Browsing by Author "Hoxha, Iris"

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    Evidence-based public policy making formedicines across countries: findings andimplications for the future
    (Future Medicine Ltd, 2021) Godman, Brian; Fadare, Joseph; Kwon, Hye-Young; Zampirolli Dias, Carolina; Kurdi, Amanj; Dias God ́oi, Isabella Piassi; Kibuule, Dan; Hoxha, Iris; Opanga, Sylvia; Saleem, Zikria; Bochenek, Tomasz; Markovi ́c-Pekovi ́c, Vanda; Mardare, Ileana; Kalungia, Aubrey C; Campbel, Stephen; Allocati, Eleonora; Pisana, Alice; Martin, Antony P; Meyer, Johanna C
    im:Global expenditure on medicines is rising up to 6% per year driven by increasing prevalence ofnon-communicable diseases (NCDs) and new premium priced medicines for cancer, orphan diseases andother complex areas. This is difficult to sustain without reforms.Methods:Extensive narrative review ofpublished papers and contextualizing the findings to provide future guidance.Results:New models arebeing introduced to improve the managed entry of new medicines including managed entry agreements,fair pricing approaches and monitoring prescribing against agreed guidance. Multiple measures have alsosuccessfully been introduced to improve the prescribing of established medicines. This includes encour-aging greater prescribing of generics and biosimilars versus originators and patented medicines in a classto conserve resources without compromising care. In addition, reducing inappropriate antibiotic utiliza-tion. Typically, multiple measures are the most effective.Conclusion:Multiple measures will be needed toattain and retain universal healthcare. Keywords:antimicrobials•biosimilars•COVID-19•demand-side measures•generics•guidelines•managedentry•oncology•orphan medicines•quality indicators•statins
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    Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries:
    (Taylor & Francis, 2019) Godman, Brian; Haque, Mainul; McKimm, Judy; Bakar, Muhamad Abu; Sneddon, Jacqueline; Wale, Janney; Campbell, Stephen; Martin, Antony P; Hoxha, Iris; Abilova, Vafa; Paramadhas, Bene D Anand; Mpinda-Joseph, Pinkie; Matome, Matshediso; Pires de Lemos, Livia Lovato; Sefah, Israel; Kurdi, Amanj; Opanga, Sylvia; Jakupi, Arianit; Saleem, Zikria; Hassali, Mohamed Azmi; Kibuule, Dan; Fadare, Joseph; Bochenek, Tomasz; Rothe, Celia; Furst, Jurij; Markovic-Pekovic, Vanda; Bojanić, Ljubica; Schellack, Natalie; Meyer, Johanna C; Matsebula, Zinhle; Thi Phuong, Thuy Nguyen; Jan, Saira; Kalungia, Aubrey; Mtapuri-Zinyowera, Sekesai; Sartelli, Massimo; Hill, Ruaraidh
    Introduction: Antibiotics are indispensable to maintaining human health; however, their overuse has resulted in resistant organisms, increasing morbidity, mortality and costs. Increasing antimicrobial resistance (AMR) is a major public health threat, resulting in multiple campaigns across countries to improve appropriate antimicrobial use. This includes addressing the overuse of antimicrobials for self-limiting infections, such as upper respiratory tract infections (URTIs), particularly in lower- and middle-income countries (LMICs) where there is the greatest inappropriate use and where antibiotic utilization has increased the most in recent years. Consequently, there is a need to document current practices and successful initiatives in LMICs to improve future antimicrobial use.Methodology: Documentation of current epidemiology and management of URTIs, particularly in LMICs, as well as campaigns to improve future antimicrobial use and their influence where known.Results: Much concern remains regarding the prescribing and dispensing of antibiotics for URTIs among LMICs. This includes considerable self-purchasing, up to 100% of pharmacies in some LMICs. However, multiple activities are now ongoing to improve future use. These incorporate educational initiatives among all key stakeholder groups, as well as legislation and other activities to reduce self-purchasing as part of National Action Plans (NAPs). Further activities are still needed however. These include increased physician and pharmacist education, starting in medical and pharmacy schools; greater monitoring of prescribing and dispensing practices, including the development of pertinent quality indicators; and targeted patient information and health education campaigns. It is recognized that such activities are more challenging in LMICs given more limited resources and a lack of healthcare professionals.Conclusion: Initiatives will grow across LMICs to reduce inappropriate prescribing and dispensing of antimicrobials for URTIs as part of NAPs and other activities, and these will be monitored.
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    Strategies to Improve Antimicrobial Utilization with a Special Focus on Developing Countries
    (MDPI, 2021) Godman, Brian; Egwuenu, Abiodun; Haque, Mainul; Ombeva Malande, Oliver; Schellack, Natalie; Kumar, Santosh; Saleem, Zikria; Sneddon, Jacqueline; Hoxha, Iris; Islam, Salequl; Mwita, Julius; Rezende Macedo do Nascimento, Renata Cristina; Piassi Dias Godói, Isabella; Lum Niba, Loveline; Amu, Adefolarin A.; Acolatse, Joseph; Incoom, Robert; Abebrese Sefah, Israel; Opanga, Sylvia; Kurdi, Amanj; Chikowe, Ibrahim; Khuluza, Felix; Kibuule, Dan; Ogunleye, Olayinka O.; Olalekan, Adesola; Markovic-Pekovic, Vanda; Meyer, Johanna C.; Alfadl, Abubakr; Thi Phuong, Thuy Nguyen; Kalungia, Aubrey C.; Campbell, Stephen; Pisana, Alice; Wale, Janney; Seaton, R. Andrew
    Antimicrobial resistance (AMR) is a high priority across countries as it increases morbidity, mortality and costs. Concerns with AMR have resulted in multiple initiatives internationally, nationally and regionally to enhance appropriate antibiotic utilization across sectors to reduce AMR, with the overuse of antibiotics exacerbated by the COVID-19 pandemic. Effectively tackling AMR is crucial for all countries. Principally a narrative review of ongoing activities across sectors was undertaken to improve antimicrobial use and address issues with vaccines including COVID-19. Point prevalence surveys have been successful in hospitals to identify areas for quality improvement programs, principally centering on antimicrobial stewardship programs. These include reducing prolonged antibiotic use to prevent surgical site infections. Multiple activities centering on education have been successful in reducing inappropriate prescribing and dispensing of antimicrobials in ambulatory care for essentially viral infections such as acute respiratory infections. It is imperative to develop new quality indicators for ambulatory care given current concerns, and instigate programs with clear public health messaging to reduce misinformation, essential for pandemics. Regular access to effective treatments is needed to reduce resistance to treatments for HIV, malaria and tuberculosis. Key stakeholder groups can instigate multiple initiatives to reduce AMR. These need to be followed up. Keywords: antimicrobials; antimicrobial stewardship programs; antimicrobial resistance; healthcareassociated infections; COVID-19; lower- and middle-income countries; misinformation; patient initiatives; surgical site infections; vaccines