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  • ADHERENCE  (1)
  • BURDEN  (1)
  • 1
    Keywords: DISEASE ; RISK-FACTORS ; REGION ; OVERWEIGHT ; WAIST CIRCUMFERENCE ; BURDEN ; ILLNESS RATING-SCALE ; SEVERE OBESITY ; CARE COSTS ; AUGSBURG
    Abstract: Methods: this cross-sectional analysis used data of n = 3,108 individuals aged 58-82 from a population-based prospective cohort study. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated based on clinical examinations. Health service use was measured by a questionnaire for a 3-month period. Corresponding costs were calculated applying a societal perspective. Results: 21.8% of the sample were normal weight, 43.0% overweight, 25.5% obese class 1 and 9.6% obese class a parts per thousand yen2 according to BMI. In 42.6%, WHtR was a parts per thousand yen0.6. For normal weight, overweight, obese class 1 and obese class a parts per thousand yen2 individuals, mean costs (3-month period) of outpatient care were 384a,not sign, 435a,not sign, 475a,not sign and 525a,not sign (P 〈 0.001), mean costs of inpatient care were 284a,not sign, 408a,not sign, 333a,not sign and 652a,not sign (P = 0.070) and mean total costs 716a,not sign, 891a,not sign, 852a,not sign and 1,244a,not sign (P = 0.013). For individuals with WHtR 〈 0.6 versus a parts per thousand yen0.6, outpatient costs were 401a,not sign versus 499a,not sign (P 〈 0.001), inpatient costs 315a,not sign versus 480a,not sign (P = 0.016) and total costs 755a,not sign versus 1,041a,not sign (P 〈 0.001). Multiple regression analyses controlling for sociodemographic variables showed a significant effect of obesity on costs of outpatient care (class 1: +72a,not sign; class a parts per thousand yen2: +153a,not sign) and total costs (class a parts per thousand yen2: +361a,not sign) while the effect of overweight was not significant. WHtR a parts per thousand yen0.6 significantly increased outpatient costs by +79a,not sign and total costs by +189a,not sign. Conclusions: excess weight is associated with increased service use and cost in elderly individuals, in particular in obese class a parts per thousand yen2 individuals.
    Type of Publication: Journal article published
    PubMed ID: 25829392
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  • 2
    Keywords: Germany ; TOOL ; TRIAL ; education ; ADULTS ; ERRORS ; COMMUNICATION ; ADHERENCE ; knowledge
    Abstract: We investigated the prevalence and quality of medication schedules of elderly ambulatory patients and assessed factors associated with the availability of a medication schedule. In particular, we evaluated whether sending out a blank medication schedule template would increase the chances to use such a document. Data originate from the ESTHER study, a cohort study conducted in Saarland, Germany, in which trained study physicians performed home visits. They scanned all medication schedules, recorded the participants' medication, and performed thorough geriatric assessments. As part of the intervention, a blank medication schedule template along with a brochure was mailed to half of the participants (intervention group) 4 weeks prior to the home visits. In total, 553 of 2470 participants (22.4 %) had a medication schedule. Almost two thirds of the schedules were issued by health care professionals (n = 353, 63.8 %). These schedules offered a higher quality, although important information such as over-the-counter (OTC) medication was regularly missing. Self-reported adherence was higher in participants who used self-issued medication schedules; however, self-reported medication adherence in patients with any medication schedule was poorer compared to those patients not using a schedule. Factors associated with the availability of a medication schedule were male sex, a higher number of medicines to take, and a more complex drug regimen. The intervention did not increase the number of patients having a medication schedule. Only a minority of elderly ambulatory patients had a medication schedule at home. Sending out a brochure along with a blank medication schedule template did not increase the prevalence of medication schedules.
    Type of Publication: Journal article published
    PubMed ID: 26105963
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