This article deals with negative, traumatic or violent birth experiences and its consideration in psychodynamic therapies. Here, a lack of clarity in the terminology and the corresponding operationalizations is evident. The aim is to sensitize therapists to this threshold situation. It should be analyzed what women potentially need before, during and after birth. After a discussion of relevant literature and a presentation of a case study, requirements for psychotherapy as well as for psychotherapy research will be derived.
This retrospective observational survey of the practice of Homeopathic Medical Doctors in Belgium including 313 patients presenting mild COVID-19 symptoms allows us to conclude that during such epidemic situation for which not any effective therapy exists and no vaccination is possible homeopathy should be considered. The efficiency score (healing of symptoms in less than 8 days) is relevant for 83,1% of these patients. 4 homeopathic medicines were prescribed to 66% of them. 1,3% needed hospitalization for some time. Not any loss of chance to cure occurred for these patients. Market data reveals that homeopathy has been largely used for prevention and healing during the early peak of COVID-19 in Belgium.
Introduction/Objectives: Health authorities are facing increasing challenges to the sustainability of their healthcare systems because of the growing expenditures on medicines, including new, high-priced oncology medicines, and changes in disease prevalence in their ageing populations. Medicine prices in European countries are greatly affected by the ability to negotiate reasonable prices. Concerns have been expressed that prices of patented medicines do not fall sufficiently after the introduction of lower-cost generic oncology medicines. The objective of this study was to examine the associations over time in selected European countries between the prices of oral oncology medicines, population size, and gross domestic product (GDP) before and after the introduction of generic versions. Evidence of periodic reassessments of the price, value, and place in treatment of these medicines was also looked for. The goal of this review was to stimulate debate about possible improvements in approaches to reimbursement negotiations. Methodology: Analysis was performed of reimbursed prices of three oral oncology medicines (imatinib, erlotinib and fludarabine) between 2013 and 2017 across Europe. Correlations were explored between GDP, population size, and prices. Findings were compared with previous research regarding prices of generic oral oncology medicines. Results: The prices of imatinib, erlotinib and fludarabine varied among European countries, and there was limited price erosion over time in the absence of generics. There appeared to be no correlation between population size and price, but higher prices of on-patent oral cancer medicines were seen among countries with higher GDP per capita. Conclusion: Limited price erosion for patented medicines contributed to increases in oncology medicine budgets across the region. There was also a concerning lack of evidence re-assessments of the price, value, and place in treatment of patented oncology medicines following the loss of patent protection of standard medicines. The use of such proactive re-assessments in negotiating tactics might positively impact global expenditures for oncology medicines.
Introduction: There are appreciable concerns among European health authorities with growing expenditure on cancer medicines and issues of sustainability. The enhanced use of low cost generics could help. Aims: Consequently, there is a need to comprehensively document current and future arrangements regarding the pricing of generic cancer medicines across Europe, and whether these are indication specific, as well as how this translates into actual prices to provide future direction. Methodology: Mixed method approach with qualitative research among senior health authority personnel and their advisers. Quantitative research via health authority databases to ascertain current prices for oral cancer medicines that had lost their patent and the influence of population size and economics on prices. Results: 25 European countries participated. Currently we see (a) variable approaches to the pricing of generic cancer medicines, which will continue; (b) no concerns with substitution for oral generic cancer medicines; (c) substantial price reductions versus originators for generic capecitabine (up to -93.1%), generic imatinib (up to -97.8%) and generic temozolomide (up to -80.7%). Prices for oncology medicines are not indication specific, and are not affected by population size although influenced by pricing approaches. There have also been price increases for some non-patented cancer medicines following manufacturer changes although now stabilising. Conclusion: The considerable price reductions seen for some generics means health authorities should further encourage the use of generic oncology medicines when they become available to fund increased volumes and new valued cancer medicines. Countries are also starting to address price increases for generics following changes in the manufacturer
The Ghent Older People's Prescriptions community Pharmacy Screening (GheOP3 S)-tool was recently developed as an explicit screening tool to detect drug-related problems (DRPs) and to help in performing medication reviews. In this study, we aimed (a) to describe the characteristics of the detected DRPs and the subsequent pharmacists' recommendations with their acceptance and implementation rate resulting from a pharmacist-led medication review using the GheOP3 S-tool and (b) to assess the potential impact of the intervention. Prospective observational study in community-dwelling older patients (70 years or older, using five or more medications). Community pharmacists performed medication reviews resulting in the documentation of “GheOP3 S-related DRPs” and “other DRPs” with corresponding pharmacists' recommendations. Acceptance was recorded during face-to-face pharmacist-general practitioner (GP) meetings. Implementation was assessed after a 3-month follow-up by consulting the electronic pharmacy record, the patient, and/or GP. The potential impact on the number of medications, the number of “GheOP3 S-related DRPs”, the anticholinergic and sedative burden quantified by the Drug Burden Index (DBI), and medication costs was assessed by a pre-post comparison of the patients' medication lists. Twenty-one pharmacists detected 470 DRPs with a median (IQR) of 6 (4-8) per patient in 75 patients (about half “GheOP3 S-related DRPs” and half “other DRPs”). Most prevalent recommendations were stopping (22.9%) and substituting (18.9%) medication. Overall acceptance was 66.9%. At follow-up, 42.9% of all recommendations were implemented. The number of GheOP3 S-criteria (P < .001) and the DBI scores (P = .033) significantly differed from baseline. This was not the case for the number of chronic medications and medication costs. This study demonstrates a relatively high acceptance of pharmacists' recommendations, although implementation could be improved. Pharmacist-led medication reviews with multidisciplinary meetings using the GheOP3 S-tool can have a potential impact on the number of DRPs and the anticholinergic and sedative burden of patients.
