An unmet need

2007 ◽  
Author(s):  
Christopher Munsey
Keyword(s):  
Unmet Need

The WHO World Mental Health (WMH) Surveys

2009 ◽  
Vol 06 (01) ◽  
pp. 5-9 ◽  
Author(s):  
S. Aguilar-Gaxiola ◽  
J. Alonso ◽  
S. Chatterji ◽  
S. Lee ◽  
T. B. Üstün ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Treatment Effectiveness ◽  
Age Of Onset ◽  
Common Mental Disorders ◽  
Mental Health Policy ◽  
Unmet Need ◽  
Cost Effective ◽  
World Mental Health ◽  
Prevalence Estimates

SummaryThe paper presents an overview of the WHO World Mental Health (WMH) Survey Initiative and summarizes recent WMH results regarding the prevalence and societal costs of mental disorders. The WMH surveys are representative community surveys that were carried out in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, burden, and unmet need for treatment of common mental disorders. Results show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th-75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behavior, and substance disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Adult mental disorders are found in the WMH data to be associated with high levels of role impairment. Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective from both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several such interventions.

Efficacy and cardiovascular safety of SGLT2 Inhibitors

2020 ◽  
Vol 15 ◽  
Author(s):  
Cornelius James Fernandez ◽  
Abisha Graciano Nevins ◽  
Shasta Nawaz ◽  
Tahir Nazir ◽  
Fahmy W F Hanna
Keyword(s):  
Decision Process ◽  
Cardiovascular Events ◽  
Unmet Need ◽  
Clinical Decision ◽  
Sglt2 Inhibitors ◽  
Renal Protection ◽  
Sodium Glucose Cotransporter ◽  
Patients With Diabetes ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

: Patients with diabetes continued to exhibit a high risk for cardiovascular and renal events despite achieving satisfactory glycemic, blood pressure and lipid targets. Studies evaluating new diabetes medications focused on cardiovascular events, largely overlooking heart failure (HF). The latter has recently been recognised as a major cause of morbidity and mortality in patients with diabetes mellitus. There had been an unmet need for drugs with cardiovascular (including HF) and renal protection, with an expectation that an ideal diabetic drug should improve these end points. Moreover, an ideal drug should have weight lowering benefits. Recently published outcome trials have shown that sodium glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1RAs) can reduce cardiovascular and renal events, together with statistically significant weight reduction. As a result, many recently published international guidelines have recommended SGLT2 inhibitors and GLP-1RAs in patients with diabetes and pre-existing cardiovascular disease (CVD). In this review we will critically analyse the efficacy and cardiovascular (CV) safety of SGLT2 inhibitors, based on the available literature to help position them in the clinical decision process.

Electronic Communication, Telehealth, and Social Media

2018 ◽  
Author(s):  
Muniya S. Khanna ◽  
Tommy Chou
Keyword(s):  
Social Media ◽  
Rural Communities ◽  
Unmet Need ◽  
Mental Healthcare ◽  
Evidence Base ◽  
Intervention Delivery ◽  
Safety Issues ◽  
Video Teleconferencing ◽  
Empirically Supported ◽  
Traditional Service

Explosive growth of communication technologies and increased ubiquity of Internet access in both urban and rural communities and particularly in youth have occurred. Coupled with concerns regarding limitations to traditional service provision models, researchers and practitioners are looking to affordable, acceptable technologies to expand the reach of evidence-based care and reduce barriers to intervention and unmet need in areas with few providers. This chapter describes the present literature on use of video teleconferencing, web-based programs, social media, and smartphone apps to enhance mental health intervention delivery, psychiatric assessment, and training and supervision. The strengths of the various delivery methods are discussed for providing empirically supported mental healthcare, focusing on implications related to science and practice with children and families. Outlined also are current limitations, risks, and challenges to technology-mediated services, including the significant gaps in the evidence base underlying these technologies and the legal, ethical, and safety issues that remain.

scholarly journals National Estimates of Genetic Testing in Women With a History of Breast or Ovarian Cancer

2017 ◽  
Vol 35 (34) ◽  
pp. 3800-3806 ◽  
Author(s):  
Christopher P. Childers ◽  
Kimberly K. Childers ◽  
Melinda Maggard-Gibbons ◽  
James Macinko
Keyword(s):  
Ovarian Cancer ◽  
Genetic Testing ◽  
Unmet Need ◽  
Cancer Control ◽  
The United States ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Age Of Diagnosis ◽  
History Of ◽  
Interview Survey

Purpose In the United States, 3.8 million women have a history of breast (BC) or ovarian cancer (OC). Up to 15% of cases are attributable to heritable mutations, which, if identified, provide critical knowledge for treatment and preventive care. It is unknown how many patients who are at high risk for these mutations have not been tested and how rates vary by risk criteria. Methods We used pooled cross-sectional data from three Cancer Control Modules (2005, 2010, 2015) of the National Health Interview Survey, a national in-person household interview survey. Eligible patients were adult females with a history of BC and/or OC meeting select 2017 National Comprehensive Cancer Network eligibility criteria on the basis of age of diagnosis and family history. Outcomes included the proportion of individuals reporting a history of discussing genetic testing with a health professional, being advised to undergo genetic testing, or undergoing genetic testing for BC or OC. Results Of 47,218 women, 2.7% had a BC history and 0.4% had an OC history. For BC, 35.6% met one or more select eligibility criteria; of those, 29.0% discussed, 20.2% were advised to undergo, and 15.3% underwent genetic testing. Testing rates for individual eligibility criteria ranged from 6.2% (relative with OC) to 18.2% (diagnosis ≤ 45 years of age). For OC, 15.1% discussed, 13.1% were advised to undergo, and 10.5% underwent testing. Using only four BC eligibility criteria and all patients with OC, an estimated 1.2 to 1.3 million individuals failed to receive testing. Conclusion Fewer than one in five individuals with a history of BC or OC meeting select National Cancer Comprehensive Network criteria have undergone genetic testing. Most have never discussed testing with a health care provider. Large national efforts are warranted to address this unmet need.

scholarly journals Biomarkers predictive of treatment response in psoriasis and psoriatic arthritis: a systematic review

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110140
Author(s):  
Conor Magee ◽  
Hannah Jethwa ◽  
Oliver M. FitzGerald ◽  
Deepak R. Jadon
Keyword(s):  
Systematic Review ◽  
Psoriatic Arthritis ◽  
Treatment Response ◽  
Unmet Need ◽  
Response To Treatment ◽  
Cochrane Library ◽  
Original Research ◽  
Eligibility Criteria ◽  
Psoriatic Disease ◽  
Subsequent Response

Aims: The ability to predict response to treatment remains a key unmet need in psoriatic disease. We conducted a systematic review of studies relating to biomarkers associated with response to treatment in either psoriasis vulgaris (PsV) or psoriatic arthritis (PsA). Methods: A search was conducted in PubMed, Embase and the Cochrane library from their inception to 2 September 2020, and conference proceedings from four major rheumatology conferences. Original research articles studying pre-treatment biomarker levels associated with subsequent response to pharmacologic treatment in either PsV or PsA were included. Results: A total of 765 articles were retrieved and after review, 44 articles (22 relating to PsV and 22 to PsA) met the systematic review’s eligibility criteria. One study examined the response to methotrexate, one the response to tofacitinib and all the other studies to biologic disease-modifying antirheumatic drugs (DMARDs). Whilst several studies examined the HLA-C*06 allele in PsV, the results were conflicting. Interleukin (IL)-12 serum levels and polymorphisms in the IL-12B gene show promise as biomarkers of treatment response in PsV. Most, but not all, studies found that higher baseline levels of C-reactive protein (CRP) were associated with a better clinical response to treatment in patients with PsA. Conclusion: Several studies have identified biomarkers associated with subsequent response to treatment in psoriatic disease. However, due to the different types of biomarkers, treatments and outcome measures used, firm conclusions cannot be drawn. Further validation is needed before any of these biomarkers translate to clinical practice.

scholarly journals Socioeconomic determinants of unmet need for outpatient healthcare services in Iran: a national cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajad Vahedi ◽  
Amin Torabipour ◽  
Amirhossein Takian ◽  
Saeed Mohammadpur ◽  
Alireza Olyaeemanesh ◽  
...  
Keyword(s):  
Health System ◽  
Age Groups ◽  
Unmet Need ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Outpatient Services ◽  
Self Medication ◽  
Cross Sectional ◽  
Organizational Policies ◽  
Utilization Of Healthcare

Abstract Background Unmet need is a critical indicator of access to healthcare services. Despite concrete evidence about unmet need in Iran’s health system, no recent evidence of this negative outcome is available. This study aimed to measure the subjective unmet need (SUN), the factors associated with it and various reasons behind it in Iran. Methods We used the data of 13,005 respondents over the age of 15 from the Iranian Utilization of Healthcare Services Survey in 2016. SUN was defined as citizens whose needs were not sought through formal healthcare services, while they did not show a history of self-medication. The reasons for SUN were categorized into availability, accessibility, responsibility and acceptability of the health system. The multivariable logistic regression was used to determine significant predictors of SUN and associated major reasons. Results About 17% of the respondents (N = 2217) had unmet need for outpatient services. Nearly 40% of the respondents chose only accessibility, 4% selected only availability, 78% chose only responsibility, and 13% selected only acceptability as the main reasons for their unmet need. Higher outpatient needs was the only factor that significantly increased SUN, responsibility-related SUN and acceptability-related SUN. Low education was associated with higher SUN and responsibility-related SUN, while it could also reduce acceptability-related SUN. While SUN and responsibility-related SUN were prevalent among lower economic quintiles, having a complementary insurance was associated with decreased SUN and responsibility-related SUN. The people with basic insurance had lower chances to face with responsibility-related SUN, while employed individuals were at risk to experience SUN. Although the middle-aged group had higher odds to experience SUN, the responsibility-related SUN were prevalent among elderly, while higher age groups had significant chance to be exposed to acceptability-related SUN. Conclusion It seems that Iran is still suffering from unmet need for outpatient services, most of which emerges from its health system performance. The majority of the unmet health needs could be addressed through improving financial as well as organizational policies. Special attention is needed to address the unmet need among individuals with poor health status.

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