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Biomedical subjects

B Wagstaff

Publications and source records attributed to B Wagstaff.

3 recordsLinked to original sources

Impact of antibiotic restrictions: the patient's perspective.

When patients seek medical help, they expect to be protected and that healthcare decisions preserve their safety - they expect to receive more benefit than harm. Harm can be caused through both action and inaction, for example by failing to provide adequate therapy because of cost constraints. Restrictions on the use of antibiotics that prevent or discourage the use of the best available treatment may jeopardise the health/recovery of patients, and undermine their trust in their doctor. What the public and patients may be less clear about is the complex interplay between competing priorities; providing quality care vs. ensuring cost efficiencies in a public healthcare system, which is under increasing pressure to deliver comprehensive care. As new technology becomes available, and the need for and expectations of healthcare increase, the pressure on governments to manage soaring healthcare costs may impact on the care that patients receive, as individuals, from their doctor. Patients vary in their desire to be involved in decisions about their treatment. Some are happy to trust the professionals; others want information from various sources, an open dialogue about the options and the ultimate right to make the best choice for themselves. Governments are keen to have more empowered patients, in the belief that this will drive up standards of care and increase patient satisfaction. This may result in greater pressure from patients for the best treatments to be made available.

Anti-Bacterial Agents↗

A cost analysis on the pattern of asthma prescribing in the UK.

There is a need to establish the proportion of adult asthmatics at each step of the recommended asthma management guidelines, the cost of their prescribed treatment, and a revised cost of treatment assuming patients who were suboptimally controlled were moved up a step. Actual prescription and cost figures and a theoretical projection of an ideal scenario was calculated from a sample of general practices in Great Britain from the Doctors Independent Network. They comprised 102 nationally distributed practices and 17,206 adult patients with a diagnosis of, and prescription related to, asthma recorded between October 1993 and March 1994. Ninety-one per cent of patients received treatment within a recognized step of the guidelines. Of these, 80% were at steps 1 and 2. Employing excess inhaled beta-agonist use as a proxy for control of asthma, between 55% and 69% of patients at Steps 1-3 should receive treatment at a higher step. This could lead to an increased expenditure of up to Pound Sterling 4.66 per adult patient per month. This would imply a rise in the annual UK cost of antiasthma prescriptions for adults from Pound Sterling 388m to a possible Pound Sterling 533m. The United Kingdom Government audit commission has suggested that current expenditure on asthma treatment appears to be insufficient. Using an entirely different approach this study has confirmed that a significant increase in asthma prescribing costs is likely to be needed if optimal control of asthma is to be achieved.

Adolescent↗