1.Proceedings from a symposium in the 2018 AFPA convention in the Philippines: Rethinking the role of Long-acting Antipsychotic Injectables (LAis) in a comprehensive, recovery-oriented treatment approach among patients with Schizophrenia
Erwin G. Benedicto ; Kristine Joy L. Tomanan ; Marvin P. Angeles ; Carl Abelardo T. Antonio
The Philippine Journal of Psychiatry 2019;41(2):34-41
Schizophrenia is a chronic, debilitating illness affecting
around 21 million people globally. It is a severe form of mental
health problem, affecting more individuals aged 15-35 years
(late adolescence to early adulthood) and commonly found
among males 1
• It is thought to result from a combination of
genetic, environmental and psychosocial factors.
In the Philippines, schizophrenia is the leading cause for
mental health consultation and treatment in hospitals2
•
Based from the Philippine Health Information System on
Mental Health data gathered from 2014 to 2015 in 14 health
facilities, around 42% out of 2,562 patients on record were
diagnosed with schizophrenia. From this data, it is estimated
that 1 % or around 1 million of the country's total population
are affected by this disorder.
Poor adherence to medication is a major cause of poor
outcomes in patients with schizophrenia, with non-adherence
as high as 50-74% in the initial phase of treatment3
-
5
• Nonadherence is associated with relapse, re-hospitalization and
poor quality of life among individuals with the illness3
•
While remission and ultimately, recovery, is the goal, the
foundation of successful treatment is appropriate medication
prescription and good adherence. The use of new generation,
long-acting injectable (LAI) antipsychotic medications is
one of the ways to improve patient's adherence to treatment
by reducing frequency of administration and improving the
consistency of drug delivery as well as bioavailability in the
circulation 6.On January 25, 2018, Johnson and Johnson Philippines
organized a symposium on LAI treatment during the
2018 International Congress of the Asian Federation of
Psychiatric Associations (AFPA) and 44th Philippine
Psychiatric Association Annual Convention at the
Philippine International Convention Center, Pasay City.
The purpose of the symposium was to discuss the role of
long-acting antipsychotic medications in a comprehensive
treatment approach for schizophrenia. A total of almost 300
psychiatrists and psychologists attended the activity.
The aim of this special report is to present the discussion of
the guest speaker Dr. Allan Tasman, and weigh the pros and
cons of using long-acting injectable (LAI) antipsychotics as
part of treatment for Filipino patients with schizophrenia.
Dr. Tasman is an internationally known psychiatrist and
advocate of integrative biopsychosocial treatment model
within a comprehensive, collaborative system of care and
innovation for psychiatric education and clinical services.
He is currently professor and emeritus chairman of the
Department of Psychiatry and Behavioral Sciences at the
University of Louisville, and Schwab Endowed Chair in
Social and Community Psychiatry.
The primary objectives of Dr. Tasman's presentation were
to: (1) review comprehensive treatment approaches in
schizophrenia, keeping in mind up-to-date medication
management as the foundation of treatment; and (2) use
evidence-based practice in maximizing the likelihood of
recovery in patients with schizophrenia.
Schizophrenia
2.Advances in the treatment and management of Filipino patients with multiple myeloma: From deadly to chronic disease with possibility of remission.
Erwin G. Benedicto ; Kristine Joy L. Tomanan ; Marvin P. Angeles ; , Carl Abelardo T. Antonio
Journal of the Philippine Medical Association 2018;97(1):54-59
BACKGROUND:
Multiple myeloma is a malignant
proliferation of plasma cells that accumulate in the
bone marrow and results in several organ dysfunctions that are debilitating and fatal. For the past 20
years, advances in the understanding of genetic
abnormalities, interactions in the bone marrow
microenvironment, developments in the diagnosis
and staging in myeloma and introduction and
incorporation of novel agents early in the disease
course have been pivotal in the clinical treatment
and management of patients with multiple myeloma.
However, the burden associated with the disease,
including treatment costs, is significant for Filipino
patients as it is still incurable. In the Philippines, the
introduction of bortezomib in the market in the last
decade have brought hope to many patients by
expanding the availability of treatment options,
improving quality of life and extending survival.
METHODS:
This paper documents the proceedings of
a forum on multiple myeloma conducted last March
2018 at Makati City. The purpose of the forum was
to discuss the major clinical presentations of the
disease as well as treatment and management of
selected patients. Speakers were hematology and
medical oncology experts in the Philippines.
RESULTS:
Five cases of multiple myeloma with different clinical presentations and management were
discussed: (1) renal insufficiency, (2) easy fatigability, (3) bone pain, (4) autologous stem cell/bone
marrow transplantation and (5) coagulopathy. Short
videos of selected patients (or their family members)
after each presentation was showed, describing their
treatment journey with myeloma. Other patients with
multiple myeloma who were treated with bortezomib
were present in the forum and briefly shared their
experiences.
CONCLUSION
As multiple myeloma is a highly
heterogeneous molecular disease, approaches and
provision of care will need to be individualized
for each patient. Because of its impressive
performance, bortezomib is likely to continue being
an important part of the clinical treatment and
management of Filipino patients with myeloma.
Bortezomib