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Pain Jun 2024Productivity loss because of chronic pain in the working age population is a widespread concern internationally. Interventions for chronic pain in working age adults...
Productivity loss because of chronic pain in the working age population is a widespread concern internationally. Interventions for chronic pain in working age adults might be expected to achieve enhanced productivity in terms of reduced costs of workers' compensation insurance, reduced disability support, and improved rates of return to work for injured workers. This would require the use of measures of productivity in the evaluation of chronic pain management interventions. The aim of this review was to identify and interpret the productivity outcomes of randomised controlled trials reported by studies that conducted economic evaluations (eg, cost-effectiveness and cost-utility) of chronic pain management interventions in the working age population published from database inception to March 2023. Econlit, Embase, and Pubmed electronic databases were searched, yielding 12 studies that met the selection criteria. All 12 studies used absenteeism to measure productivity, translating return to work measures into indirect costs. Only one study included return to work as a primary outcome. Ten studies found no statistically significant improvements in productivity-related costs. Despite evidence for reduced pain-related disability after pain management interventions, this review suggests that the use of measures for assessing productivity gains is lacking. Including such measures would greatly assist administrators and payers when considering the broader societal benefits of such interventions.
Topics: Humans; Chronic Pain; Pain Management; Efficiency; Return to Work; Cost-Benefit Analysis; Absenteeism
PubMed: 38323645
DOI: 10.1097/j.pain.0000000000003149 -
A systematic review of work-related musculoskeletal disorders and risk factors among computer users.Heliyon Feb 2024Rapid technological developments, especially in the use of electronic devices, have affected workers. MSDs are a major burden for both employees and employers, and in...
INTRODUCTION
Rapid technological developments, especially in the use of electronic devices, have affected workers. MSDs are a major burden for both employees and employers, and in contemporary society. Millions of computer workers suffer musculoskeletal diseases and it is the most common cause of occupational illness in the USA and result in medical costs and absenteeism that cost the sector between $45 and $54 billion annually. A single review was done about WMSDs, however it only investigated neck and upper extremities disorders. Therefore, this study aimed to review epidemiological evidence about the prevalence and risk factors of overall WMSDs among computer user bankers and office workers.
METHODS
An extensive literature search was undertaken in the PubMed, Web of Sciences, Google Scholar, and Scopus databases. Articles published in peer-reviewed English-language journals were considered for inclusion criteria. Articles published in conference proceedings, reports, abstracts, and not full text were excluded. After a thorough search of databases, a total of 90 articles were discovered, and finally, 25 of them met the inclusion criteria and were investigated in detail.
RESULT
The magnitude of WMSDs ranged from 33.8 to 95.3 %. The lower back, neck, upper back, and shoulder were the most affected body parts, and the elbow, hip/thigh, knee, wrist/hand, and ankle/feet were the least affected body parts. Prolonged computer use, being older, repetitive moments, female sex, working in awkward posture, low educational status, a lack of physical exercise, and ergonomics training were significantly affected by MSDs.
CONCLUSION
and recommendation: The prevalence of WMSDS was very high, and as a result, an interventional study should be conducted. Reducing prolonged use of computers and working in the right posture will reduce the magnitude of MSD among computer users.
PubMed: 38318034
DOI: 10.1016/j.heliyon.2024.e25075 -
Journal of Managed Care & Specialty... Feb 2024Schizophrenia is a chronic, relapsing, and burdensome psychiatric disorder affecting approximately 0.25%-0.6% of the US population. Oral antipsychotic treatment (OAT)... (Review)
Review
A systematic review of the real-world effectiveness and economic and humanistic outcomes of selected oral antipsychotics among patients with schizophrenia in the United States: Updating the evidence and gaps.
BACKGROUND
Schizophrenia is a chronic, relapsing, and burdensome psychiatric disorder affecting approximately 0.25%-0.6% of the US population. Oral antipsychotic treatment (OAT) remains the cornerstone for managing schizophrenia. However, nonadherence and high treatment failure lead to increased disease burden and medical spending. Cost-effective management of schizophrenia requires understanding the value of current therapies to facilitate better planning of management policies while addressing unmet needs.
OBJECTIVE
To review existing evidence and gaps regarding real-world effectiveness and economic and humanistic outcomes of OATs, including asenapine, brexpiprazole, cariprazine, iloperidone, lumateperone, lurasidone, olanzapine/samidorphan, paliperidone, and quetiapine.
METHODS
We conducted a literature search using PubMed, American Psychological Association PsycINFO (EBSCOhost), and the Cumulative Index of Nursing and Allied Health Literature from January 2010 to March 2022 as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English-language articles describing adults with schizophrenia receiving at least 1 of the selected OATs and reporting real-world effectiveness, direct or indirect costs, humanistic outcomes, behavioral outcomes, adherence/persistence patterns, or product switching were identified.
RESULTS
We identified 25 studies from a total of 24,190 articles. Real-world effectiveness, cost, and adherence/persistence outcomes were reported for most OATs that were selected. Humanistic outcomes and product switching were reported only for lurasidone. Behavioral outcomes (eg, interpersonal relations and suicide ideation) were not reported for any OAT. The key economic outcomes across studies were incremental cost-effectiveness ratios, cost per quality-adjusted life-years, and health care costs. In studies that compared long-acting injectables (LAIs) with OATs, LAIs had a higher pharmacy and lower medical costs, while total health care cost was similar between LAIs and OATs. Indirect costs associated with presenteeism, absenteeism, or work productivity were not reported for any of the selected OATs. Overall, patients had poor adherence to OATs, ranging between 20% and 61% across studies. Product switching did not impact the all-cause health care costs before and after treatment.
CONCLUSIONS
Our findings showed considerable gaps exist for evidence on behavioral outcomes, humanistic outcomes, medication switching, and adherence/persistence across OATs. Our findings also suggest an unmet need regarding treatment nonadherence and lack of persistence among patients receiving OATs. We identified a need for research addressing OATs' behavioral and humanistic outcomes and evaluating the impact of product switching in adults with schizophrenia in the United States, which could assist clinicians in promoting patient-centered care and help payers understand the total value of new antipsychotic drugs.
Topics: Adult; Humans; United States; Antipsychotic Agents; Schizophrenia; Lurasidone Hydrochloride; Paliperidone Palmitate; Quetiapine Fumarate
PubMed: 38308625
DOI: 10.18553/jmcp.2024.30.2.183 -
The International Journal of Health... May 2024As global CO emissions continue to rise and the 'era of global boiling' takes hold, the health workforce must cope with the challenge of providing care to increasing...
BACKGROUND
As global CO emissions continue to rise and the 'era of global boiling' takes hold, the health workforce must cope with the challenge of providing care to increasing numbers of patients affected by climate change-related events (e.g., hurricanes, wildfires, floods). In this review, we describe the impacts of these events on the health workforce, and strategies responding to these challenges.
METHODS
This rapid systematic review was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses and a registered protocol (PROSPERO CRD42023433610). Eight databases were searched in May 2022 and again in June 2023. Empirical studies discussing climate change and workforce policy, planning, preparedness, and capacity were included. Inductive thematic analysis of extracted data was conducted.
RESULTS
From the 60 included studies, two categories emerged: the impacts of climate events on the health workforce (n = 39), and workforce responses to and preparations for climate events (n = 58). Thirty-seven studies reported on both categories. Four impact themes were identified: absenteeism, psychological impacts, system breakdown, and unsafe working conditions; and six responses and preparations themes: training/skill development, workforce capacity planning, interdisciplinary collaboration, role flexibility, role incentivisation, and psychological support.
CONCLUSION
This review provides an overview of some of the deleterious impacts of climate events on the health workforce, as well as potential strategies for the health workforce to prepare or respond to climate events. Future studies should assess the implementation and effectiveness of these strategies to ensure a continuously improving healthcare system, and a well-supported health workforce.
Topics: Climate Change; Humans; Capacity Building; Health Workforce; Delivery of Health Care; Health Planning
PubMed: 38308433
DOI: 10.1002/hpm.3769 -
Journal of Public Health Dentistry Mar 2024To summarize evidence on the impact of oral health on individual and family economic outcomes, describe trends in the literature, and identify areas for additional...
OBJECTIVES
To summarize evidence on the impact of oral health on individual and family economic outcomes, describe trends in the literature, and identify areas for additional research to inform public health research and practice.
METHODS
Searches were conducted within PubMed, CINAHL, EconLit, Cochrane Library, PsycInfo, and Web of Science databases. Article review, selection, abstraction, and reporting processes were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.
RESULTS
Of 2758 unduplicated records identified, 52 met inclusion criteria. Study outcomes included indicators of employment/employability (n = 9), earnings/earnings potential (n = 26), parent missed work and family financial impacts of child oral health (n = 19), and financial loss (n = 3). Dental caries-related variables were the most common predictors of poorer economic outcomes. Other oral health problems, such as poorer dental functioning or poorer self-reported oral health status, also were associated with adverse economic outcomes. Significant associations with employment were found among studies that assessed interventions designed to improve oral health. Only one study estimated the impact of oral health on earnings. One-third of studies conducted multivariable analyses, and 14% incorporated race and ethnicity variables.
CONCLUSIONS
Although existing evidence suggests associations between oral health problems and poorer economic outcomes, there is a substantial need for more rigorous research to better understand the extent of economic impact of oral health problems and which populations are most affected. Additional high-quality research is needed to inform which interventions are most likely to improve oral health, reduce adverse economic impacts, and promote health and economic equity.
Topics: Child; Humans; Dental Caries; Health Promotion; Oral Health; Policy; Public Health
PubMed: 38305646
DOI: 10.1111/jphd.12599 -
Vaccine Feb 2024The rapid development of COVID-19 vaccines is a cornerstone in the global effort to combat the pandemic. Healthcare workers (HCWs), being at the forefront of the... (Review)
Review
Are COVID-19 vaccination mandates for healthcare workers effective? A systematic review of the impact of mandates on increasing vaccination, alleviating staff shortages and decreasing staff illness.
INTRODUCTION
The rapid development of COVID-19 vaccines is a cornerstone in the global effort to combat the pandemic. Healthcare workers (HCWs), being at the forefront of the pandemic response, have been the focus of vaccine mandate policies. This review aims to evaluate the impacts of COVID-19 vaccine mandates among HCWs, a critical step in understanding the broader implications of such policies in healthcare settings.
OBJECTIVE
The review seeks to synthesize available literature to contribute to greater understanding of the outcomes associated with COVID-19 vaccine mandates for HCWs including vaccine uptake, infection rates, and staffing.
METHODS
A systematic search of relevant literature published from March 2020 to September 2023 was conducted. The Newcastle-Ottawa scale was employed for quality assessment of the included articles. A total of 4,779 publications were identified, with 15 studies meeting the inclusion criteria for the review. A narrative synthesis approach was used to analyze these studies.
RESULTS
COVID-19 vaccine mandates for HCWs were broadly successful in increasing vaccine uptake in most settings. Although the penalties imposed on unvaccinated HCWs did not lead to major disruption of health services, less well-resourced areas may have been more impacted. Furthermore, there is insufficient literature on the impact of the vaccine mandate on reducing SARS-CoV-2 infection among HCWs.
CONCLUSION
COVID-19 vaccine mandates for HCWs have significant implications for public health policy and healthcare management. The findings underscore the need for tailored approaches in mandate policies, considering the specific contexts of healthcare settings and the diverse populations of HCWs. While mandates have shown potential in increasing vaccine uptake with minimal impacts to staffing, more work is needed to investigate the impacts of mandates across various contexts. In addition to these impacts, future research should focus on long-term effects and implications on broader public health strategies.
Topics: Humans; COVID-19 Vaccines; COVID-19; SARS-CoV-2; Vaccination; Health Personnel
PubMed: 38281897
DOI: 10.1016/j.vaccine.2024.01.041 -
Human Resources For Health Jan 2024Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who... (Meta-Analysis)
Meta-Analysis
Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations.
BACKGROUND
Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR).
METHODS
We reviewed literature retrieved from MEDLINE-PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes.
RESULTS
The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted.
DISCUSSION
PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.
Topics: Humans; COVID-19; Pandemics; SARS-CoV-2; Public Health; Quality of Life; Cross-Sectional Studies; Emergencies; Policy
PubMed: 38273317
DOI: 10.1186/s12960-024-00892-2 -
Journal of Pediatric Gastroenterology... Apr 2024Rumination syndrome (RS) is a complex functional disorder characterized by recurrent, repetitive regurgitation of recently swallowed food. RS may have medical and... (Review)
Review
Rumination syndrome (RS) is a complex functional disorder characterized by recurrent, repetitive regurgitation of recently swallowed food. RS may have medical and psychosocial implications, compromising the quality of life and causing high rates of school absenteeism. Pediatric RS has been poorly studied and little evidence regarding its treatment is available. This systematic review aims to evaluate the literature on the nonpharmacological treatment of RS in childhood. A systematic literature search was conducted on MEDLINE/PubMed, CINAHL, Cochrane Library, PsycINFO, and PEDro, from 2000 to 2023. The methodological quality of the publications was assessed by applying the guidelines proposed by the Equator network, according to the different designs of study, and the risk of bias was evaluated with the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I). Five hundred ninety-six studies were screened, and 7 studies were included in the review. Diaphragmatic breathing was the most used nonpharmacological treatment, and it was always combined with other therapeutic strategies. The vast heterogeneity of the physical or mental comorbidities and the methodology adopted in the publications did not allow a comparative analysis of the different treatments. Regardless of the type of treatment, high-intensity therapeutic programs and specific operators' training emerged as the most influencing factors for patients' outcomes. According to the available evidence, there is not enough high-quality evidence to suggest a defined therapeutic strategy. Large observational studies on selected patients accounting for possible confounders, with adequate follow-up times, and with clearly defined treatment regimens are needed to identify the best therapeutic approach.
Topics: Humans; Child; Quality of Life; Rumination Syndrome; Comorbidity
PubMed: 38268062
DOI: 10.1002/jpn3.12038 -
Population Health Management Feb 2024Out-of-pocket (OOP) health care expenditures in the United States have increased significantly in the past 5 decades. Most research on OOP costs focuses on expenditures... (Review)
Review
Out-of-pocket (OOP) health care expenditures in the United States have increased significantly in the past 5 decades. Most research on OOP costs focuses on expenditures related to insurance and cost-sharing payments or on costs related to specific conditions or settings, and does not capture the full picture of the financial burden on patients and unpaid caregivers. The aim for this systematic literature review was to identify and categorize the multitude of OOP costs to patients and unpaid caregivers, aid in the development of a more comprehensive catalog of OOP costs, and highlight potential gaps in the literature. The authors found that OOP costs are multifarious and underestimated. Across 817 included articles, the authors identified 31 subcategories of OOP costs related to direct medical (eg, insurance premiums), direct nonmedical (eg, transportation), and indirect spending (eg, absenteeism). In addition, 42% of articles studied an expenditure that the authors did not label as "OOP." A holistic and comprehensive catalog of OOP costs can inform future research, interventions, and policies related to financial barriers to health care in the United States to ensure the full range of costs for patients and unpaid caregivers are acknowledged and addressed.
Topics: Humans; United States; Caregivers; Health Expenditures; Delivery of Health Care; Cost Sharing
PubMed: 38099925
DOI: 10.1089/pop.2023.0238 -
La Medicina Del Lavoro Dec 2023Within any work environment, employees may be affected by "workplace bullying", a form of violent and repeated social behavior towards subordinates and colleagues. This... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Within any work environment, employees may be affected by "workplace bullying", a form of violent and repeated social behavior towards subordinates and colleagues. This review aimed to investigate the prevalence of bullied workers in Italy, the causes of the phenomenon, and the consequences at physical, psychological, and organizational levels.
METHODS
We included observational studies and systematic reviews examining the prevalence of bullied workers and the causes and consequences in Italian workplaces. Data extraction and analysis were performed on all included studies. The research strategy included three electronic databases (PubMed, Scopus, and Web of Science). A comprehensive search was done to retrieve articles based on a PRISMA-compliant protocol registered in PROSPERO: CRD 42023394635.
RESULTS
One hundred eighty-four articles were retrieved, and once duplicates and irrelevant articles were removed, 42 useful articles were reviewed. The mean pooled prevalence, calculated based on workers complaining of mistreatment, was 6.7% (SD: 4,09) and increased significantly to 17.0% (SD: 12.88) when considering only healthcare workplaces. Causes include how impaired mental health and high workload reinforce the possibility of being bullied in the workplace, resulting in a worsening of the worker's quality of life (physical and psychological) and the work organization with increased absenteeism and job changes.
CONCLUSIONS
Workplace bullying is a very present phenomenon within workplaces in Italy. In light of this, it is necessary to put prevention plans in place and find solutions to maintain optimal organizational well-being in the work environment.
Topics: Humans; Quality of Life; Workplace; Occupational Stress; Aggression; Bullying; Italy
PubMed: 38060211
DOI: 10.23749/mdl.v114i6.14673