对于有或没有系统性自身免疫性风湿性疾病的患者,与成本相关的药物治疗行为
Jeong Yee1, Candace H Feldman1, Emily G Oakes1
1Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Arthritis care & research
|September 23, 2024
概括
患有系统性自身免疫性风湿性疾病 (SARD) 的患者面临更高的药物费用,导致不坚持和增加医疗保健利用率. 解决药物负担能力对于有效管理SARDs至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 医疗保健服务研究 医疗服务研究
- 药物经济学 药物经济学
背景情况:
- 药物不坚持是管理系统性自身免疫性类风湿性疾病 (SARDs) 的重要障碍.
- 与成本相关的药物行为可能会不成比例地影响SARD患者.
研究的目的:
- 调查SARD患者中与成本相关的药物使用行为.
- 为了将这些行为与没有SARDs的患者在一个大型,多样化的美国队列中进行比较.
主要方法:
- 利用了来自"我们所有人"研究计划 (第7版) 的数据,这是一个全国范围的队列,有链接的电子健康记录.
- 对与成本相关的药物行为进行了问卷调查,并分析了3,997名SARD患者和73,990名对照患者的数据.
- 采用千平方测试和逻辑回归来比较群体并计算赔率比率.
主要成果:
- 与对照组相比,患有SARD的患者表现出负担不起 (1.56x),不坚持 (1.43x) 和降低成本策略 (1.23x) 的可能性增加.
- 在SARD患者中,药物负担不起与减少使用疾病修饰药物 (16.5%的可能性较低) 和增加使用葡萄糖皮质激素 (18.1%的可能性更高) 相关.
- 负担不起与更高的急诊室访问率相关:每年1~2次访问1.27倍,每年3次以上访问1.38倍.
结论:
- 患有SARD的患者比没有SARD的患者表现出更多与成本相关的药物治疗行为.
- 在SARD患者中,药物负担不起与非最佳治疗 (较少的DMARD) 和增加医疗资源利用率 (ER访问) 相关.
- 研究结果强调,急需采取干预措施,降低SARD患者的药物费用,以改善疾病管理和减少医疗负担.
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