S Malhan

Prevalence and Risk Factors for Female Sexual Dysfunction in Turkish Women

PURPOSE We assessed the prevalence of and risk factors for FSD using the Turkish version of the FSFI in Turkish women. MATERIALS AND METHODS The study consisted of 518 women 18 to 55 years old living in Ankara, who completed the FSFI for the evaluation of FSD. The women were divided into 3 groups according to age, that is 18 to 30 (273), 31 to 45 (192) and 46 to 55 years (53). Demographic characteristics and risk factors were assessed in all women. Findings were compared between women with and without FSD. RESULTS According to the FSFI score 48.3% of women reported FSD (FSFI score less than 25). The prevalence of FSD was 41% at ages 18 to 30 years, 53.1% at ages 31 to 45 years and 67.9% at ages 46 to 55 years. FSD was detected as a desire problem in 48.3% of women, an arousal problem in 35.9%, a lubrication problem in 40.9%, an orgasm problem in 42.7%, a satisfaction problem in 45.0% and a pain problem in 42.9%. Risk factors for FSD were age, smoking (OR 2.4, 95% CI 6.8 to 18.1), menopause (OR 1.7, 95% CI 2.7 to 10.2), diet (OR 1.2, 95% CI 1.9 to 5.5) and marital status (OR 0.8, 95% CI 1.5 to 3.2) (each p <0.001). CONCLUSIONS Overall 48.3% of women in our study had FSD according to the FSFI. Apart from age, the most important risk factors for FSD were smoking, diet based life-style changes, menopause status and marital status.

A comparison of four different HRQoL generic questionnaire in five different patient groups

Most of musculoskeletal diseases involve pain and reduced physical functioning. Recognition of the coexistence of more than one musculoskeletal disease is important because they are relatively common and has a substantial impact on health-related quality of life (HRQoL). Our aim was to compare the results of four generic QoL questionnaires—QoL-5, Nottingham Health Profile (NHP), Short Form (SF)-6D, and Visual Analogue Scale (VAS)—in five different patient groups. Two hundred and one patients representing five different disease groups (knee osteoarthritis, osteoporosis, back pain, rheumatoid arthritis and ankylosing spondylitis), randomly selected through the Ankara Numune Education and Research Hospital Physical Medicine and Rehabilitation Outpatient Clinic, were included in the study. Scores indicating low QoL for each of the five diseases compared are reported. Patients in each disease group stated high disability. No strong correlation between any of the scales could be determined, and NHP was identified as the only scale able to differentiate between the diseases. Many instruments are available for measuring HRQoL. The QoL-5, NHP, SF-6D, and VAS are four commonly used generic (i.e., not disease-specific) measures for quantifying HRQoL in patients with musculoskeletal disorders. Most studies have focused on only one musculoskeletal disease, but comorbidity of musculoskeletal disorders is common. We emphasize in this study the effect of multiple musculoskeletal diseases on HRQoL.

Annual costs of rheumatoid arthritis in Turkey

Objective of the present study is aimed to determine costs of rheumatoid arthritis (RA) based on reimbursement agencies perspective [Social Security Institution(SSI)] in Turkey. The international clinical guidelines for RA are followed for analysing the direct costs. Data were collected from hospital bills, social security institution price lists, and Ministry of Health drug price list. Direct costs of RA patients were estimated as €2,669.14 patient/year. Outpatient costs were found to be €240.40. Routine tests during the year were calculated as €98.85. Ten percent of patients are hospitalized per year, and 0.62% of these patients received arthroplasty and/or other interventions. The cost during hospital stay was €87.76. €2,238 was determined as being paid per year for medication alone (including anti-TNF) and €4 is spent on auxiliary materials annually. Our data show a remarkable economic impact of RA over society. We hope that the cost of RA studies will help package price practices for reimbursement agencies.

Nonmalignant Chronic Pain Evaluation in the Turkish Population as Measured by the McGill Pain Questionnaire

Background:  The purpose of this study was to explore how Turkish nonmalignant pain patients described their pain and how the language of pain used by Turkish patients compares to the language found in common pain assessment tools.

Cost Evaluation of Inhaler Therapies Used in Respiratory Diseases: 1998--2015 Period in Turkey

BACKGROUND With the rise in life expectancy, the burden of chronic diseases, including obstructive pulmonary diseases, has increased throughout the world. OBJECTIVES To evaluate the sales trends of inhaler pharmaceuticals. METHODS The changes in box sales and sales amounts (in Turkish lira) of inhaler pharmaceuticals during the period 1998 to 2015 were examined and sales were projected for the next 3 years. Pharmaceuticals were classified according to form and pharmacological groups. RESULTS The sales of inhaler pharmaceuticals have increased rapidly since 2008. The fastest increase in consumption has occurred in short-acting β2 agonist preparations and nebulizer pharmaceuticals. Inhaled corticosteroid and long-acting β2 agonist combination sales have been the highest since 2002, when these products entered the Turkish market. CONCLUSIONS The inhaler pharmaceutical market has grown over the years, and this growth will continue in the future. The increased use of short-acting preparations, which should be used as symptom relievers, indicates that treatment management continues to be inadequate.

Cost-Minimization Analysis of Linagliptin Compared to Sitagliptin in theTreatment of Type 2 Diabetes Mellitus from a Turkish Healthcare Perspective

Objective: The aim of the present study is to evaluate linagliptin and sitagliptin in terms of pharmacoeconomics, by comparing the two dipeptidyl-peptidase 4 inhibitors (DPP-4i) with cost-minimization analysis. Methods: Cost-minimization analysis was used to compare linagliptin and sitagliptin in terms of pharmacoeconomics. In a recent meta-analysis, linagliptin and sitagliptin were reported to have similar effects regarding the reduction in the HbA1c levels achieved at the 24th week of treatment (HbA1c reduction at 24th week: -0.8%). Direct medical costs in Turkey were used for the comparisons. Cost data was constituted from the perspective of the healthcare payer, taking alternative therapies and all possible complications into consideration, and reviewing actual data from a tertiary healthcare center, related literature and clinical guidelines. A model was established with Microsoft Office Excel 2015 software, using the local data specifically from diabetes (DM) patients. Cost analysis was performed for one-year time frame. Results: Average direct annual treatment cost per patient in type 2 diabetes mellitus (T2DM) was € 1,481.4 with linagliptin and € 1,500.1 with sitagliptin. In comparison to sitagliptin, linagliptin is determined to be a cost-saving alternative (- € 18.7). Probabilistic sensitivity analysis with Monte Carlo Simulation showed that linagliptin treatment (95% confidence interval € 1,393.8- € 1,523.9; n=1,000) is 52.9% equal or cost-saving compared to sitagliptin treatment (95% confidence interval € 1,380.5- € 1,509.1; n=1,000). Conclusion: From the healthcare payers perspective in Turkey regarding treatment of T2DM, linagliptin, a DPP-4 inhibitor, is a cost-saving treatment alternative to sitagliptin, with both having similar effects on HbA1c levels.

Cost of illness among patients with diabetic foot ulcer in Turkey

AIM To evaluate the annual cost of patients with Wagner grade 3-4-5 diabetic foot ulcer (DFU) from the public payer’s perspective in Turkey. METHODS This study was conducted focused on a time frame of one year from the public payer’s perspective. Cost-of-illness (COI) methodology, which was developed by the World Health Organization, was used in the generation of cost data. By following a clinical path with the COI method, the main total expenses were reached by multiplying the number of uses of each expense item, the percentage of cases that used them and unit costs. Clinical guidelines and real data specific to Turkey were used in the calculation of the direct costs. Monte Carlo Simulation was used in the study as a sensitivity analysis. RESULTS The following were calculated in DFU treatment from the public payer’s perspective: The annual average per patient outpatient costs

A Cost-Effectiveness Evaluation for a New Therapy in HIV Treatment.

579.5 (4.1%), imaging test costs

PMH70 TURKISH CULTURAL ADAPTATION AND VALIDATION OF THE ALCOHOL DEPENDENCE SCALE

283.2 (2.0%), laboratory test costs

PIH63 TURKISH CULTURAL ADAPTATION AND VALIDATION OF GLASGOW HEALTH STATUS INVENTORY

284.8 (2.0%), annual average per patient cost of intervention, rehabilitation and trainings