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Senin, 19 Maret 2012

Opioid Addiction - Diacetylmorphine Better And Cheaper Than Methadone

According to a study in the Canadian Medical Association Journal (CMAJ), methadone is not the most effective way to treat chronic opioid addiction. Researchers from the Center for Health Evaluation and Outcome Sciences (CHEOS) at Providence Health Care, University of British Columbia, Université de Montréal and the Northern Ontario School of Medicine (Sudbury, Ont.), have found that injecting an active ingredient in heroin, called diacetylmorphine, is more effective and less expensive treatment.

Even though the most prevalent treatment for opioid addition is methadone, results from studies suggest that the majority of people start using illegal drugs again over time.

Results from the North American Opiate Medication initiative, a randomized controlled trial, showed that although the cost of diacetylmorphine treatment is more expensive than methadone, patients are more likely to adhere to treatment.

The researchers used a model in order to estimate costs for both diacetylmorphine treatment and methadone treatment based on outcomes from the North American Opiate Medication Initiative. They took into consideration length of therapies, chances of HIV infection, abstinence, and relapse.

The scientists found that using diacetylmorphine for opioid addiction was a less expensive treatment option than methadone.

Based on projections from the model, they found that an individual in a methadone program would live 14.54 years, spend 8.79 years in treatment, 5.52 years in relapse and cost society an estimated $1,137,614. An individual taking diacetylmorphine treatment would live 15.43 years, spend 10.41 years in treatment, 4.05 years in relapse and cost society $1,096,053.

Dr. Aslam Anis, director of CHEOS at Providence Health Care and professor at UBC's School of Population and Public Health, and co-authors, write:

"Our model indicated that diacetylmorphine would decrease societal costs, largely by reducing costs associated with crime, and would increase both the duration and quality of life of treatment recipients.

Because opioid users commit less crime and have lower rates of health care use and death while in treatment, the benefits in cost and health utility attributable to diacetylmorphine stemmed chiefly from its capacity to retain patients in treatment for longer periods than with methadone maintenance treatment."

They conclude that a diacetylmorphine treatment strategy could lower costs in treating chronic opioid addiction.

Written by Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our alcohol / addiction / illegal drugs section for the latest news on this subject. “Cost-effectiveness of diacetylmorphine versus methadone for chronic opioid dependence refractory to treatment” Bohdan Nosyk et al.
CMAJ March 12, 2012 First published March 12, 2012, doi: 10.1503/cmaj.110669 Please use one of the following formats to cite this article in your essay, paper or report:

MLA

Grace Rattue. "Opioid Addiction - Diacetylmorphine Better And Cheaper Than Methadone." Medical News Today. MediLexicon, Intl., 16 Mar. 2012. Web.
17 Mar. 2012. APA

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'Opioid Addiction - Diacetylmorphine Better And Cheaper Than Methadone'

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20.33 | 0 komentar

Minggu, 18 Maret 2012

More Is Not Always Better, Frequent Dialysis Does Not Markedly Improve Physical Health

Some recent observational studies suggest that more frequent hemodialysis may prolong kidney failure patients' lives compared with conventional dialysis. If it does, what's the quality of that extra life? The additional treatments which are time-consuming and take a considerable toll on patients do not markedly improve patients' physical health, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN).

Kidney failure, or end-stage kidney disease, afflicts more than 2 million people worldwide. Many of these individuals are on long-term hemodialysis and suffer from relatively poor physical health.

Researchers and clinicians have wondered whether increasing the frequency of dialysis treatments can improve or at least preserve kidney failure patients' overall physical capacity by reducing excess body fluid, improving their exercise ability, providing a better balance of nutrition, and preserving muscle mass, among other things.

To test this, Yoshio Hall, MD (University of Washington, Seattle) and his colleagues examined changes in physical health among patients enrolled in two studies: the Frequent Hemodialysis Network Daily and Nocturnal Trials, which randomized patients to receive either frequent (six times per week) or conventional (three times per week) dialysis for one year. All patients in the Daily Trial received treatments in a clinic while nearly all of those in the Nocturnal Trial received them at home, while they slept.

Among the major findings:

-- Among the 245 patients in the Daily Trial, patients randomized to frequent compared with conventional dialysis experienced no significant change in physical performance, but they reported that they felt that their physical health and functioning had improved.

-- Among the 87 patients in the Nocturnal Trial, patients who received frequent dialysis did not demonstrate better physical performance or report better physical health and functioning compared with patients who received conventional dialysis. Patients in both groups experienced improved physical health and functioning over the course of the year, though, perhaps due to the switch from clinical to home-based treatments.

"Frequent hemodialysis as currently practiced may improve the lives of some but is not a cost-effective or practical solution to improving the physical health of most patients with end-stage kidney disease," said Dr. Hall. "Faced with rising numbers of persons with progressive chronic kidney disease worldwide, we need to broadly consider innovative strategies beyond manipulating the dose of dialysis to substantially improve or preserve the physical capacity of patients with end-stage kidney disease," he added.

Study co-authors include Brett Larive (Cleveland Clinic Foundation); Patricia Painter, PhD (University of Utah, Salt Lake City); George Kaysen, MD, PhD (University of California, Davis); Robert Lindsay, MD (University of Western Ontario and London Health Sciences Center, in Canada); Allen Nissenson, MD (DaVita, Inc.); Mark Unruh, MD (University of Pittsburgh); Michael Rocco, MD (Wake Forest University School of Medicine); Glenn Chertow, MD (Stanford University School of Medicine); and the Frequent Hemodialysis Network Trial Group.

Article adapted by Medical News Today from original press release.
Visit our urology / nephrology section for the latest news on this subject. There are no references listed for this article. Please use one of the following formats to cite this article in your essay, paper or report:

MLA

American Society of Nephrology. "More Is Not Always Better, Frequent Dialysis Does Not Markedly Improve Physical Health." Medical News Today. MediLexicon, Intl., 16 Mar. 2012. Web.
17 Mar. 2012. APA

Please note: If no author information is provided, the source is cited instead.


'More Is Not Always Better, Frequent Dialysis Does Not Markedly Improve Physical Health'

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For any corrections of factual information, or to contact the editors please use our feedback form.

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Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.



20.09 | 0 komentar
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