The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach's alpha coefficient of 0.67.
Evidence-based medication algorithms have the potential to bring much-needed improvement in effectiveness of antidepressant treatment in "real-world" clinical settings.
Furthermore, the concept of appropriateness in healthcare has progressively become one of the guiding principles of health systems with more and more attention being given to both quality improvement and effectiveness of health care [ 6].
Compared to SMBG, use of CGM with intensive insulin treatment resulted in an expected improvement in effectiveness of 0.52 QALYs, and an expected increase in cost of $23,552, resulting in an ICER of approximately $45,033/QALY.
With public health facilities in the Ghanaian health sector providing care to a large percentage of the population [ 6], improvement in effectiveness of treatment in public health facilities is likely to be benefited by a large percentage of the population.
According to the definition given by the World Health Organization (WHO), evaluation aims to produce information that can be used by those who have an interest in the improvement and effectiveness of interventions [ 4].
The CMD research process is modelled as evolutionary cycles consisting of three phases: (1) Understanding Practice (qualitative empirical investigations), (2) Deliberate Improvements (aiming to solve the problems identified in the first phase) and (3) Implement and Observe Improvements (checking the effectiveness of the improvements).
Nevertheless the role of combination therapy in PsA has been not defined in term of improvement of effectiveness and safety compared to biologic monotherapy, even if etanercept showed promising results when associated to methotrexate [ 11] or cyclosporine [ 12].
