Iris Hoxha | Faculty of Medicine, University of Tirana (original) (raw)
Papers by Iris Hoxha
Journal of Comparative Effectiveness Research
Aim: Global expenditure on medicines is rising up to 6% per year driven by increasing prevalence ... more Aim: Global expenditure on medicines is rising up to 6% per year driven by increasing prevalence of non-communicable diseases (NCDs) and new premium priced medicines for cancer, orphan diseases and other complex areas. This is difficult to sustain without reforms. Methods: Extensive narrative review of published papers and contextualizing the findings to provide future guidance. Results: New models are being introduced to improve the managed entry of new medicines including managed entry agreements, fair pricing approaches and monitoring prescribing against agreed guidance. Multiple measures have also successfully been introduced to improve the prescribing of established medicines. This includes encouraging greater prescribing of generics and biosimilars versus originators and patented medicines in a class to conserve resources without compromising care. In addition, reducing inappropriate antibiotic utilization. Typically, multiple measures are the most effective. Conclusion: Multi...
Frontiers in Pharmacology
Introduction: Surveillance of antimicrobial medicines consumption is central to improving their u... more Introduction: Surveillance of antimicrobial medicines consumption is central to improving their use and reducing resistance rates. There are few published data on antibiotic consumption in Eastern Europe and Central Asia. To address this, 18 non-European Union (EU) countries and territories contribute to the WHO Regional Office for Europe (WHO Europe) Antimicrobial Medicines Consumption (AMC) Network. Objectives: (i) Analyze 2015 consumption of J01 class antibacterials for systemic use from 16 AMC Network members; (ii) compare results with 2011 data and 2015 ESAC-Net estimates; (iii) assess consumption against suggested indicators; (iv) evaluate the
Current Medical Research and Opinion
Hill (2020) Ongoing strategies to improve the management of upper respiratory tract infections an... more Hill (2020) Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future,
Journal of Pharmaceutical Policy and Practice, 2016
Background: In 2014, a qualitative multi-country research project was launched to study the reaso... more Background: In 2014, a qualitative multi-country research project was launched to study the reasons behind the high use of antibiotics in regions of Southeast Europe by using previously untrained national interviewers (who were engaged in other antibiotic microbial resistance-related investigations) to conduct qualitative interviews with local patients, physicians and pharmacists. Little knowledge exists about how to implement qualitative multi-country research collaborations involving previously untrained local data collectors. The aim of this paper was therefore to contribute to the knowledge regarding how to conduct these types of research projects by evaluating a pilot study of the project. Methods: Local data collectors conducted the study according to a developed protocol and evaluated the study with the responsible researcher-team from University of Copenhagen. The pilot study focused on 'local ownership', 'research quality' and 'feasibility' with regard to successful implementation and evaluation. The evaluation was achieved by interpreting 'Skype' and 'face to face' meetings and email correspondence by applying 'critical common sense'. Results: Local data collectors achieved a sense of joint ownership. Overall, the protocol worked well. Several minor challenges pertaining to research quality and feasibility were identified, in particular obtaining narratives when conducting interviews and recruiting patients for the study. Furthermore, local data collectors found it difficult to allocate sufficient time to the project. Solutions were discussed and added to the protocol. Conclusions: Despite the challenges, it was possible to achieve an acceptable scientific level of research when conducting qualitative multi-country research collaboration under the given circumstances. Specific recommendations to achieve this are provided by the authors.
Background: Emphasis on the misuse of antibacterials in Albania and an increased sensibility on t... more Background: Emphasis on the misuse of antibacterials in Albania and an increased sensibility on the antibacterial resistance have been reported in the grey literature lately. However, until now there are no consistent data on antibacterial use, its related misuse and antibacterial resistance, either other reports produced by health institutions.
Objective: Our objective was to determine students´ perception of the current Pharmacy curriculum... more Objective: Our objective was to determine students´ perception of the current Pharmacy curriculum in the University of Medicine, Tirana (Albania). Methods: A 10 questions survey regarding different aspects of Pharmacy curriculum (2008)(2009)(2010)(2011)(2012)(2013) and personal data was developed by faculty staff and filled by Pharmacy students in their last year of graduation, before their final practice exam. To summarize the data, descriptive statistics and thematic analysis were used. Main outcome measures were: frequency of students´ satisfaction with different aspects of Pharmacy curriculum and perceived indispensable and not indispensable subjects of Pharmacy curriculum. Results: The survey response rate was 99% (107 students), showing their high interest in participating. A majority of the students (79.4%) agreed that there is a need to change the pharmacy curriculum; however, they assess the current curriculum with an average of 7.32 (SD 1.388) on a scale from 1 to 10. A significant number (66%) of the students in our study were satisfied with the knowledge gained to practice their future profession as pharmacists. Conclusion: Pharmacy students´ perception suggests need for a change in the current curriculum, especially towards active learning activities and students´ evaluation methods. Their suggestions on different aspects of the actual curriculum would be useful in future curriculum assessment.
Moderate to severe psoriasis is associated with increased alcohol intake and excessive mortality ... more Moderate to severe psoriasis is associated with increased alcohol intake and excessive mortality from alcohol-related causes. Alcohol biomarkers are those providing an objective measurement of its consumption. The objective of this study is to assess alcohol consumption in a cohort of patients with psoriasis and to investigate the influence of alcohol intake on disease severity. Patients with psoriasis hospitalized at the Clinic of Dermatology, in Mother Teresa University Hospital were recruited in this cross-sectional study. Alcohol consumption was assessed via CAGE questionnaire and the self-reported amount of alcohol consumed, whereas disease severity was evaluated via PASI scoring system. Blood specimens were taken at admission and levels of gamma glutamyltransferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and mean corpuscular volume of erythrocytes (MCV) were measured. Statistical analysis was performed using SPSS 20.0 statistical package. A total of 62 in-patients completed the study. Significant correlations were observed between GGT and AST values with raki and beer consumption, ALT value with raki, beer and wine consumption and MCV value with raki consumption. Disease severity did not correlate significantly with raki and beer consumption (p> 0.05). Logistic regression analysis between Psoriasis Area and Severity Index (PASI) score and raki consumption in male patients with psoriasis duration of more than 3 years resulted in statistical significance (b= 23.5, p< 0.05). Combination of parameters related to chronic alcohol consumption offers advantage over every isolated test. Measurement of simple laboratory parameters combined with self-report methods of consumption allows identification of users.
Journal of Comparative Effectiveness Research
Aim: Global expenditure on medicines is rising up to 6% per year driven by increasing prevalence ... more Aim: Global expenditure on medicines is rising up to 6% per year driven by increasing prevalence of non-communicable diseases (NCDs) and new premium priced medicines for cancer, orphan diseases and other complex areas. This is difficult to sustain without reforms. Methods: Extensive narrative review of published papers and contextualizing the findings to provide future guidance. Results: New models are being introduced to improve the managed entry of new medicines including managed entry agreements, fair pricing approaches and monitoring prescribing against agreed guidance. Multiple measures have also successfully been introduced to improve the prescribing of established medicines. This includes encouraging greater prescribing of generics and biosimilars versus originators and patented medicines in a class to conserve resources without compromising care. In addition, reducing inappropriate antibiotic utilization. Typically, multiple measures are the most effective. Conclusion: Multi...
Frontiers in Pharmacology
Introduction: Surveillance of antimicrobial medicines consumption is central to improving their u... more Introduction: Surveillance of antimicrobial medicines consumption is central to improving their use and reducing resistance rates. There are few published data on antibiotic consumption in Eastern Europe and Central Asia. To address this, 18 non-European Union (EU) countries and territories contribute to the WHO Regional Office for Europe (WHO Europe) Antimicrobial Medicines Consumption (AMC) Network. Objectives: (i) Analyze 2015 consumption of J01 class antibacterials for systemic use from 16 AMC Network members; (ii) compare results with 2011 data and 2015 ESAC-Net estimates; (iii) assess consumption against suggested indicators; (iv) evaluate the
Current Medical Research and Opinion
Hill (2020) Ongoing strategies to improve the management of upper respiratory tract infections an... more Hill (2020) Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future,
Journal of Pharmaceutical Policy and Practice, 2016
Background: In 2014, a qualitative multi-country research project was launched to study the reaso... more Background: In 2014, a qualitative multi-country research project was launched to study the reasons behind the high use of antibiotics in regions of Southeast Europe by using previously untrained national interviewers (who were engaged in other antibiotic microbial resistance-related investigations) to conduct qualitative interviews with local patients, physicians and pharmacists. Little knowledge exists about how to implement qualitative multi-country research collaborations involving previously untrained local data collectors. The aim of this paper was therefore to contribute to the knowledge regarding how to conduct these types of research projects by evaluating a pilot study of the project. Methods: Local data collectors conducted the study according to a developed protocol and evaluated the study with the responsible researcher-team from University of Copenhagen. The pilot study focused on 'local ownership', 'research quality' and 'feasibility' with regard to successful implementation and evaluation. The evaluation was achieved by interpreting 'Skype' and 'face to face' meetings and email correspondence by applying 'critical common sense'. Results: Local data collectors achieved a sense of joint ownership. Overall, the protocol worked well. Several minor challenges pertaining to research quality and feasibility were identified, in particular obtaining narratives when conducting interviews and recruiting patients for the study. Furthermore, local data collectors found it difficult to allocate sufficient time to the project. Solutions were discussed and added to the protocol. Conclusions: Despite the challenges, it was possible to achieve an acceptable scientific level of research when conducting qualitative multi-country research collaboration under the given circumstances. Specific recommendations to achieve this are provided by the authors.
Background: Emphasis on the misuse of antibacterials in Albania and an increased sensibility on t... more Background: Emphasis on the misuse of antibacterials in Albania and an increased sensibility on the antibacterial resistance have been reported in the grey literature lately. However, until now there are no consistent data on antibacterial use, its related misuse and antibacterial resistance, either other reports produced by health institutions.
Objective: Our objective was to determine students´ perception of the current Pharmacy curriculum... more Objective: Our objective was to determine students´ perception of the current Pharmacy curriculum in the University of Medicine, Tirana (Albania). Methods: A 10 questions survey regarding different aspects of Pharmacy curriculum (2008)(2009)(2010)(2011)(2012)(2013) and personal data was developed by faculty staff and filled by Pharmacy students in their last year of graduation, before their final practice exam. To summarize the data, descriptive statistics and thematic analysis were used. Main outcome measures were: frequency of students´ satisfaction with different aspects of Pharmacy curriculum and perceived indispensable and not indispensable subjects of Pharmacy curriculum. Results: The survey response rate was 99% (107 students), showing their high interest in participating. A majority of the students (79.4%) agreed that there is a need to change the pharmacy curriculum; however, they assess the current curriculum with an average of 7.32 (SD 1.388) on a scale from 1 to 10. A significant number (66%) of the students in our study were satisfied with the knowledge gained to practice their future profession as pharmacists. Conclusion: Pharmacy students´ perception suggests need for a change in the current curriculum, especially towards active learning activities and students´ evaluation methods. Their suggestions on different aspects of the actual curriculum would be useful in future curriculum assessment.
Moderate to severe psoriasis is associated with increased alcohol intake and excessive mortality ... more Moderate to severe psoriasis is associated with increased alcohol intake and excessive mortality from alcohol-related causes. Alcohol biomarkers are those providing an objective measurement of its consumption. The objective of this study is to assess alcohol consumption in a cohort of patients with psoriasis and to investigate the influence of alcohol intake on disease severity. Patients with psoriasis hospitalized at the Clinic of Dermatology, in Mother Teresa University Hospital were recruited in this cross-sectional study. Alcohol consumption was assessed via CAGE questionnaire and the self-reported amount of alcohol consumed, whereas disease severity was evaluated via PASI scoring system. Blood specimens were taken at admission and levels of gamma glutamyltransferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and mean corpuscular volume of erythrocytes (MCV) were measured. Statistical analysis was performed using SPSS 20.0 statistical package. A total of 62 in-patients completed the study. Significant correlations were observed between GGT and AST values with raki and beer consumption, ALT value with raki, beer and wine consumption and MCV value with raki consumption. Disease severity did not correlate significantly with raki and beer consumption (p> 0.05). Logistic regression analysis between Psoriasis Area and Severity Index (PASI) score and raki consumption in male patients with psoriasis duration of more than 3 years resulted in statistical significance (b= 23.5, p< 0.05). Combination of parameters related to chronic alcohol consumption offers advantage over every isolated test. Measurement of simple laboratory parameters combined with self-report methods of consumption allows identification of users.