From Research to Policy Implementation: Trastuzumab in Early-Stage Breast Cancer Treatment in Thailand.

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From Research to Policy Implementation: Trastuzumab in Early-Stage Breast Cancer Treatment in Thailand.

Value Health Reg Issues. 2018 Nov 10;18:47-53

Authors: Kongsakon R, Lochid-Amnuay S, Kapol N, Pattanaprateep O

Abstract
OBJECTIVES: To evaluate the adjuvant therapy of trastuzumab cost and quality-adjusted life-years (QALYs) in lifetime horizon and describe the use of an economic evaluation in supporting policy-making decisions in the treatment of early-stage breast cancer in Thailand.
METHODS: A Markov model was used to evaluate the cost effectiveness of 1-year adjuvant trastuzumab for patients with early-stage breast cancer who were considered human epidermal growth factor receptor 2/neu-positive with a societal perspective and lifetime horizon. The research variables were probability of health state change, health utility, and cost of treatment. A sensitivity analysis was conducted using probabilistic methods. A budget impact analysis was also performed.
RESULTS: The results revealed that the treatment cost and QALYs in the trastuzumab group yielded 4.59 QALYs. The incremental cost-effectiveness ratio was $3387 (THB 118 572; THB = Thai baht) per QALY. On the basis of the willingness-to-pay threshold in Thailand, a 1-year adjuvant trastuzumab treatment for breast cancer was a cost-effective therapy.
CONCLUSIONS: A combination therapy that includes trastuzumab is a preferable choice and should be used in early-stage breast cancer treatment. The Thai government has listed trastuzumab on the National List of Essential Medicines to be used for the early stages of breast cancer since 2014.

PMID: 30428405 [PubMed - as supplied by publisher]

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Effects of exercise training and follow-up calls at home on physical activity and quality of life after a mastectomy.

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Effects of exercise training and follow-up calls at home on physical activity and quality of life after a mastectomy.

Jpn J Nurs Sci. 2018 Nov 14;:

Authors: Nemli A, Tekinsoy Kartin P

Abstract
AIM: To determine the effects of exercise training that was supported with follow-up calls at home on the postoperative level of physical activity and quality of life of women with breast cancer.
METHODS: The study was carried out with a quasi-experimental design. Women who had underwent an axillary dissection and mastectomy and who were receiving ongoing chemotherapy treatment in the ambulatory unit of a university hospital were included in the study. Sixty-two women were randomly assigned to an intervention (n = 31) or a control (n = 31) group. The women in the intervention group were given exercise training and then they were followed up by phone calls at home for 12 weeks in order to ensure the continuity of the exercises.
RESULTS: At the end of the study, the number of "very active" individuals and the "total physical activity level" increased significantly in the intervention group but decreased significantly in the control group. In the intervention group, "future healthy function" in the functional area subscale significantly increased but "systematic therapy side-effects," "breast symptoms," and "arm symptoms" in the symptom subscale increased significantly.
CONCLUSION: Exercise training that is supported with home follow-up calls after surgery increases the level of physical activity, which then favorably relates with a good quality of life of women with breast cancer.

PMID: 30428503 [PubMed - as supplied by publisher]

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[Prevention in older age : key factors].

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[Prevention in older age : key factors].

Rev Med Suisse. 2018 Nov 07;14(626):1998-2002

Authors: Coutaz M

Abstract
The extended life expectancy questions the quality of life of these additional years: with or without disability ? A review of the literature gives us some tips on preventive measures to maintain good health at an advanced age. Engaging in regular and moderate physical activity (such as walking) offers a range of health benefits, including reduced risk of all-cause mortality, lower risk for various diseases (ischemic stroke, ischemic heart disease, diabetes, breast and colon cancer), prevention of falls and functional decline in seniors living at home. Maintaining a healthy lifestyle (non-smoking, low alcohol consumption, adequate nutrition) as well as up-to-date immunization status and vitamin D supplementation in the deficient or vulnerable population, are factors that contribute to a better health in the last years of life.

PMID: 30422418 [PubMed - in process]

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