai abbreviated version of the World Health Organization quality of life (WHOQOL-BREF THAI) and HIV-related symptom instruments, questions about ease of understanding HU approaches and sociodemographic items. Data were analyzed with repeated-measures ANOVA, followed by Dunn-Bonferroni t-test, intraclass coefficients (ICC), Spearmans rank correlation, and multiple linear regressions. RESULTS The mean (95% confidence interval) HUs were as follows: VAS, 0.79 (0.76-0.82); EQ-5D, 0.80 (0.77-0.84); and SG, 0.65 (0.60-0.70). A significant difference in HU by method was found (P < 0.001). Agreement by ICC was 0.71 for VAS versus EQ-5D, 0.41 for VAS versus SG, and 0.38 for EQ-5D and SG. The regression models showed that WHOQOL-BREF THAI, frequency of HIV symptoms, and patient characteristics could explain approximately 50% of the variation in the VAS and the EQ-5D and 20% in the SG(2). Among these three HU methods, the SG was the most difficult task. CONCLUSION VAS, EQ-5D and SG yielded different HUs for this sample. VAS and EQ-5D showed stronger construct validity with other health measures than SG. From a feasibility perspective, the SG was the least satisfactory of the three approaches.

Surveillance of antimicrobial consumption: methodological review for systems development in Thailand

Tangcharoensathien, Viroj; Sommanustweechai, Angkana; Chanthong, Boonrat; Sumpradit, Nithima; Sakulbumrungsil, Rungpetch; Jaroenpoj, Sasi; Sermsinsiri, Varavoot; Thai SAC Working Group; (2017) Surveillance of antimicrobial consumption: methodological review for systems development in Thailand. JOURNAL OF GLOBAL HEALTH, 7 (1). 010307-. ISSN 2047-2978 DOI: https://doi.org/10.7189/jogh.07.010307 Downloaded from: http://researchonline.lshtm.ac.uk/id/eprint/4652262/ DOI: https://doi.org/10.7189/jogh.07.010307

Comparison on Human Resource Requirement between Manual and Automated Dispensing Systems

OBJECTIVE This study was conducted to compare human resource requirement among manual, automated, and modified automated dispensing systems. METHODS Data were collected from the pharmacy department at the 2100-bed university hospital (Siriraj Hospital, Bangkok, Thailand). Data regarding the duration of the medication distribution process were collected by using self-reported forms for 1 month. The data on the automated dispensing machine (ADM) system were obtained from 1 piloted inpatient ward, whereas those on the manual system were the average of other wards. Data on dispensing, returned unused medication, and stock management processes under the traditional manual system and the ADM system were from actual activities, whereas the modified ADM system was modeled. The full-time equivalent (FTE) of each model was estimated for comparison. RESULTS The result showed that the manual system required 46.84 FTEs of pharmacists and 132.66 FTEs of pharmacy technicians. By adding pharmacist roles on screening and verification under the ADM system, the ADM system required 117.61 FTEs of pharmacists. Replacing counting and filling medication functions by ADM has decreased the number of pharmacy technicians to 55.38 FTEs. After the modified ADM system canceled the return unused medication process, FTEs requirement for pharmacists and pharmacy technicians decreased to 69.78 and 51.90 FTEs, respectively. CONCLUSIONS The ADM system decreased the workload of pharmacy technicians, whereas it required more time from pharmacists. However, the increased workload of pharmacists was associated with more comprehensive patient care functions, which resulted from the redesigned work process.

Cost-Utility Analysis of Erythropoietin for Anemia Treatment in Thai End-Stage Renal Disease Patients with Hemodialysis

OBJECTIVE To compare the cost utility of using erythropoietin (EPO) to maintain different hemoglobin (Hb) target levels in hemodialysis patients from a societal perspective. METHODS A Markov model was used to estimate the incremental cost and quality-adjusted life-year of five Hb levels: 9 or less, more than 9 to 10, more than 10 to 11, more than 11 to 12, and more than 12 g/dl. A systematic review of EPO treatment in hemodialysis patients was conducted to estimate transitional probabilities. Cost data were estimated on the basis of the reference price of Siriraj Hospital, the largest university hospital in Thailand. Utility scores were derived from the six-dimensional health state short form (derived from short-form 36 health survey), which were collected from 152 hemodialysis patients receiving EPO at Siriraj hospital. Probabilistic sensitivity analysis was conducted to investigate the effect of uncertain parameters. All future costs and outcomes were discounted at the rate of 3% per annum. RESULTS The incremental cost-effectiveness ratios of Hb levels more than 9 to 10, more than 10 to 11, more than 11 to 12, and more than 12 g/dl compared with the least costly option (Hb ≤ 9 g/dl) were US

Psychometric properties of WHOQOL-BREF-THAI in patients with HIV/AIDS

24,128.03, US

Extension of market exclusivity and its impact on the accessibility to essential medicines, and drug expense in Thailand: Analysis of the effect of TRIPs-Plus proposal

18,789.07, US

Development of Patient-reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QoL): A novel instrument for medication management

22,427.36, and US

An Innovative Decision Support Service for Improving Pharmaceutical Acquisition Capabilities

28,022.33 per quality-adjusted life-year, respectively. From probabilistic sensitivity analysis, the hemoglobin level of more than 10 to 11 g/dl was appropriate when the willingness to pay was US

Quality of Life and Hemoglobin Levels of Hemodialysis Patient at Siriraj Hospital

15,523.88 to US

PUK5 COMPARISON OF SF-6D, EQ-5D AND VAS IN HEMODIALYSIS THAI PATIENT

46,610.17 and the probability of cost-effective was 29.32% to 95.94%. CONCLUSIONS Providing EPO for a hemoglobin level of more than 10 to 11 g/dl had a cost-effectiveness higher than that of doing so for other hemoglobin levels. This finding will be put forward to the policy level to set up the EPO treatment guideline of the hospital for hemodialysis patients.