BACKGROUND AND OBJECTIVES

Non-Hodgkin Lymphoma (NHL) ranks 11th in cancer incidence and mortality in the Philippines with the combination chemotherapy composed of Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) being commonly used as treatment. However, the addition of Rituximab to CHOP (R-CHOP) has been shown to exhibit higher response rates and longer remissions, potentially improving quality of life. Currently, there is conflicting evidence on the cost-utility of CHOP versus R-CHOP. The study aimed to describe the patient- and country-specific factors, and treatment modalities used for NHL and systematically review cost-utility evidence of R-CHOP versus CHOP in adult NHL patients.

METHODS

A systematic literature search of cost-utility studies on R-CHOP versus CHOP for NHL treatment was performed on eight databases: PubMed/MEDLINE, Scopus, Web of Science, EBSCOHost, Cochrane, York Research Database, Centre for Reviews and Dissemination Database, and HERDIN, where 607 studies were identified. Upon screening using an eligibility criteria, 10 studies were included and critically assessed using four appraisal tools: CHEERS, Drummond, Cooper, and ECOBIAS. These were performed independently by two authors with a third author assisting to help reach a consensus.

RESULTS

All studies from high-income countries (HICs) (n=8) and low-middle-income country (LMIC) (n=1) suggested that R-CHOP was more cost-effective for NHL treatment than CHOP in terms of utility outcomes. The study conducted in a low-income country (LIC) (n=1) suggested the opposite, favoring CHOP over R-CHOP. Methodological differences such as perspective, discount rate, willingness-to-pay (WTP), time horizon, and economic model were observed. Methodological limitations include completeness of data reported and credibility of sources used.

CONCLUSION

The results of this review shall be interpreted with caution as those favoring R-CHOP over CHOP for NHL treatment in terms of cost-utility were concentrated in HICs. More economic evaluations from LICs, LMICs, and upper-middle income countries (UMICs) are needed for a robust conclusion. Additionally, establishing a universally recognized guideline for economic evaluations is essential to guide researchers effectively.

Cost-benefit Analysis ; Hodgkin Disease ; Lymphoma ; Systematic Review ; Lymphoma, Non-hodgkin

BACKGROUND AND OBJECTIVES

Pharmacists are in a unique position to provide important medication information, prevent errors, and help improve patient outcomes. Patient medication counseling (PMC) is integral in medication therapy management of pharmacists. Students perceive PMC as an important step in ensuring the most appropriate pharmacotherapy for the patients and as an essential component of drug management. The objective of the study is to describe the students’ perceptions on a university-led patient medication counseling program implemented in a patient medication counseling course.

METHODS

The study employs a qualitative study design with a total population sampling of forty-two (42) Clin Pharm 176 BS Pharmacy students in a College of Pharmacy. A self-evaluation adapted from the United States Pharmacopeia medication counseling behavior guidelines (USP-MCBG) scale was performed which has with four components: needs assessment, precautions and warnings, management of the treatment, and communication. A synthesis session was conducted utilizing a semi-structured questionnaire. The data was analyzed using measures of central tendency and thematic analysis.

RESULTS

Forty-two (42) students answered the USP-MCBG scale and participated in the synthesis session. Participants rated highest in communication (88.81±8.78) and lowest in treatment management (79.49±12.90) which suggests that the students were better equipped in displaying effective nonverbal behaviors and using appropriate language but were least confident in developing and managing treatment plans. There were five main domains on how the students evaluated the course and the PMC program which include pre-counseling session requirements, challenges in patient interaction, interprofessional collaboration, professional outlook, and program recommendations.

CONCLUSION

A university-led PMC program is effective in providing training for student pharmacists to identify and provide recommendations on medication therapy problems, and to practice interprofessional collaboration. It is recommended to continue the student training in the PMC program and to integrate this in the student internship program to evaluate the skills development of students during their clinical rotations.

Students, Pharmacy