Navegando por Palavras-chave "home care"

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    Children and adults with primary antibody deficiencies gain quality of life by subcutaneous IgG self-infusions at home
    (Mosby, Inc, 2004-10-01) Gardulf, Ann; Nicolay, Uwe; Asensio, Oscar; Bernatowska, Ewa; Bock, Andreas; Costa-Carvalho, Beatriz Tavares [UNIFESP]; Granert, Carl; Haag, Stefan; Hernandez, Dolores; Kiessling, Peter; Kus, Jan; Matamoros, Nuria; Niehues, Tim; Schmidt, Sigune; Schulze, Ilka; Borte, Michael; Karolinska Univ Hosp; Consorcio Hosp Parc Tauli; Childrens Mem Hlth Inst; Univ Vienna; Universidade Federal de São Paulo (UNIFESP); ZLB Behring GMBH; Hosp Univ La Fe; Natl Res Inst TB & Lung Dis; Hosp Univ Son Dureta; Univ Klinikum Dusseldorf; Univ Freiburg; Humboldt Univ; Univ Leipzig
    Background: A large number of children and adults with primary antibody deficiencies need lifelong IgG replacement therapy. It is mostly unknown what effect the choice of replacement therapy has on the patients' health-related quality of life (HRQOL) and treatment satisfaction (TS).Objective: To investigate whether a switch from hospital-based intravenous IgG (IVIG) to home-based subcutaneous IgG (SCIG) therapy would improve the HRQOL and TS.Methods: Fifteen children (<14 years; hospital-based IVIG therapy at enrollment) and 32 adults (greater than or equal to14 years; 22 on hospital-based IVIG and 10 on home-based SCIG therapy at enrollment) were included. Questionnaires were completed at baseline and at 6 and 10 months: the Child Health Questionnaire-Parental Form 50 (children) or Short Form 36 (adults), the Life Quality Index, and questions regarding therapy preferences.Results: the SCIG home therapy was reported to give better health (P = .001) and improved school/social functioning (P = .02) for the children, reduced emotional distress (P = .02) and limitations on personal time for the parents (P = .004), and fewer limitations on family activities (P = .002). Adults switching therapy reported improved vitality (P = .04), mental health (P = .05), and social functioning (P = .01). Adults already on SCIG home therapy at enrollment retained high HRQOL and TS scores. the SCIG home therapy improved TS because it led to greater independence and better therapy convenience (P <.05). the patients preferred the SCIG administration route and having the treatment at home.Conclusions: Home-based SCIG therapy improves several important aspects of HRQOL and provides the patients with primary antibody deficiencies and their families with greater independence and better control of the therapy situation and daily life. SCIG home therapy is an appreciated therapeutic alternative for adults and children in need of lifelong IgG replacement therapy.
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    Critical appraisal of published economic evaluations of home care for the elderly
    (Elsevier B.V., 2004-11-01) Ramos, MLT; Ferraz, M. B.; Sesso, R.; Sao Luiz Hosp; Universidade Federal de São Paulo (UNIFESP)
    The goal of the study was to appraise the economic evaluations published between 1980 and 2004 of home care for the elderly, focusing on the methodological aspects. MEDLINE was searched to identify and assess economic evaluations (defined as an analysis comparing two or more strategies, involving the assessment of both costs and consequences) related to home care exclusively for the elderly (65 years or more) and to critically appraise the methodology using five accepted principles used worldwide for conducting economic evaluations. Twenty-four economic evaluations of home care for the elderly were identified and the articles were assessed. All five principles were satisfactorily addressed in two studies (8.3%), four principles in four studies (16.7%), three principles in five studies (20.8%), two principles in eight studies (33.3%) and only one principle in five studies (20.8%). A disparity in the methodology of writing economic evaluations compromises the comparisons among outcomes and lately jeopardizes decisions on the choice of the most appropriate healthcare interventions. the methodological principles represent important guidelines but the discussion of the context of the economic evaluation and the special characteristics of some services and populations should be considered for the appropriate use of economic evaluations. (C) 2004 Elsevier Ireland Ltd. All rights reserved.