Predictive factors for work-day loss in Behçet's syndrome: A multi-center study.

OBJECTIVE: The aim of this multi-center study was to assess predictive factors for work-day loss as an indirect cost element in Behçet's syndrome (BS). METHODS: In this cross-sectional, multi-center study, 834 BS patients (F/M: 441/393, age mean: 38.4 ± 10.9 years) were included. Data were collected by a questionnaire regarding treatment protocols, disease duration, smoking pattern, frequency of medical visits during the previous year and self-reported work-day loss during the previous year. RESULTS: Work-day loss was observed in 16.2% of patients (M/F: 103/32). The percentages of being a smoker (81.8%), using immunosuppressive (IS) medications (82%), and having disease duration <5 years (74%) were higher in male patients with work-day loss (P < .05). The majority of males (90.9%) had more than four clinic visits during the previous year. Moreover, the mean work-day loss (30.8 ± 57.7 days) was higher in patients with vascular involvement (56.1 ± 85.9) than those without (26.4 ± 50.6 days) (P = .046). In addition, increased frequency of ocular involvement (25.9%) was also observed in patients with work-day loss compared to others (8.6%) (P = .059). CONCLUSION: Work-day loss was associated with both vascular and ocular involvement. Close associations were observed among male gender, early period of the disease, frequent medical visits, being a smoker and treatment with IS medications in patients with work-day loss.

Adherence to treatment in patients with Behçet's disease.

AIM: Behçet's disease (BD) is a chronic, inflammatory disease with multisystem involvement. Adherence to treatment is low in chronic diseases as well as inflammatory and autoimmune diseases. This study assessed factors associated with non-adherence to treatment in patients with BD. METHODS: All the patients with BD who visited in the outpatient clinic of Connective Tissue Diseases Research Center in Tabriz University of Medical Sciences were included in the study. Adherence to treatment was evaluated by the consideration of medication compliance and appointment-keeping behavior. The relationships between adherence rate and six groups of variables were examined. A regression analysis was performed. RESULTS: A total of 137 patients (84 male and 53 female) were included. Totally, 50.7% of the patients were non-adherent to treatment. Side effects of medications and the high cost of treatment were the most frequent causes of non-adherence. Non-adherence was significantly more common in men, patients with low income, patients who were unaware of the disease complications, employed persons, and in patients who were on treatment with non-steroidal anti-inflammatory drugs (NSAIDs). CONCLUSIONS: Non-adherence is common in patients with BD. Male sex, low income, low knowledge about the disease, being employed and being on treatment with NSAIDs are the main risk factors for non-adherence.

A cost analysis of Behcet's syndrome in Turkey.

OBJECTIVE: Behçet's syndrome (BS), a common chronic inflammatory disease in Turkey, results in considerable morbidity and increased mortality. We aimed to estimate its direct and indirect costs. METHODS: We studied 119 (78 male/41 female) patients with BS at our multidisciplinary BS out-patient clinic in Istanbul, between March and July 2005. The mean age and disease duration were 35 +/- 9 and 10 +/- 6 S.D. yrs. According to the primary clinical problem, patients were divided into: (i) ocular; (ii) vascular; (iii) neurological and (iv) mucocutaneous-joint disease subgroups. They were interviewed with a standardized questionnaire addressing: (a) direct costs such as medication, diagnostic tests, hospital visits, hospitalization fees and lodging and transportation expenses and (b) indirect costs such as lost workdays and wages. The costs were assessed retrospectively by assessing the expenses within a year of the survey and were expressed as US$ mean +/- S.D. RESULTS: The mean annual total cost per patient was US$ 3226 +/- 3488 (S.D.). The direct cost accounted for 68% of the total cost. Medication expenses made up 79% of the total direct cost. About 42% of the patients reported lost workdays that averaged 119 +/- 96 days S.D. Among the clinical subgroups mucocutaneous-joint involvement (US$ 1180 +/- 1053) had the lowest economic impact while the neurological disease (US$ 5005 +/- 2707) had the highest. CONCLUSION: In this first cost of illness study in BS, the neurological involvement had the highest annual cost. Direct costs were higher than the indirect costs. Drug costs were the major cost driver. BS causes considerable economic burden for the health care system in Turkey.

[Study of yearly changes in intractable disease patients receiving financial aid for treatment].

Yearly changes of intractable disease patients receiving financial aid for treatment were observed for 24 intractable disease patients from 1983 to 1987. The results obtained were as follows. 1. The number of intractable disease patients receiving financial aid for treatment increased from 1983 to 1987 for 23 of the diseases. Only the number of SMON patients did not increase. 2. Medical care expenditures for these patients also increased since 1983. Greater increases for in-patients than for out-patients were seen for Huntington's chorea and Behcet's disease, while larger increases were seen for out-patients with Parkinson's disease, Scleroderma.dermatomyositis.primary multiple myositis, Buerger's disease, and others. 3. The proportion of national health insurance holders among intractable disease patients was 42.1% as compared with 34.7% among total national patients. The proportion was especially higher for Huntington's chorea (64.6%), Parkinson's disease (64.1%) and SMON (59.4%) patients.