アカデミック・メディカル・センターの小児患者の成長ホルモンへのアクセスの障壁
Chardé Parrish1, Danielle Baird1, Terra Redd2
1Vanderbilt Specialty Pharmacy, Vanderbilt Health System, Nashville, TN, USA.
まとめ
ヒト成長ホルモン (hGH) 治療へのアクセスは,診断,保険,検査によって遅れる可能性があります. しかし,hGH開始までの時間は,治療決定から1年後の患者の成長に影響を与えませんでした.
科学分野:
- 小児内分泌学
- 薬学経済学
背景:
- 治療を必要とする小児患者のために,ヒト成長ホルモン (hGH) に適時なアクセスが不可欠です.
- 患者と治療の公平性を改善するために,HGHへのアクセスの障壁を理解することは不可欠です.
研究 の 目的:
- 小児患者のヒト成長ホルモン (hGH) アクセスを遅らせたり制限したりする障壁を評価する.
- hGHのアクセスまでの時間と,患者の要因と成長への影響との関連を調べる.
主な方法:
- hGH治療を受けた小児患者の電子医療記録の遡及的レビュー
- コックス比例リスクモデルを用いて,hGHへのアクセス時間に関連する要因の分析.
- 線形回帰を用いた高さzスコアの変化に影響を与える要因の評価
主要な成果:
- 承認方法によって,HGHへのアクセスまでの平均時間は大きく変化し,3日 (事前承認) から94日 (現金支給) まででした.
- 診断,追加の検査の必要性,最終的なアクセス方法は,hGHアクセスまでの時間と有意に関連していました.
- 診断と人種は成長の結果と関連しているが,hGH開始までの時間は1年後の患者の成長に有意な影響を及ぼさなかった.
結論:
- 診断,保険,追加の検査などの障壁は,ヒト成長ホルモン (hGH) にアクセスする時間に影響します.
- アクセス時間の変動にもかかわらず,hGH治療の開始は1年後の患者の成長軌跡に影響を与えませんでした.
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