The paradox of public participation in the healthcare in Poland--what citizens want, and what they think.

OBJECTIVE: To assess the concept of public involvement in the decision-making process in the healthcare sector in Poland. METHODS: A poll was conducted in 2011 on a representative random sample of residents of Poland. Respondents were asked about their preferences concerning the selection of the groups most appropriately representing public interests in the process of decision-making in the healthcare: Patients' Advocacy Groups (PAGs), Carers' Advocacy Groups (CAGs) and Citizens' Councils (CCs). A systematic literature review was performed to study real life examples of patients' involvement in the decision making processes in the Polish healthcare sector as well. RESULTS: In total, 83% of respondents would wish the participation of PAGs in decision-making concerning healthcare resources. The attitude to the engagement of CAGs and CCs was still positive but significantly lower, by 6 and 7 percentage points respectively. Some socio-demographic differences were observed. In the literature review, five examples of the Polish patients' empowerment and three cases of PAGs' engagement in decision making process were identified. CONCLUSIONS: Although its importance was met with a universal approval by the majority of responders, real life examples of public engagement in decision making process indicate there is still room for improvement in the Polish healthcare.

Frequency of BCR-ABL gene mutations in Polish patients with chronic myeloid leukemia treated with imatinib: a final report of the MAPTEST study.

INTRODUCTION: The presence of BCR-ABL oncogene mutations in patients with chronic myeloid leukemia (CML) may be responsible for the failure of tyrosine kinase inhibitor treatment. OBJECTIVES: The aim of the study was to evaluate the frequency of BCR-ABL gene mutations in patients with CML (the MAPTEST study) treated with imatinib (IM). PATIENTS AND METHODS: Direct sequencing analysis of BCR-ABL gene was performed in 92 patients treated with IM for more than 3 months. The mean time of IM treatment was 18 months. At the time of the analysis, 75 patients were in the first chronic phase (CP), 4 in the second CP, 5 in the acceleration and 8 in the blastic phase. Fifty-seven patients (62%) were treated with IM at a daily dose of 400 mg and 35 patients with higher doses (600 or 800 mg daily). Inclusion criteria were based on the European Leukemia Net definitions for failure and suboptimal response to IM. RESULTS: Twelve mutations were detected in 11 of 92 patients, including 4 mutations (36.7%) diagnosed during CP, 3 (27.3%) in acceleration, and 4 (36.7%) in blast crisis. In 1 patient with lymphoid blast crisis of CML coexisting F359V and Y253F mutations were detected. In the whole group mutations were detected in 2 of 5 patients (40%) with primary resistance (M351T, F359V + Y253F) and in 9 of 87 patients (10.3%) (E255K, T315I-3x, M351T, E355G, F359V-2x) with acquired resistance to IM. CONCLUSIONS: The study confirmed the usefulness of BCR-ABL gene mutation screening in patients with CML resistant to IM therapy.