Melania Brzozowska - Academia.edu (original) (raw)

Papers by Melania Brzozowska

Value in Health, 2017

A729 descriptive statistics. Study lasted from January to October 2016. Results: The average age ... more A729 descriptive statistics. Study lasted from January to October 2016. Results: The average age of 102 patients who participated in the study was 31.69±11.53. 10 (9.8%) of the patients were on once daily medications, 89 (87.3%) on twice daily while 3 (2.9%) were on thrice daily. Whereas 83 (81.4%) were on monotherapy, 16 (15.7%) were on dual therapy, and 3 (2.9%) on polytherapy. Adherence was high in 9 (8.8%) of the patients while 63.3 (91.2%) were non-adherent. The level of seizure control was good in 19 (18.6%), fair in 46 (45.1%) and poor in 37 (36.4). The factors affecting adherence from the study were side effect of drugs 34 (33.3%), lack of knowledge about the illness 34 (33.3), cost of medication 17 (16.7%) and forgetfulness 17 (16.7%). Physicians admitted they assessed patients' adherence through assessment of patients' condition 68%, pill count 17%, and patients' interview 100%. All the physicians admitted to emphasize adherence to therapy before and after prescribing. ConClusions: Patients adherence to anticonvulsant therapy in the facility was poor. Non-adherence was associated with preventable factors bordering on the patients and health care providers.

Zdrowie Publiczne i Zarządzanie, 2013

A very important new law (the Reimbursement Law) has been implemented in Poland on turn of years ... more A very important new law (the Reimbursement Law) has been implemented in Poland on turn of years 2011 and 2012 and it has deeply changed the national pharmaceutical pricing and reimbursement policy. The aim of this paper is to characterize the current status of affairs in this area and also to analyze the influence of changes on relationship between physicians and patients. The implementation of the Reimbursement Law has had a multifaceted impact on the Polish health care system and it has interfered relationships among its stakeholders. Several amendments to the new law are being expected in the forthcoming years, so all relevant experiences of the various stakeholders should be taken into due consideration during further pharmaceutical policy reforms. Appropriate preparations should be made beforehand, involving not only the state regulator and the public payer.

Epidemiology of asthma in Poland in urban and rural areas, based on provided health care services... more Epidemiology of asthma in Poland in urban and rural areas, based on provided health care services Epidemiologia astmy w Polsce z podziałem na regiony wiejskie i miejskie na podstawie danych dotyczących udzielanych świadczeń zdrowotnych The authors declare no finacial disclosure Introduction: Asthma is a serious health and social problem, also in Poland. The epidemiological data indicate that the problem of asthma concerns approximately 4 million people in Poland, whereas almost approximately 70 % of them have no diagnosis and are not aware of their illness, and on the other hand in 39 % of persons who declared the diagnosis of asthma in a survey the diagnosis was negatively verified (overdiagnosis of asthma). So far, no detailed comparative studies for asthma incidence rate in urban and rural areas were conducted in Poland.

Endocrine Abstracts, 2017

Medical Science Monitor, 2021

Financial support: Departmental sources Background: The mortality caused by hepatocellular carcin... more Financial support: Departmental sources Background: The mortality caused by hepatocellular carcinoma is expected to rise in the upcoming decade. Sorafenib has become the preferred systemic treatment option in patients with unresectable HCC. This study aimed to present the median overall survival (OS) in a group of patients with advanced HCC, treated with sorafenib in Poland between 2011 and 2019. Material/Methods: The analyzed group of patients was qualified for treatment with sorafenib, financed by the National Health Fund, based on the guidelines of the Polish Drug Program. Kaplan-Meier method was used to plot the OS curves, and the log-rank test was used for testing. Multivariate assessment of factors (sex and age) related to the time to death of the patient was done using Cox regression. Results: Of the 2072 treated patients, 75% were men (1556) and 25% were women (516). The minimum age of patients in the trial group was 18 years and the maximum age was 90 years. Among the 1556 analyzed cases in males, 27.44% (427) did not end with death (by the date of completing the analysis). The percentage of one-year survival for this population was 58.16%, and the 2-, 3-, and 5-year survival rates were 34.45%, 21.81%, and 9.72%, respectively. The percentage of censored cases in the 516 females was 25.78% (133). The 1-2-, 3-, and 5-year survival for this population was 59.30%, 36.27%, 22.47%, and 11.34%, respectively. Statistical tests did not reveal a significant difference in the curve profiles by sex. There were no associations between OS and age. Conclusions: Systemic treatment with sorafenib in accordance with the presented criteria allows for very good results, comparable to the results of selected groups of patients presented by other authors.

PLOS ONE, 2021

This paper presents a realistic evaluation of the prevalence of type 2 diabetes mellitus (T2DM) a... more This paper presents a realistic evaluation of the prevalence of type 2 diabetes mellitus (T2DM) among Polish schizophrenic patients who have sought treatment through the Polish National Health Fund in the years 2010–2017. Data from the National Health Fund database was used and T2DM and schizophrenia groups were defined according to International Classification of Diseases (ICD-10) codes. Demographic data were collected from the web page of Statistics Poland (GUS). The annual prevalence of T2DM and schizophrenia was estimated, and the age groups were categorised into eight sets. The incidence of schizophrenia in T2DM patients in the years 2010–2017 was measured, including relative risk and 95% confidence interval (95% CI). The incidence of T2DM has been assessed in various subtypes of schizophrenia. In the eight years of follow-up study, 1,481,642 patients with schizophrenia were included, of which 185,205 were also diagnosed with T2DM. This accounted for 12.50% of all patients with...

Introduction. The goal of the study is to assess the usefulness of Sankey model in the analysis o... more Introduction. The goal of the study is to assess the usefulness of Sankey model in the analysis of healthcare phenomena. Material and methods. Sequence analysis and Sankey model generation was based on the data provided to the National Health Fund in the years 20132015 for the following diseases defined by the following ICD-10 codes: C50.% – malignant neoplasm of breast; G35 – multiple sclerosis; B18.2, B17.1 – chronic hepatitis C. The reported data concerned all types of services provided by the public payer. Results. The analysis was conducted for: C50.% – 3.26 million data records, for 236.6 thousand patients; G35 – 110 thousand data records, for 23.9 thousand patients; B18.2, B17.1 – 1,1 million data records, for 100 thousand patients. Sequence analysis and the generated Sankey diagrams indicate that paths taken by patients in the health care system are varied and are strictly conditional on the medical problem. Conclusion. Sequence analysis, and in particular the diagram-based ...

Background. Literature points out that the frequency of occurrence of type 2 diabetes mellitus (T... more Background. Literature points out that the frequency of occurrence of type 2 diabetes mellitus (T2DM) in children, adolescents and young adults has been increasing rapidly. However, there is still lack of epidemiological research in this area. Objectives. The national observation study was used to determine the trend of T2DM in the Polish paediatric and young adult population. Material and methods. The Polish National Health Fund database from 2010 to 2017, which was representative of the Polish population, was examined. Overall, 8,530 patients with T2DM were included in the study. The annual prevalence of T2DM was estimated according to the age groups, especially in three groups: group 1-children (up to 10 years of age), group 2-adolescents (between 11 and 20 years of age) and group 3-young adults (21-30 years of age). The T2DM groups were defined according to the ICD-10 codes. The relative risk (RR) with a 95% confidence interval (95% CI) was also calculated. Results. The frequency of occurrence of T2DM in the population of children and adolescents is relatively stable and reached-depending on the year of observation-between 0.33% and 0.22% of all T2DM patients. Each year, physicians diagnose about 255 new cases of T2DM among children up to 10 years of age and about 812 among adolescents between 11 and 20 years of age. Conclusions. The tendency of occurrence of T2DM among children and teenagers is relatively stable. This problem requires taking appropriate steps in order to prevent the development of T2DM and improve medical care aimed at these patients.

Wstep. Cukrzyca kazdego roku dotyka coraz wiekszej grupy osob. Mimo to liczba osob chorych na cuk... more Wstep. Cukrzyca kazdego roku dotyka coraz wiekszej grupy osob. Mimo to liczba osob chorych na cukrzyce w Polsce nie jest dokladnie znana. Aby moc te chorobowośc oszacowac, celem pracy stala sie ocena chorobowości z powodu cukrzycy w latach 2010–2014 w calej populacji polskiej z uzyciem bazy danych Narodowego Funduszu Zdrowia. Material i metody. Od 1 stycznia 2010 roku do 31 grudnia 2014 roku wyodrebniono wedlug numerow PESEL pacjentow: 1. dla ktorych świadczeniodawcy w sprawozdaniach rozliczeniowych ze świadczen jako glowną przyczyne interwencji medycznej wykazali kody ICD-10 związane z cukrzycą; 2. ktorzy zrealizowali recepty na jakikolwiek refundowany lek hipoglikemizujący lub na refundowane testy paskowe do glukometrow. Oceniono liczbe pacjentow wykazanych jako osoby chore na cukrzyce na podstawie kodu ICD-10 oraz liczbe pacjentow, ktorzy zrealizowali recepty na leki hipoglikemizujące lub testy paskowe. Na podstawie tych danych oceniono chorobowośc z powodu cukrzycy (odsetek osob...

Archives of Medical Science, 2021

IntroductionMortality, whether in or out of hospital, increases with age. However, studies evalua... more IntroductionMortality, whether in or out of hospital, increases with age. However, studies evaluating in-hospital mortality in large populations did not distinguish between surgical and non-surgical causes of death, either in young or in elderly patients. The aim of the study was to assess in-hospital non-surgical mortality in a large group of patients, with a special focus on the elderly.Material and methodsData from the database of the Polish National Health Fund (NHF) regarding hospitalizations of adult (≥ 18 years) patients not related to surgical procedures in the years 2009–2013 were used to assess in-hospital mortality.Results15,345,025 hospitalizations were assessed. The mean in-hospital non-surgery-related mortality rate was 3.96 ±0.17%, and increased from 3.79% to 4.2% between 2009 and 2013. The mean odds ratio for in-hospital death increased with the age of patients, reaching a 229-fold higher rate in the ≥ 95 years age group as compared to the 18–24 age group. The highes...

Rheumatology International, 2020

Psoriatic arthritis (PsA) is a heterogeneous inflammatory arthritis, usually seronegative and ass... more Psoriatic arthritis (PsA) is a heterogeneous inflammatory arthritis, usually seronegative and associated with psoriasis (Ps). The prevalence and incidence of psoriatic arthritis show strong ethnic and geographic variations. The aim of the study was to assess the epidemiological trends in psoriatic arthritis in Poland. The National Health Fund (NHF) database for the period 2008–2018 was analyzed. PsA was defined as ICD-10 codes L40.5, M07, M07.0, M07.1, M07.2 and M07.3, while psoriasis as ICD-10 codes L40 and L40.X (L40.0 to L40.9). A steady increase in the number of PsA patients (from 16,790 to 32,644) and in PsA recorded prevalence (from 38.47 per 100,000 in 2008 to 73.11 per 100,000 in 2018) was observed between 2008 and 2018. The PsA/Ps ratio increased to a similar extent (from 8.3 to 17.5%). The percentage of PsA patients receiving rehabilitation services remained constant throughout the observation period (mean: 17.35%; range 16.7–18.9%). The study showed a steady and continuou...

Annals of Agricultural and Environmental Medicine, 2020

The problem of Lyme borreliosis infections in urban and rural residents in Poland, based on the N... more The problem of Lyme borreliosis infections in urban and rural residents in Poland, based on the National Health Fund data. Ann Agric Environ Med.

Archives of Medical Science, 2020

IntroductionMultiple myeloma is the third most common blood cancer in Europe and accounts for app... more IntroductionMultiple myeloma is the third most common blood cancer in Europe and accounts for approx. 10–15% of these cancers. The objective of this study was to determine the incidence, prevalence, mortality and survival in multiple myeloma (ICD code: C90.0) patients in Poland in the years 2008–2017.Material and methodsThe analysis used the data on healthcare services provided to patients with multiple myeloma defined with the ICD-10 (International Statistical Classification of Diseases and Related Health Problems) code C90.0 and reported by healthcare entities to the National Health Fund (NFZ).ResultsIn 2009, the C90.0 incidence per 100,000 inhabitants was 6.4, while in 2017 it was 8.3. The prevalence in the same period increased by 76%, from 13.6/100,000 to 23.9/100,000. The mortality to prevalence ratio gradually decreased from 78% in 2008 to 22.8% in 2017. The 1-year, 3-year and 5-year survival rates in patients with this diagnosis made in the years 2009 and 2013 were 70.5%, 51...

Polish Archives of Internal Medicine, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution-No... more This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA4.0), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited, distributed under the same license, and used for noncommercial purposes only.

Nowotwory. Journal of Oncology, 2019

Introduction. The aim of our study was to analyze the number and structure of patients diagnosed ... more Introduction. The aim of our study was to analyze the number and structure of patients diagnosed and treated due to cancers of lips, mouth and throat in Poland between 2008 and 2015. Material and methods. Secondary statistical analysis of data obtained from the Polish National Cancer Registry (KRN) and Polish National Health Fund (NFZ), concerning patients diagnosed for the first time between 2008 and 2015. Results. Based on the available data, in total there were 30 800 new cases of cancers in population of Poland, and 29 800 people starting their treatment financed from the National Health Fund. Discussion. Cancers of the discussed locations, considered individually, are often rare diseases, with the incidence counted in hundreds of people per year in the entire Polish population. Due to the etiology and course, however, they should be analyzed together, which means that they become a significant group. Conclusions. In recent years, the annual incidence of these tumours was about 4000 cases, 70% of them were men. There is an approximately 10% difference in the number of registered cases of these cancers in NFZ databases. The creation of a medical register, including administrative, epidemiological and clinical data, would significantly improve the observation of the population of patients with these tumours.

Rheumatology International, 2019

The prevalence of axial spondyloarthritis (axSpA) in the published data varies significantly. Two... more The prevalence of axial spondyloarthritis (axSpA) in the published data varies significantly. Two types of axSpA can be distinguished depending upon the presence of abnormalities consistent with sacroiliitis on plain radiography: ankylosing spondylitis (AS) and nonradiographic axial SpA (nr-axSpA). The aim of this study is to perform a retrospective analysis of axSpA prevalence in Poland in the years 2008-2017. The National Health Fund (NHF) database for the period 2008-2017 was analysed. Data of all patients with the ICD-10 codes M46 (M46.1, M46.8, M46.9) or M45 (further named other inflammatory spondylopathies-OIS and AS, respectively) as the main or co-existing diagnosis were extracted and analysed. The AS prevalence was stable during the period under examination amounting to approximately 0.083%, while the OIS prevalence increased from 0.036 to 0.059%. For both men and women, the AS prevalence increased with age, reaching a maximum around the age of 70; however, in men, a marked increase in prevalence was observed earlier as compared to women (20-24 vs. 40-44 years, respectively). The OIS prevalence also increased with age; however, the maximum was reached earlier as in case of AS. Moreover, a sharp increase in OIS prevalence occurred earlier than in AS (15-19 years) with no difference between sexes. In Poland, approximately 0.1% of the population suffers from AS-the prevalence remained stable over the last decade. The prevalence of OIS increased markedly over the studied period which presumably reflects an increasing prevalence of nr-axSpA as the effect of the introduction of ASAS classification criteria for axSpA.

Advances in Dermatology and Allergology, 2019

Introduction: In Poland, it is uniquely possible to assess real effects of the introduction of ne... more Introduction: In Poland, it is uniquely possible to assess real effects of the introduction of new oncological therapies on the overall survival in patients as such therapies are funded by one payer only-the National Health Fund (NHF). Data collected by the NHF make it possible to analyse the survival of all patients who were diagnosed with melanoma. Aim: The paper presents findings of a retrospective analysis of the efficacy of systemic treatment in patients with malignant melanoma of the skin in Poland with regard to the overall survival. Material and methods: The analysis of the overall survival was performed with the Kaplan-Meier method in the population receiving systemic treatment. Three groups of patients were analysed. Group 1 included all patients who had started systemic treatment between 1 March 2011 and 1 March 2015: 1,258 patients. The median overall survival was 8.4 months. Group 2 included 444 patients who had started systemic treatment between 1 March 2011 and 28 February 2013. The median overall survival was 6.6 months in this group. Group 3 included 814 patients who had started systemic treatment between 1 March 2013 and 1 March 2015 and included 546 patients who were also treated in drug programmes with ipilimumab and vemurafenib (approx. 67%). The median overall survival was 9.4 months. Results: A difference in the overall survival between group 3 and 2 was statistically significant (p < 0.05). Conclusions: The introduction of vemurafenib and ipilimumab into systemic treatment in Poland using public funds had a significant effect on the prolongation of the overall survival in patients with malignant melanoma of the skin.

Medical Science Pulse, 2019

Background: Multiple sclerosis is a chronic and highly debilitating disease with very high econom... more Background: Multiple sclerosis is a chronic and highly debilitating disease with very high economic and social consequences. Designing changes to improve the functioning of the healthcare model primarily requires learning about the needs of beneficiaries. Aim of the study: The purpose of our study is the results’ description and summary of conclusions of the research conducted in the past years. These results are currently being used for the construction of a coordinated care model for MS patients. Material and methods: One questionnaire survey addressed to MS patients, carried out between 01.12.2013 and 01.02.2014 and the second one addressed to Polish and European medical professionals, carried out between 01.09.2016 and 04.10.2016 performed in 51 European centers and 2 branches of the Turkish Association of patients with MS. Results: In the first survey 84.4% patients declared that during the illness they received mental support mostly from their family: 48.5% received it from ph...