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A Pharmacoeconomics Study for Anticoagulants used for Hospitalized COVID-19 Patients in Al-Najaf Al-Ashraf city –Iraq(Conference Paper )#
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Abstract

Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions.

Objective:

compare the clinical outcome and the costs of two anticoagulants (heparin and (enoxaparin)) used to treat hospitalized patients with COVID-19 infection.

Patients and method:

The study was a retrospective review of medical records of adult, non-pregnant, COVID-19 infected hospitalized patients who had baseline and last outcome measurements at Alamal Epidemiology Center, Al-Najaf city from (Augast 2020 to June 2021).

The outcome measures included D-dimer, length of stay (LOS), and mortality rate. Only the cost of the medical treatment was considered in the analysis.

The pharmacoeconomics analysis was done in three different cost-effectiveness analysis methods. Microsoft Excel spreadsheet and Statistical Package for the Social Sciences software (SPSS), was used to conduct statistical analysis. Kaplan Meier test was used to compare the mortality rate. T-TEST was used to compare the outcomes of the two groups.

Results and discussion:

two groups were compared, the first group consists of 72 patients who received heparin, and the second group consists of 72 patients who received enoxaparin.

COVID-19 infected patients had a higher abnormal average D-dimer (2534.675 ng/dl). No significant differences between both genders with regards to the basal average D-dimer (males= 2649.95 ng/dl, females= 2374.1mg/dl, P-value>0.05). There was a significant difference between patient's ages 60 years and patients <60. (3177.33 ng/dl, 1763.06 ng/dl, P-value <0.05). It seems that, higher D-dimer levels were associated with a higher mortality rate (died=3166.263 ng/dl, survived= 1729.94 ng/dl, P-value <0.05). Heparin was more effective in decreasing D-dimer levels than enoxaparin which inversely increased the D-dimer levels (-24.4 ng/dl/day, +154.701 ng/dl/day, P-value <0.05). Additionally, heparin was more effective in increasing the survival rate compared to enoxaparin (55% vs, 35%, P-value<0.05). Heparin was associated with a longer duration of stay in hospital than enoxaparin but with no significant difference (13.7 days, 12.3 days, P-value >0.05).

Concerning the cost, treatment with heparin cost less than enoxaparin (2.08 U.S $, 9.44 U.S $)/per patient/per day.

Conclusion:

Originator heparin was a more cost-effective anticoagulant therapy compared to originator enoxaparin, it was associated with a lower cost and better effect, treatment with Heparin resulted in positive INB= 11.3, where a positive result means that heparin is more cost-effective than Enoxaparin. All three methods of pharmacoeconomic analysis decide that heparin was more cost-effective than enoxaparin in treating COVID-19 infected patients.

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Publication Date
Sat Apr 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Vigilance and strategic role in improving the level of nursing services / Applied Research in Ghazi al-Hariri Hospital
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The current research aims to focus on strategic vigilance dimensions and contained (environmental vigilance, technological vigilance, competitive vigilance, vigilance marketing) to improve nursing services, which include a) the quality, timeliness, problem-solving and decision-making, relationships with others, leadership skills) and measure the degree link and influence between strategic vigilance in the hospital respondent and improve nursing service that the problem of the research lies in the weakness of strategic plans and health organizations in general and the hospital surveyed (martyr Ghazi al-Hariri), in particular, the lack of awareness of the hospital researched strategy vigilant management to improve nursing services,

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Publication Date
Sun Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Instructional Program Concerning Healthy Lifestyle on Patients’ Attitudes after Percutaneous Coronary Intervention at Cardiac Centers in Baghdad City
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Abstract:

Objective: The study’s aim to evaluate the effectiveness of instructional program about healthy lifestyle on patients’ attitudes after undergoing percutaneous coronary intervention.

Methodology: Quasi-experimental design/ has been utilized for the current study starting from December 2018 to March 2020 to achieve the objectives of the study. Non-probability (purposive) sample of 60 patients was divided into intervention and control groups. Data were analyzed by the application of descriptive and inferential statistical methods.

Results: findings reported that before intervention both study and control groups demonstrated low total mean of score relat

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Screening Program for Idiopathic Scoliosis by Adam's Bending Forward Test of Prepubertal Children at Primary Schools in Baghdad City
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Objective: The study aimed to screen the prepubertal children for idiopathic scoliosis at earlier stages, and find
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schools at Baghdad city, starting from 24th of February to the end of October 2010. Non- probability
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Publication Date
Wed Aug 31 2022
Journal Name
Journal Of Positive School Psychology
Impact Of An Educational Program For Nursing Management About Care Of Children Treated With VP Shunt In Mosul City
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Sat May 08 2021
Journal Name
Social Science And Humanities Journal
The impact of accounting for material flow costs in reducing costs: Exploratory study
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Rapid and continuous developments and changes in the modern business environment in all areas of economic, environmental, social, technology and communications push economic units to search for modern methods and methodologies to produce products at low cost as well as produce products that meet the wishes of customers in terms of quality and environment to maintain their market position, and accounting for the costs of the flow of materials is one of the most prominent environmental management accounting techniques capable of providing information to help produce

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The level of Mental Mindfulness of College of Education Students at Umm Al-Qura University in the light of Corona Pandemic
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The aim of this research is to identify the level of mental mindfulness among female students of the College of Education at Umm Al-Qura University, as well as to identify the statistically significant differences in the level of mental mindfulness according to academic level, specialization, and academic achievement. A mental mindfulness scale was designed to cover five dimensions. The study employed the analytic descriptive approach applied to a random sample of (217) female students from various academic specializations. The findings indicated that the level of mental mindfulness was average among female students. Statistically significant differences were attributable to the academic level, academic specializations, and academic achi

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Publication Date
Thu Jun 25 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Prevalence of Potentially Inappropriate Prescribing in Geriatric Patients with Psychiatric Disorders in Iraq
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Potentially inappropriate prescribing is the prescribing of a medication that may cause more harm than benefit, the elderly population aged 65 years or older is more prone to potentially inappropriate prescribing because of alterations in their physiology, pharmacokinetics, and pharmacodynamics as well as polypharmacy and comorbidities, Beers list is a screening tool that help doctors to detect potentially inappropriate prescribing in geriatric patients and is designed to solve this problem, the aim of this study is to measure the prevalence of potentially inappropriate prescribing among psychiatric patients using the Beers criteria as an assessment tool and find the relationship between duration of hospitalization, comorbidities and pol

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Tue May 01 2012
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Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Photoacoustic Imaging for Tumor Detection: An in vitro Simulation Study
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Photoacoustic is a unique imaging method that combines the absorption contrast of light or radio frequency waves with ultrasound resolution. When the deposition of this energy is sufficiently short, a thermo-elastic expansion takes place whereby acoustic waves are generated. These waves can be recorded and stored to construct an image. This work presents experimental procedure of laser photoacoustic two dimensional imaging to detect tumor embedded within normal tissue. The experimental work is accomplished using phantoms that are sandwiched from fish heart or blood sac (simulating a tumor) 1-14mm mean diameter embedded within chicken breast to simulate a real tissue. Nd: YAG laser of 1.064μm and 532nm wavelengths, 10ns pulse duration, 4

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Educational And Psychological Researches
Factors associated with the phenomenon of marriage outside the court And the consequences of it A field study in Sadr City
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Marriage outside the court is a manifestation of the oppression that women are subjected to in Iraq its seriousness comes out of the consequences that it leads to The. It overlooks the age of the girl and her marriage in younger age or coerced to marry as it leads to neglecting the affordability of marital relationship as long as the marriage does not have any legal or material consequences. The present study aims to detect Characteristics of both wives, husbands and families Who agree to marry her daughters outside the court. And the reasons that lead them to marry outside the courts. It also aims to provide information on the circumstances of marriage and reasons for refusing to ratify it in court. The study was based on the sample soc

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