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A.Sabry, N., D. Dawoud, A. Al-Ansary, and N. Hounsome, "Outcomes of a protocol-based intervention to promote timely switching from intravenous to oral paracetamol: an interrupted time series analysis.", Journal of Evaluation in Clinical Practice, vol. 21, issue 6, pp. 1081-1088, 2016.
Alhyas, L., J. J. D. Nielsen, D. Dawoud, and A. Majeed, "Factors affecting the motivation of healthcare professionals providing care to Emiratis with type 2 diabetes.", JRSM short reports, vol. 4, issue 2, pp. 14, 2013 Feb. Abstract

OBJECTIVE: We aimed to identify facilitators of and barriers to healthcare professionals' motivation in a diabetes centre in the United Arab Emirates (UAE).

DESIGN: A qualitative research approach was employed using semistructured interviews to assess perception of and attitudes regarding healthcare professionals' motivation in providing good quality diabetes care.

SETTING: A diabetes centre located in Abu-Dhabi, UAE.

PARTICIPANTS: Healthcare professionals including specialist physicians, dieticians, podiatrists, health educators and nurses were recruited through purposive sampling.

MAIN OUTCOME MEASURES: After data collection, the audiotaped interviews were transcribed verbatim and subjected to content analysis.

RESULTS: Nine semistructured interviews were conducted with healthcare professionals of various professional backgrounds. Important facilitators and barriers related to patient, professional, organization and cultural factors were identified. Barriers that related to heavy workload, disjointed care, lack of patient compliance and awareness, and cultural beliefs and attitudes about diabetes were common. Key facilitators included the patient's role in achieving therapeutic outcomes as well as compliance, cooperation and communication.

CONCLUSION: This qualitative study provides some unique insights about factors affecting healthcare professionals' motivation in providing good quality care. To improve the motivation of healthcare professionals in the management of diabetes and therefore the quality of diabetes care, several steps are needed. Importantly, the role of primary care should be reinforced and strengthened regarding the management of type 2 diabetes mellitus, privacy of the consultation time should be highly protected and regulated, and awareness of the Emirate culture and its impact on health should be disseminated to the healthcare professionals providing care to Emirates with diabetes. Also, greater emphasis should be placed on educating Emiratis with diabetes on, and involving them in, the management of their condition.

Atif, M., iram Malik, D. Dawoud, A. Gilani, N. Ahmed, and Z. - U. - D. Babar, "Essential Medicine List, Policies, and the World Health Organization", Encyclopedia of Pharmacy Practice and Clinical Pharmacy: Elsevier, 2019.
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Dawoud, D., "Discrete choice experiment", Encyclopedia of Pharmacy Practice and Clinical Pharmacy: Elsevier, 2019.
Dawoud, D., A. M. H. Chen, C. V. Rossing, V. Garcia-Cardenas, A. V. Law, P. Aslani, I. Bates, Z. - U. - D. Babar, and S. Desselle, "Pharmacy practice research priorities during the COVID-19 pandemic: Recommendations of a panel of experts convened by FIP Pharmacy Practice Research Special Interest Group.", Research in social & administrative pharmacy : RSAP, vol. 17, issue 1, pp. 1903-1907, 2021. Abstract

Across the globe, pharmacists on the frontline continue to fight COVID-19 and its continuously evolving physical, mental, and economic consequences armed by their knowledge, professionalism, and dedication. Their need for credible scientific evidence to inform their practice has never been more urgent. Despite the exponentially increasing number of publications since the start of the pandemic, questions remain unanswered, and more are created, than have been resolved by the increasing number of publications. A panel of leading journal editors was convened by the International Pharmaceutical Federation (FIP) Pharmacy Practice Research Special Interest Group to discuss the current status of COVID-19 related research, provide their recommendations, and identify focal points for pharmacy practice, social pharmacy, and education research moving forward. Key priorities identified spanned a wide range of topics, reflecting the need for good quality research to inform practice and education. The panel insisted that a foundation in theory and use of rigorous methods should continue forming the basis of inquiry and its resultant papers, regardless of topic area. From assessing the clinical and cost effectiveness of COVID-19 therapies and vaccines to assessing different models of pharmaceutical services and education delivery, these priorities will ensure that our practice is informed by the best quality scientific evidence at this very challenging time.

Dawoud, D., R. O'Mahony, D. Wonderling, J. Cobb, B. Higgins, and S. A. Amiel, "Basal Insulin Regimens for Adults with Type 1 Diabetes Mellitus: A Systematic Review and Network Meta-Analysis.", Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, vol. 21, issue 2, pp. 176-184, 2018 02. Abstract

OBJECTIVE: To assess the relative efficacy and safety of basal insulin regimens in adults with type 1 diabetes mellitus (T1DM).

METHODS: A systematic review and Bayesian network meta-analysis (NMA) of randomized controlled trials comparing two or more basal insulin regimens were conducted. The following basal insulin regimens were included: Neutral Protamine Hagedorn (iNPH) (once [od], twice [bid], and four times daily [qid]), insulin detemir (iDet) (od and bid), insulin glargine 100 IU (iGlarg) (od), and insulin degludec (iDegl) (od). We searched the following databases: MEDLINE via OVID, Embase via OVID, and the Cochrane Library (Wiley). Study quality was appraised using Cochrane risk-of-bias checklist for randomized controlled trials. Two outcomes (change in hemoglobin A [HbA] and rate of severe/major hypoglycemia [SH]) were analyzed. Network inconsistency was assessed using Bucher and chi-square tests.

RESULTS: Thirty studies met the eligibility criteria. Twenty-five were included in the HbA network and 16 in the SH network. All studies were of moderate quality. No network inconsistency was evident in the HbA network. Of the seven regimens of interest, iDet (bid) had the highest probability of being best (mean change in HbA -0.48; 95% credible interval -0.69 to -0.29). In contrast, the SH network demonstrated both considerable uncertainty and significant network inconsistency (χ test, P = 0.003).

CONCLUSIONS: Of the specified frequency regimens, iDet (bid) had the highest probability of being the best basal insulin regimen in terms of reduction in HbA. Ranking of the regimens in terms of the SH rate was highly uncertain and no clear conclusion could be made.

Dawoud, D., K. Chalkidou, R. Sullivan, F. J. Ruiz, and A. Adler, "USA stockpiling of remdesivir: How should the world respond?", Journal of comparative effectiveness research, vol. 9, issue 18, pp. 1243-1246, 2020. Abstract

The race to find an effective treatment for coronavirus disease 2019 (COVID-19) is still on, with only two treatment options currently authorized for emergency use and/or recommended for patients hospitalized with severe respiratory symptoms: low-dose dexamethasone and remdesivir. The USA decision to stockpile the latter has resulted in widespread condemnation and in similar action being taken by some other countries. In this commentary we discuss whether stockpiling remdesivir is justified in light of the currently available evidence.

Dawoud, D., E. Fenu, B. Higgins, D. Wonderling, and S. A. Amiel, "Basal Insulin Regimens for Adults with Type 1 Diabetes Mellitus: A Cost-Utility Analysis", Value in Health, vol. 20, issue 10, pp. 1279–1287, 2017.
Dawoud, D., "Emerging from the other end: Key measures for a successful COVID-19 lockdown exit strategy and the potential contribution of pharmacists.", Research in social & administrative pharmacy : RSAP, vol. 17, issue 1, pp. 1950-1953, 2021. Abstract

As the world edges towards relaxing the lockdown measures taken to control the spread of the novel coronavirus SARS-CoV-2 (COVID-19), governments have started putting in place a variety of measures to avoid a second peak in the number of infections. The implementation of and adherence to such measures will be key components of any successful lockdown exit strategy. Ranging from expanded testing and widespread use of technology to building the public's trust in the post COVID-19 world, there is a role for pharmacists to play. In this commentary, these measures and the potential contribution of pharmacists to their successful implementation are outlined and discussed.

Dawoud, D. M., M. Smyth, J. Ashe, T. Strong, D. Wonderling, J. Hill, M. Varia, P. Dyer, and J. Bion, "Effectiveness and cost effectiveness of pharmacist input at the ward level: a systematic review and meta-analysis.", Research in social & administrative pharmacy : RSAP, vol. 15, issue 10, pp. 1212-1222, 2019. Abstract

BACKGROUND: Pharmacists play important role in ensuring timely care delivery at the ward level. The optimal level of pharmacist input, however, is not clearly defined.

OBJECTIVE: To systematically review the evidence that assessed the outcomes of ward pharmacist input for people admitted with acute or emergent illness.

METHODS: The protocol and search strategies were developed with input from clinicians. Medline, EMBASE, Centre for Reviews and Dissemination, The Cochrane Library, NHS Economic Evaluations, Health Technology Assessment and Health Economic Evaluations databases were searched. Inclusion criteria specified the population as adults and young people (age >16 years) who are admitted to hospital with suspected or confirmed acute or emergent illness. Only randomised controlled trials (RCTs) published in English were eligible for inclusion in the effectiveness review. Economic studies were limited to full economic evaluations and comparative cost analysis. Included studies were quality-assessed. Data were extracted, summarised. and meta-analysed, where appropriate.

RESULTS: Eighteen RCTs and 7 economic studies were included. The RCTs were from USA (n = 3), Sweden (n = 2), Belgium (n = 2), China (n = 2), Australia (n = 2), Denmark (n = 2), Northern Ireland, Norway, Canada, UK and Netherlands. The economic studies were from UK (n = 2), Sweden (n = 2), Belgium and Netherlands. The results showed that regular pharmacist input was most cost effective. It reduced length-of-stay (mean = -1.74 days [95% CI: 2.76, -0.72], and increased patient and/or carer satisfaction (Relative Risk (RR) = 1.49 [1.09, 2.03] at discharge). At £20,000 per quality-adjusted life-year (QALY)-gained cost-effectiveness threshold, it was either cost-saving or cost-effective (Incremental Cost Effectiveness Ratio (ICER) = £632/QALY-gained). No evidence was found for 7-day pharmacist presence.

CONCLUSIONS: Pharmacist inclusion in the ward multidisciplinary team improves patient safety and satisfaction and is cost-effective when regularly provided throughout the ward stay. Research is needed to determine whether the provision of 7-day service is cost-effective.

Dawoud, D. M., A. Haines, D. Wonderling, J. Ashe, J. Hill, M. Varia, P. Dyer, and J. Bion, "Cost Effectiveness of Advanced Pharmacy Services Provided in the Community and Primary Care Settings: A Systematic Review.", PharmacoEconomics, vol. 37, issue 10, pp. 1241-1260, 2019. Abstract

BACKGROUND: Pharmacists working in community and primary care are increasingly developing advanced skills to provide enhanced services, particularly in dealing with minor acute illness. These services can potentially free-up primary care physicians' time; however, it is not clear whether they are sufficiently cost effective to be recommended for wider provision in the UK.

OBJECTIVE: The aim of this study was to review published economic evaluations of enhanced pharmacy services in the community and primary care settings.

METHODS: We undertook a systematic review of economic evaluations of enhanced pharmacy services to inform NICE guidelines for emergency and acute care. The review protocol was developed and agreed with the guideline committee. The National Health Service Economic Evaluation Database, Health Technology Assessment Database, Health Economic Evaluations Database, MEDLINE and EMBASE were searched in December 2016 and the search was updated in March 2018. Studies were assessed for applicability and methodological quality using the NICE Economic Evaluation Checklist.

RESULTS: Of 3124 records, 13 studies published in 14 papers were included. The studies were conducted in the UK, Spain, The Netherlands, Australia, Italy and Canada. Settings included community pharmacies, primary care/general practice surgeries and patients' homes. Most of the studies were assessed as partially applicable with potentially serious limitations. Services provided in community and primary care settings were found to be either dominant or cost effective, at a £20,000 per quality-adjusted life-year threshold, compared with usual care. Those delivered in the patient's home were not found to be cost effective.

CONCLUSIONS: Advanced pharmacy services appear to be cost effective when delivered in community and primary care settings, but not in domiciliary settings. Expansion in the provision of these services in community and primary care can be recommended for wider implementation.

Dawoud, D. M., D. Wonderling, J. Glen, S. Lewis, X. L. Griffin, B. J. Hunt, G. Stansby, M. Reed, N. Rossiter, J. K. Chahal, et al., "Cost-Utility Analysis of Venous Thromboembolism Prophylaxis Strategies for People Undergoing Elective Total Hip and Total Knee Replacement Surgeries in the English National Health Service.", Frontiers in pharmacology, vol. 9, pp. 1370, 2018. Abstract

Major orthopedic surgery, such as elective total hip replacement (eTHR) and elective total knee replacement (eTKR), are associated with a higher risk of venous thromboembolism (VTE) than other surgical procedures. Little is known, however, about the cost-effectiveness of VTE prophylaxis strategies in people undergoing these procedures. The aim of this work was to assess the cost-effectiveness of these strategies from the English National Health Service perspective to inform NICE guideline (NG89) recommendations. Cost-utility analysis, using decision modeling, was undertaken to compare 15 VTE prophylaxis strategies for eTHR and 12 for eTKR, in addition to "no prophylaxis" strategy. The analysis complied with the NICE Reference Case. Structure and assumptions were agreed with the guideline committee. Incremental net monetary benefit (INMB) was calculated, vs. the model comparator (LMWH+ antiembolism stockings), at a threshold of £20,000/quality-adjusted life-year (QALY) gained. The model was run probabilistically. Deterministic sensitivity analyses (SAs) were undertaken to assess the robustness of the results. The most cost-effective strategies were LMWH for 10 days followed by aspirin for 28 days (INMB = £530 [95% CI: -£784 to £1,103], probability of being most cost-effective = 72%) for eTHR, and foot pump (INMB = £353 [95% CI: -£101 to £665]; probability of being most cost-effective = 18%) for eTKR. There was considerable uncertainty regarding the cost-effectiveness ranking in the eTKR analysis. The results were robust to change in all SAs. For eTHR, LMWH (standard dose) for 10 days followed by aspirin for 28 days is the most cost-effective VTE prophylaxis strategy. For eTKR, the results are highly uncertain but foot pump appeared to be the most cost-effective strategy, followed closely by aspirin (low dose). Future research should focus on assessing cost-effectiveness of VTE prophylaxis in the eTKR population.

Dawoud, D. M., and K. Y. Soliman, "Cost-Effectiveness of Antiviral Treatments for Pandemics and Outbreaks of Respiratory Illnesses, Including COVID-19: A Systematic Review of Published Economic Evaluations.", Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, vol. 23, issue 11, pp. 1409-1422, 2020. Abstract

OBJECTIVE: To review published economic evaluations of antiviral treatment for pandemics and outbreaks of respiratory illnesses.

METHODS: We conducted a systematic review to identify economic evaluations of antiviral treatment for pandemics and outbreaks of respiratory illnesses, including coronavirus disease 2019 (COVID-19). We searched Medline (EBSCOhost), EMBASE (Ovid), EconLit (Ovid), National Health Service Economic Evaluation Database (Ovid), and Health Technology Assessment (Ovid). The search was last rerun on July 5, 2020. Citation tracking and reference checking were used. Only full economic evaluations published as peer-reviewed articles in the last 10 years were included. Studies were quality assessed using the National Institute for Health and Care Excellence economic evaluation checklist.

RESULTS: Overall, 782 records were identified, of which 14 studies met the inclusion criteria. The studies were mostly conducted in high-income countries. All were model-based. Seven (50%) were cost-utility analyses, 4 (28.6%) were cost-effectiveness analyses, 2 (14.3%) were cost-consequences analyses, and 1 (7.1%) was a cost-benefit analysis. Strategies including antiviral treatment were found to be either cost-saving or cost-effective, at the study-specific willingness-to-pay thresholds. Empirical treatment was more cost-effective than test-guided treatment for young adults but less so for older adults.

CONCLUSIONS: Antiviral treatment for managing pandemics and outbreaks of respiratory illnesses that have very high case fatality rate, similar to COVID-19 pandemic, are likely to be cost-effective either as a standalone intervention or part of a multifaceted strategy. Investing in the development of such curative treatments and promptly evaluating their cost-effectiveness, relative to other strategies in use at the time of their introduction should be the focus going forward to inform resource allocation decisions particularly in low- and middle-income countries.

Dawoud, D., P. Griffiths, J. Maben, L. Goodyer, and R. Greene, "Pharmacist supplementary prescribing: a step toward more independence?", Research in social & administrative pharmacy : RSAP, vol. 7, issue 3, pp. 246-56, 2011 Sep. Abstract

BACKGROUND: Supplementary prescribing (SP) is a drug therapy management model implemented in the United Kingdom since 2003. It is a voluntary partnership between an independent prescriber; a supplementary prescriber, for example, nurse or pharmacist; and the patient, to implement an agreed patient-specific clinical management plan (CMP).

OBJECTIVE: To investigate pharmacist prescribers' views and experiences of the early stages of SP implementation.

METHODS: A qualitative, longitudinal study design was used. A purposive, maximum variability sample of 16 pharmacist supplementary prescribers, trained in Southern England, participated. Eleven were hospital pharmacists, owing to the overrepresentation of hospital pharmacists in the first cohort. Two semistructured interviews were conducted with each participant, at 3 and 6 months after their registration as prescribers. The Framework approach was used for data collection, management, and analysis.

RESULTS: Three typologies of pharmacists' experiences were identified: "a blind alley", "a stepping stone" and "a good fit". Despite some delays in its implementation, SP was seen as a step forward. Some participants also believed that it improved patient care and pharmacists' integration in the health care team and increased their job satisfaction. However, there was a concern that SP, as first implemented, was bureaucratic and limited pharmacists' freedom in their decision making. Hence, pharmacists were more supportive of the then imminent introduction of a pharmacist independent prescribing (IP) role.

CONCLUSIONS: Despite challenges, the SP role represented a step forward for pharmacists in the United Kingdom. It is possible that pharmacist SP can coexist with IP in the areas suitable for CMP use. Elsewhere, SP is likely to become more of a "stepping stone" to an IP role than the preferred model for pharmacist prescribing. Future research needs to objectively assess the outcomes of pharmacist SP, preferably in comparison with IP, to inform decision making among pharmacists regarding the adoption of such an innovative role.

Dawoud, N. M., O. H. Ayoub, E. S. Essa, and D. M. Dawoud, "Myelodysplasia in a psoriasis patient receiving etanercept: Cause or coincidence?", Indian journal of dermatology, venereology and leprology, vol. 84, issue 4, pp. 463-465, 2018 Jul-Aug.
Dawoud, D. M., F. El-Dahiyat, A. Abojedi, N. Dawoud, A. M. Soliman, M. Hussein, O. Mohamed, S. S. Hasan, Z. - U. - D. Babar, and S. A. Kharroubi, "Translation, cultural adaptation and psychometric validation of the SF-6D measure of health-related quality of life for use in Arabic-Speaking countries.", Research in social & administrative pharmacy : RSAP, vol. 16, issue 12, pp. 1754-1759, 2020. Abstract

BACKGROUND: The SF-6D is a generic, six-dimensional health-related quality of life (HRQoL) measure derived from a selection of items from the SF-36.

OBJECTIVES: To translate, culturally adapt and validate the SF-6D for use in Arabic-speaking countries.

METHODS: The International Quality of Life Assessment (IQOLA) methodology was followed. Two forward translations, one consensus and one backward translation were undertaken. Difficulties encountered were categorized as grammatical, idiomatic, semantic/conceptual, and cultural. The content validity of the final version was tested and Cronbach's alpha test of internal consistency was used for assessing reliability. Confirmatory factor analysis (CFA), was also used to assess construct validity and to test a pre-specified relationship of observed measures.

RESULTS: Minor changes were made to the forward translation to improve cultural appropriateness. The Backward translation did not reveal major problems and equivalence to the original was confirmed following committee review. A total of 470 participants from Jordan, Egypt, UAE, Qatar and Palestine completed the translated SF-6D. All the incremental indices values are ≥0.90 and close to 1. Item loading values ranged from 0.52 to 0.87. The measurement model weight for those with chronic health conditions ranged from 0.68 to 0.91, and from 0.42 to 0.73 for those without. The percentage of variation in self-reported health state was about 55%. The measurement weight of SF-6D on self-reported health state among chronic responders was 0.87 while among responders reporting no chronic disease was 0.61. The t-value for the difference in measurement weight was -8.93 (p ≤ 0.01).

CONCLUSION: Arabic translation and cultural adaptation of SF-6D has resulted in an acceptable and culturally-adapted version that can be used in Arabic-speaking countries. Reliability and validity have been confirmed as well as ability to assess the difference in quality of life between patients with chronic health conditions and healthy individuals.

Dawoud, D., and D. Baines, "Economic Evaluation and Its Types", Economic Evaluation of Pharmacy Services, London, Academic Press (imprint of Elsevier), 2016. Abstract

In this chapter, we provide a basic introduction to the different forms of economic evaluation, including cost-minimization analysis, cost-effectiveness analysis, cost–benefit analysis, and cost–utility analysis. In particular, we discuss the measurement of costs and outcomes in these types of economic evaluation and explain how the perspective of an evaluation affects these forms of analysis. We discuss the measurement of costs and patient outcomes and introduce the main measurement tools used by health economists. The chapter also introduces the concepts of incremental analysis, the cost-effectiveness plane, and cost-effectiveness acceptability curves. Finally, we discuss how the results of economic evaluations can be used in decision-making.

Desselle, S. P., A. M. Chen, M. Amin, P. Aslani, D. Dawoud, M. J. Miller, and L. S. Norgaard, "Generosity, collegiality, and scientific accuracy when writing and reviewing original research.", Research in social & administrative pharmacy : RSAP, vol. 16, issue 2, pp. 261-265, 2020. Abstract

In spite of concerns about the lack of recognition for its conduct, peer review remains the backbone of scientific evaluation and advancement of scientific knowledge. Given the challenges and evolution in the peer review system, collegiality among authors, reviewers, editors, and even consumers of content is more important than ever. While general guidance has been provided recently in the pharmacy literature, this commentary provides both philosophical underpinnings and specific mechanics for enhancing effectiveness of reviews and improving the quality of writing for authors concurrently, thus examining each major section in an original research contribution. Generosity, courtesy, diligence, thoroughness, and empathy are required of us all to advance the scientific paradigm of our discipline and profession.

Desselle, S. P., M. Amin, P. Aslani, A. M. Chen, D. Dawoud, M. J. Miller, and L. S. Norgaard, "Moving the needle-what does RSAP look for and what does it aim to do?", Research in social & administrative pharmacy : RSAP, vol. 15, issue 1, pp. 1-2, 2019.
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Elnady, B., T. Elkhouly, N. M. Dawoud, D. E. Desouky, H. H. Kewan, D. M. Dawoud, and C. Ritchlin, "New onset of axial spondyloarthropathy in patients treated with isotretinoin for acne vulgaris: incidence, follow-up, and MRI findings.", Clinical rheumatology, vol. 39, issue 6, pp. 1829-1838, 2020. Abstract

INTRODUCTION: Oral isotretinoin is commonly prescribed for acne vulgaris. Several case reports and observational studies have reported serious musculoskeletal side effects; however, the incidence, imaging findings, and longitudinal follow-up data are limited for patients who develop inflammatory back pain (IBP).

OBJECTIVE: To assess the incidence of isotretinoin-triggered axial spondyloarthropathy (SpA) in acne vulgaris patients based on clinical features and MRI findings and to examine clinical and radiological outcomes following drug withdrawal.

METHODS: Five hundred thirteen acne patients receiving isotretinoin were screened for IBP; IBP patients were assessed for CRP, plain radiographs, and MRI of the sacroiliac joint. MRI-proven sacroiliitis was scored semi-quantitatively. Patients were followed longitudinally to assess SpA clinical course and longitudinal MRI sacroiliac joints, and CRP levels were reassessed 3 weeks after patients were symptom-free, following isotretinoin discontinuation.

RESULTS: Of the 513 patients, 23.98% developed IBP. MRI-proven sacroiliitis was detected in 42.3% of the symptomatic patients or 10.1% of the cohort. Among MRI-proven sacroiliitis cases, 51.9% fulfilled the Assessment of Spondyloarthritis International Society criteria for axial SpA. Mean CRP level was 32.05 ± 17.23 mg/L at pain onset and 3.4 ± 2.7 mg/L after symptom resolution. MRI findings completely resolved within 9 months (mean 6.27 ± 1.7) after isotretinoin discontinuation. MRI scores positively correlated with baseline CRP levels and global acne grading system score, pain, and the Ankylosing Spondylitis Disease Activity Score.

CONCLUSION: Isotretinoin-induced axial SpA is a prevalent side effect in acne vulgaris patients. Early detection and follow-up of isotretinoin-induced sacroiliitis can be facilitated by MRI. Cessation of isotretinoin resulted in complete resolution in all affected patients.Key Points• Detection of underdiagnosed isotretinoin side effects which are common but not always correctly diagnosed and managed.• Incidence, diagnosis, and management of these side effects in a real-world setting.• This is the first large prospective longitudinal cohort study to report on axial manifestations in patients treated with isotretinoin as well as the effect of drug cessation upon the clinical, laboratory, and radiological findings.

Elvidge, J., and D. Dawoud, "Assessing Technologies for COVID-19: What are the Challenges for Health Technology Assessment Agencies? Findings From a Survey and Roundtable Workshop.", PharmacoEconomics, vol. 39, issue 12, pp. 1455-1463, 2021. Abstract

BACKGROUND: To date, health technology assessment (HTA) agencies have not been at the forefront of decision making regarding the adoption of interventions for coronavirus disease 2019 (COVID-19). Instead, policymakers have prioritised rapid action in response to the pandemic emergency, with no assessment of value for money. As COVID-19 vaccination coverage increases and healthcare systems begin to recover, HTA agencies will be expected to assess technologies for COVID-19.

OBJECTIVE: We aimed to identify the key challenges when assessing therapeutic and diagnostic technologies for COVID-19, from the perspective of HTA agencies, and identify whether there is a case for novel HTA methods and/or processes to address them.

METHODS: We used a mixed-methods approach, by conducting an online survey of HTA agencies, to collect data about the challenges faced when assessing or planning to assess diagnostic and therapeutic technologies for COVID-19. The online survey was followed by a 'roundtable' workshop of HTA agencies' representatives to discuss the results and to elaborate on their responses.

RESULTS: We received 21 completed surveys (response rate of 45%) and 11 of the respondents joined the roundtable discussion. Five themes emerged from the responses: assessing clinical effectiveness (44%), assessing cost effectiveness (19%), practical (19%), political (11%), and decision making (11%) challenges. At the roundtable, attendees elaborated on the challenges and identified two additional themes: how HTA agencies have responded to the pandemic to date, and how their role might change over time.

CONCLUSION: HTA agencies face both methodological and logistical challenges when assessing or planning to assess technologies for COVID-19. An interim best-practice HTA framework to address the key challenges would be valuable.

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Neilson, J., F. O'Neill, D. Dawoud, and P. Crean, "Intravenous fluids in children and young people: summary of NICE guidance.", BMJ (Clinical research ed.), vol. 351, pp. h6388, 2015.
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Amiel, S. A., N. Pursey, B. Higgins, and D. Dawoud, "Diagnosis and management of type 1 diabetes in adults: summary of updated NICE guidance.", BMJ (Clinical research ed.), vol. 351, pp. h4188, 2015.
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Hasan, S. S., W. Sunter, N. Ahmed, D. Dawoud, and S. T. R. Zaidi, "Venous thromboembolism prophylaxis in patients undergoing knee replacements: comparison of real-world outcomes.", International journal of clinical pharmacy, vol. 43, issue 3, pp. 621-628, 2021. Abstract

Background Increasing evidence for the use of the aspirin in patients undergoing an orthopaedic surgery for venous thromboembolism prophylaxis has led to a change in the national guidelines substituting anticoagulants with aspirin. Little is known about the impact of such substitution on real-world outcomes from clinical practice. Objective The study was designed to examine clinical outcomes associated with the use of aspirin and apixaban. Setting Two large-scale general hospitals in West Yorkshire region of England. Method A 1-year observational study among adults who underwent elective knee replacements and received venous thromboembolism prophylaxis within the first 14 days post replacements. Main outcome measure The incidence of postoperative venous thromboembolism, leaking wounds during the hospital stay, and 30-day any readmission for the two drugs. Results A total of 420 patients were included. There was a significant drop in apixaban prescribing (from 80.37 to 10.51%) and increase in aspirin use (from 19.02 to 81.71%) after the implementation of the revised guidelines. There were 52 (12.38%) cases of leaking wound, 16 (3.81%) cases of postoperative venous thromboembolism, 45 (10.71%) cases of 30-day readmission and no case of 30-day major bleeding. The leaking wounds and 30-day readmissions were almost twice more frequent in obese compared to non-obese patients. Multivariate logistic regression found an increased risk of leaking wound with apixaban and postoperative venous thromboembolism and 30-day readmission with aspirin use but the differences were not statistically significant. Conclusion The results suggest aspirin to be as effective as apixaban in preventing venous thromboembolism and readmission. Apixaban usage decreased with a corresponding increase in Aspirin use. The impact of obesity and length of hospital stay need further investigations.

Hasan, S. S., C. S. Kow, D. Dawoud, O. Mohamed, D. Baines, and Z. - U. - D. Babar, "Pharmaceutical Policy Reforms to Regulate Drug Prices in the Asia Pacific Region: The Case of Australia, China, India, Malaysia, New Zealand, and South Korea.", Value in health regional issues, vol. 18, pp. 18-23, 2019. Abstract

Medicine price directly affects affordability and access to medicines particularly in countries where a major portion of pharmaceutical spending is through out-of-pocket payment, such as in the Asia Pacific region. We have undertaken a detailed appraisal of the pharmaceutical policy reforms to regulate drug prices in 3 developed (Australia, New Zealand, and South Korea) and 3 emerging (China, India, and Malaysia) economies of the Asia Pacific region. Despite continuous efforts by the authorities in adopting a wide range of reformatory pharmaceutical pricing policies to ensure affordability of medicines, these policies may not be optimal where drug prices were not lowered as expected (eg, in Korea). On the contrary, considerable price reductions of various pharmaceuticals have been observed in New Zealand and India because of the reform in pharmaceutical pricing policy. This review of pharmaceutical pricing reforms reinforces the need for constant monitoring by policy makers in Asia Pacific countries to regulate drug prices and to undertake reform in pharmaceutical pricing policies when necessary to ensure affordability and access to medicines.

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