{"id":"https://openalex.org/W7119225002","doi":"https://doi.org/10.7759/cureus.101071","title":"Barriers and Facilitators to Vadadustat Use for Managing Anemia in Adult Patients Undergoing Dialysis: A Qualitative Evidence Synthesis","display_name":"Barriers and Facilitators to Vadadustat Use for Managing Anemia in Adult Patients Undergoing Dialysis: A Qualitative Evidence Synthesis","publication_year":2026,"publication_date":"2026-01-08","ids":{"openalex":"https://openalex.org/W7119225002","doi":"https://doi.org/10.7759/cureus.101071","pmid":"https://pubmed.ncbi.nlm.nih.gov/41658817"},"language":"en","primary_location":{"id":"doi:10.7759/cureus.101071","doi":"https://doi.org/10.7759/cureus.101071","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.101071","pdf_url":"https://www.cureus.com/articles/449323-barriers-and-facilitators-to-vadadustat-use-for-managing-anemia-in-adult-patients-undergoing-dialysis-a-qualitative-evidence-synthesis.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.cureus.com/articles/449323-barriers-and-facilitators-to-vadadustat-use-for-managing-anemia-in-adult-patients-undergoing-dialysis-a-qualitative-evidence-synthesis.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5076434048","display_name":"Piercarlo Minoretti","orcid":"https://orcid.org/0000-0002-6512-611X","observed_orcids":["https://orcid.org/0000-0002-6512-611X","https://orcid.org/0009-0009-4435-586X"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Piercarlo Minoretti","raw_affiliation_strings":["Occupational Health, Studio Minoretti, Oggiono, ITA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Occupational Health, Studio Minoretti, Oggiono, ITA","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5069514442","display_name":"Simone Lista","orcid":"https://orcid.org/0000-0001-6804-7858","observed_orcids":["https://orcid.org/0000-0001-6804-7858"]},"institutions":[{"id":"https://openalex.org/I2801392616","display_name":"Universidad Europea Miguel de Cervantes","ror":"https://ror.org/02p350r61","country_code":"ES","type":"education","lineage":["https://openalex.org/I2801392616"]}],"countries":["ES"],"is_corresponding":false,"raw_author_name":"Simone Lista","raw_affiliation_strings":["Neurology, Miguel de Cervantes European University, Valladolid, ESP"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Neurology, Miguel de Cervantes European University, Valladolid, ESP","institution_ids":["https://openalex.org/I2801392616"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5034470636","display_name":"Kayvan Khoramipour","orcid":"https://orcid.org/0000-0003-1598-8640","observed_orcids":["https://orcid.org/0000-0003-1598-8640"]},"institutions":[{"id":"https://openalex.org/I2801392616","display_name":"Universidad Europea Miguel de Cervantes","ror":"https://ror.org/02p350r61","country_code":"ES","type":"education","lineage":["https://openalex.org/I2801392616"]}],"countries":["ES"],"is_corresponding":false,"raw_author_name":"Kayvan Khoramipour","raw_affiliation_strings":["Health Sciences, Miguel de Cervantes European University, Valladolid, ESP"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Sciences, Miguel de Cervantes European University, Valladolid, ESP","institution_ids":["https://openalex.org/I2801392616"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5091175038","display_name":"Alejandro Santos\u2010Lozano","orcid":"https://orcid.org/0000-0002-2309-3583","observed_orcids":["https://orcid.org/0000-0002-2309-3583"]},"institutions":[{"id":"https://openalex.org/I2801392616","display_name":"Universidad Europea Miguel de Cervantes","ror":"https://ror.org/02p350r61","country_code":"ES","type":"education","lineage":["https://openalex.org/I2801392616"]}],"countries":["ES"],"is_corresponding":false,"raw_author_name":"Alejandro Santos-Lozano","raw_affiliation_strings":["Epidemiology and Public Health, Miguel de Cervantes European University, Valladolid, ESP"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Epidemiology and Public Health, Miguel de Cervantes European University, Valladolid, ESP","institution_ids":["https://openalex.org/I2801392616"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5087722833","display_name":"Enzo Emanuele","orcid":"https://orcid.org/0000-0003-3908-0290","observed_orcids":["https://orcid.org/0000-0003-3908-0290","https://orcid.org/0000-0002-4356-9366"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Enzo Emanuele","raw_affiliation_strings":["Clinical Pathology, 2E Science, Robbio, ITA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Clinical Pathology, 2E Science, Robbio, ITA","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.01310301,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"18","issue":"1","first_page":"e101071","last_page":"e101071"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11534","display_name":"Erythropoietin and Anemia Treatment","score":0.9937000274658203,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11534","display_name":"Erythropoietin and Anemia Treatment","score":0.9937000274658203,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10291","display_name":"Dialysis and Renal Disease Management","score":0.00279999990016222,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10629","display_name":"Health Policy Implementation Science","score":0.0006000000284984708,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/vadadustat","display_name":"vadadustat","score":1.0},{"id":"https://openalex.org/keywords/chronic-kidney-disease","display_name":"chronic kidney disease","score":0.7879999876022339},{"id":"https://openalex.org/keywords/hypoxia-inducible-factor-prolyl-hydroxylase-inhibitor","display_name":"hypoxia-inducible factor prolyl hydroxylase inhibitor","score":0.9390000104904175},{"id":"https://openalex.org/keywords/erythropoiesis-stimulating-agents","display_name":"erythropoiesis-stimulating agents","score":0.949999988079071},{"id":"https://openalex.org/keywords/cardiovascular-safety","display_name":"cardiovascular safety","score":0.656000018119812},{"id":"https://openalex.org/keywords/esa-hyporesponsiveness","display_name":"ESA hyporesponsiveness","score":0.9229999780654907},{"id":"https://openalex.org/keywords/shared-decision-making","display_name":"shared decision-making","score":0.9079999923706055},{"id":"https://openalex.org/keywords/patient-selection","display_name":"patient selection","score":0.503000020980835}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9667999744415283},{"id":"https://openalex.org/C2778248108","wikidata":"https://www.wikidata.org/wiki/Q5445","display_name":"Anemia","level":2,"score":0.6467000246047974},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.604200005531311},{"id":"https://openalex.org/C2779703844","wikidata":"https://www.wikidata.org/wiki/Q760125","display_name":"Reimbursement","level":3,"score":0.5436000227928162},{"id":"https://openalex.org/C2778653478","wikidata":"https://www.wikidata.org/wiki/Q1054718","display_name":"Kidney disease","level":2,"score":0.5421000123023987},{"id":"https://openalex.org/C2779978075","wikidata":"https://www.wikidata.org/wiki/Q202301","display_name":"Dialysis","level":2,"score":0.52920001745224},{"id":"https://openalex.org/C2779056158","wikidata":"https://www.wikidata.org/wiki/Q1756474","display_name":"Peritoneal dialysis","level":2,"score":0.5117999911308289},{"id":"https://openalex.org/C54847362","wikidata":"https://www.wikidata.org/wiki/Q177635","display_name":"Nephrology","level":2,"score":0.5070000290870667},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.4300999939441681},{"id":"https://openalex.org/C2778534260","wikidata":"https://www.wikidata.org/wiki/Q218706","display_name":"Erythropoietin","level":2,"score":0.39149999618530273},{"id":"https://openalex.org/C2778063415","wikidata":"https://www.wikidata.org/wiki/Q391744","display_name":"Hemodialysis","level":2,"score":0.35910001397132874},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.35370001196861267},{"id":"https://openalex.org/C2426938","wikidata":"https://www.wikidata.org/wiki/Q3355478","display_name":"Medical prescription","level":2,"score":0.34200000762939453},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.3246999979019165},{"id":"https://openalex.org/C2780472472","wikidata":"https://www.wikidata.org/wiki/Q424337","display_name":"Acute kidney injury","level":2,"score":0.3142000138759613},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.3093000054359436},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.2962000072002411},{"id":"https://openalex.org/C2775944032","wikidata":"https://www.wikidata.org/wiki/Q22907659","display_name":"Patient satisfaction","level":2,"score":0.29019999504089355},{"id":"https://openalex.org/C2780303639","wikidata":"https://www.wikidata.org/wiki/Q740909","display_name":"Kidney transplantation","level":3,"score":0.2800000011920929},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.2777000069618225},{"id":"https://openalex.org/C2777288759","wikidata":"https://www.wikidata.org/wiki/Q4164182","display_name":"Dosing","level":2,"score":0.2777000069618225},{"id":"https://openalex.org/C10446079","wikidata":"https://www.wikidata.org/wiki/Q155491","display_name":"Clinical pharmacy","level":3,"score":0.27300000190734863},{"id":"https://openalex.org/C2778373050","wikidata":"https://www.wikidata.org/wiki/Q1774706","display_name":"Clinical pathway","level":2,"score":0.2721000015735626},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.2712000012397766},{"id":"https://openalex.org/C71405471","wikidata":"https://www.wikidata.org/wiki/Q757012","display_name":"Quality management","level":3,"score":0.26579999923706055},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.26429998874664307},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.26100000739097595},{"id":"https://openalex.org/C502991105","wikidata":"https://www.wikidata.org/wiki/Q5133849","display_name":"Clinical research","level":2,"score":0.2606000006198883},{"id":"https://openalex.org/C2780035454","wikidata":"https://www.wikidata.org/wiki/Q8386","display_name":"Drug","level":2,"score":0.25760000944137573},{"id":"https://openalex.org/C2780877353","wikidata":"https://www.wikidata.org/wiki/Q2518253","display_name":"Health services research","level":3,"score":0.2572999894618988},{"id":"https://openalex.org/C2776732101","wikidata":"https://www.wikidata.org/wiki/Q954674","display_name":"Iron-deficiency anemia","level":3,"score":0.2549999952316284}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.7759/cureus.101071","doi":"https://doi.org/10.7759/cureus.101071","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.101071","pdf_url":"https://www.cureus.com/articles/449323-barriers-and-facilitators-to-vadadustat-use-for-managing-anemia-in-adult-patients-undergoing-dialysis-a-qualitative-evidence-synthesis.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},{"id":"pmid:41658817","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41658817","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Journal Article"},{"id":"pmh:oai:europepmc.org:11689631","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12882105","pdf_url":null,"source":{"id":"https://openalex.org/S4306400806","display_name":"Europe PMC (PubMed Central)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1303153112","host_organization_name":"European Bioinformatics Institute","host_organization_lineage":["https://openalex.org/I1303153112"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Text"}],"best_oa_location":{"id":"doi:10.7759/cureus.101071","doi":"https://doi.org/10.7759/cureus.101071","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.101071","pdf_url":"https://www.cureus.com/articles/449323-barriers-and-facilitators-to-vadadustat-use-for-managing-anemia-in-adult-patients-undergoing-dialysis-a-qualitative-evidence-synthesis.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"sustainable_development_goals_aurora":[{"id":"https://metadata.un.org/sdg/9","score":0.41467559337615967,"display_name":"Industry, innovation and infrastructure"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7119225002.pdf","grobid_xml":"https://content.openalex.org/works/W7119225002.grobid-xml"},"referenced_works_count":54,"referenced_works":["https://openalex.org/W1588433505","https://openalex.org/W1982242007","https://openalex.org/W1995949395","https://openalex.org/W2068545985","https://openalex.org/W2408629254","https://openalex.org/W2567220532","https://openalex.org/W2584947097","https://openalex.org/W2800908159","https://openalex.org/W2895682445","https://openalex.org/W2903985864","https://openalex.org/W2969787806","https://openalex.org/W2972371768","https://openalex.org/W3004599034","https://openalex.org/W3036505091","https://openalex.org/W3080820045","https://openalex.org/W3108166106","https://openalex.org/W3135755919","https://openalex.org/W3147940220","https://openalex.org/W3157159493","https://openalex.org/W3159725307","https://openalex.org/W3174686843","https://openalex.org/W3178875310","https://openalex.org/W4205692196","https://openalex.org/W4205702396","https://openalex.org/W4283458238","https://openalex.org/W4289832202","https://openalex.org/W4319318802","https://openalex.org/W4320490905","https://openalex.org/W4362731143","https://openalex.org/W4366990305","https://openalex.org/W4386238431","https://openalex.org/W4387187818","https://openalex.org/W4389470757","https://openalex.org/W4389526991","https://openalex.org/W4392094794","https://openalex.org/W4393195719","https://openalex.org/W4399043167","https://openalex.org/W4399319223","https://openalex.org/W4401195088","https://openalex.org/W4402287906","https://openalex.org/W4404136302","https://openalex.org/W4405086601","https://openalex.org/W4405108476","https://openalex.org/W4406561113","https://openalex.org/W4407908363","https://openalex.org/W4408357602","https://openalex.org/W4408597407","https://openalex.org/W4409053611","https://openalex.org/W4409488839","https://openalex.org/W4409706481","https://openalex.org/W4412199115","https://openalex.org/W4412594717","https://openalex.org/W4413806188","https://openalex.org/W4416722402"],"related_works":[],"abstract_inverted_index":{"Anemia":[0],"in":[1,97,229],"patients":[2,50],"on":[3,51,186,197],"maintenance":[4],"dialysis":[5,52,100,231],"is":[6,223],"routinely":[7],"managed":[8],"with":[9,156],"erythropoiesis-stimulating":[10],"agents":[11],"(ESAs)":[12],"and":[13,29,44,81,85,118,128,137,147,153,178,206,216,246],"iron":[14,31,171],"supplementation.":[15],"Vadadustat,":[16],"an":[17],"oral":[18,168,183],"hypoxia-inducible":[19],"factor":[20],"prolyl":[21],"hydroxylase":[22],"inhibitor":[23],"(HIF-PHI)":[24],"that":[25,234],"stimulates":[26],"endogenous":[27],"erythropoietin":[28],"improves":[30],"metabolism,":[32],"presents":[33],"a":[34,107,191],"novel":[35],"therapeutic":[36],"alternative.":[37],"Following":[38],"its":[39],"March":[40],"2024":[41],"U.S.":[42],"Food":[43],"Drug":[45],"Administration":[46],"approval":[47],"for":[48,53,93,101,182,225],"adult":[49],"at":[54],"least":[55],"three":[56],"months,":[57],"the":[58,83,88,119,157,165,230],"clinical":[59,114,134],"adoption":[60],"of":[61,91,167],"vadadustat":[62,92,241],"continues":[63],"to":[64,72,79,174],"face":[65],"significant":[66],"implementation":[67,194,221],"hurdles":[68],"despite":[69],"demonstrating":[70],"non-inferiority":[71],"ESAs.":[73],"In":[74],"this":[75],"study,":[76],"we":[77,189],"sought":[78],"identify":[80],"characterize":[82],"barriers":[84,127,141],"facilitators":[86,130,163],"influencing":[87],"real-world":[89],"integration":[90],"managing":[94],"symptomatic":[95],"anemia":[96,227],"adults":[98],"undergoing":[99],"chronic":[102],"kidney":[103],"disease.":[104],"We":[105],"conducted":[106],"qualitative":[108],"evidence":[109],"synthesis,":[110],"analyzing":[111],"data":[112],"from":[113,240],"trials,":[115],"regulatory":[116],"documents,":[117],"nephrology":[120],"literature.":[121],"Our":[122],"analysis":[123],"identified":[124],"59":[125],"distinct":[126],"51":[129],"across":[131],"healthcare":[132],"systems,":[133],"practice,":[135],"patient,":[136],"pharmacoeconomic":[138],"domains.":[139],"Prominent":[140],"include":[142],"cardiovascular":[143],"safety":[144,245],"concerns,":[145],"cost":[146],"reimbursement":[148],"challenges,":[149],"established":[150],"ESA":[151,176],"infrastructure,":[152],"prescriber":[154],"unfamiliarity":[155],"HIF-PHI":[158],"drug":[159],"class.":[160],"Conversely,":[161],"key":[162],"comprise":[164],"convenience":[166],"administration,":[169],"improved":[170],"utilization,":[172],"potential":[173],"overcome":[175],"hyporesponsiveness,":[177],"individual":[179],"patient":[180,202,236],"preference":[181],"therapy.":[184],"Based":[185],"these":[187,220],"findings,":[188],"propose":[190],"synthesis-derived":[192],"multidisciplinary":[193],"framework":[195],"built":[196],"six":[198],"core":[199],"principles:":[200],"evidence-based":[201],"selection,":[203],"risk":[204],"stratification":[205],"monitoring,":[207],"shared":[208],"decision-making,":[209],"gradual":[210],"transition":[211],"strategies,":[212],"interdisciplinary":[213],"team":[214],"engagement,":[215],"outcomes-based":[217],"evaluation.":[218],"Understanding":[219],"determinants":[222],"crucial":[224],"optimizing":[226],"management":[228],"population,":[232],"ensuring":[233],"appropriate":[235],"subgroups":[237],"can":[238],"benefit":[239],"administration":[242],"while":[243],"balancing":[244],"cost-effectiveness.":[247]},"counts_by_year":[],"updated_date":"2026-10-13T10:08:12.033832","created_date":"2026-01-08T00:00:00"}