Irish journal of medical science
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There is limited quantitative evidence on the migration patterns of training doctors in Ireland. The aim of this study is to estimate the number of trainee doctors leaving the Irish health system and the numbers returning. ⋯ Previous research has highlighted Irish doctor's intentions to migrate and intentions to return to Ireland. This study documents for the first time the extent to which Irish doctors are leaving and returning to the Irish health system from 2015 to 2021. The paper also gives a picture of variations across medical disciplines and the location of emigration of qualified specialists.
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Review Meta Analysis
Effects of myo-inositol vs. metformin on hormonal and metabolic parameters in women with PCOS: a meta-analysis.
Polycystic Ovary Syndrome is the most prevalent hormonal disorder in females. Over the years, metformin (MET) has become the first-line choice of treatment; however, due to its gastrointestinal side effects, a more recent drug, myo-inositol (MI), has been introduced. We aim to conduct a systematic review and meta-analysis to compare the effects of MET and MI on hormonal and metabolic parameters. ⋯ Our meta-analysis comparing hormonal and metabolic parameters between MET and MI did not show much significant difference, indicating both drugs are equally beneficial in improving metabolic and hormonal parameters in patients with PCOS.
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Dupilumab was the first biological medicine to receive marketing authorisation, in Ireland, for the treatment of atopic dermatitis (AD). In 2019, Ireland's National Centre for Pharmacoeconomics recommended that dupilumab not be reimbursed at the submitted price; it was not cost effective. Following confidential price negotiations, the Health Service Executive (HSE) reimbursed dupilumab subject to a HSE-Managed Access Protocol (MAP). Patients with refractory, moderate-to-severe AD were deemed eligible to receive treatment under the MAP; the cohort for which dupilumab is expected to be most effective and most cost effective (versus standard of care). Approval, for treatment, is granted on an individual patient basis by the HSE-Medicines Management Programme. ⋯ The majority of applications submitted were approved. This work highlights how a MAP can facilitate access to treatment in patients who are deemed eligible whilst containing overall expenditure.
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COVID-19 pandemic has been challenging for all, particularly for high-risk groups including people with cystic fibrosis (PWCF). ⋯ COVID 19 pandemic has greatly impacted PWCF in terms of hospital visits, access to tests, CF care, and psychological well-being. Younger PWCF reported greater impact on psychological health. Online consultation and electronic prescription were welcomed and could have a role post-pandemic.
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Anecdotally, the COVID-19 pandemic has resulted in more severe cases of eye disease, decreased medication compliance/availability, and decreased treatment volume due to the lockdown. ⋯ Ophthalmologists across the world have reported a general increase in disease severity and decrease in medication and examination compliance 1 year after the beginning of COVID-19.