哮喘联盟

   摘要
   目的：评估和比较强化哮喘管理（无论是作为常规护理的辅助手段还是单独应用）与单用常规护理的成本效益。
   方法：通过在线数据库全面搜索从1990年到2012年发表的的英文期刊文章，使用检索词“哮喘” 和（“干预”或“管理”）和（“药物经济学”或“经济评估”或“成本－效果”或“成本－效益”或“成本 - 效用”）。本地出版物用手工搜索完成。只纳入已经进行了全面经济学评估的强化哮喘管理研究（成本－后果（CC），成本－效果（CE），成本－效益（CB），或成本－效用（CU）分析）。进行数据的提取，并对经济评估设计的质量和证据来源的质量进行评估。
   结果：本研究共纳入49项研究。强化哮喘管理有3种干预类型：教育，环境控制和自我管理。最具成本－效益的强化哮喘管理方案是教育和自我管理的联合，通过医疗保健机构和专职医护人员组成的团队来实施。总体来说，这些研究的经济评价质量中等，平均QHES得分73.7（SD=9.7），证据来源的质量较好。
   结论：尽管经济评估的整体质量中等，但是证据来源质量较好。这篇综述表明，提供强化哮喘管理方案，无论是单一或混合模式，整体来说是有效果的，同时也能降低成本。然而，可用性和可行性是同样重要的需要考虑的因素，成本-效益管理的可持续性需要进一步调查研究，最好选用较长时间跨度特别是慢性疾病如哮喘。
 

（杨冬 审校）
Pharm Pract (Granada). 2014 Oct;12(4):493. Epub 2014 Mar 15.
 

Economic evaluation of enhanced asthma management: a systematic review.
 

Yong YV1, Shafie AA2.
 

Abstract
OBJECTIVES: To evaluate and compare full economic evaluation studies on the cost-effectiveness of enhanced asthma management (either as an adjunct to usual care or alone) vs. usual care alone.
METHODS: Online databases were searched for published journal articles in English language from year 1990 to 2012, using the search terms '"asthma" AND ("intervene" OR "manage") AND ("pharmacoeconomics" OR "economic evaluation" OR "cost effectiveness" OR "cost benefit" OR "cost utility")'. Hand search was done for local publishing. Only studies with full economic evaluation on enhanced management were included (cost consequences (CC), cost effectiveness (CE), cost benefit (CB), or cost utility (CU) analysis). Data were extracted and assessed for the quality of its economic evaluation design and evidence sources.
RESULTS: A total of 49 studies were included. There were 3 types of intervention for enhanced asthma management: education, environmental control, and self-management. The most cost-effective enhanced management was a mixture of education and self-management by an integrated team of healthcare and allied healthcare professionals. In general, the studies had a fair quality of economic evaluation with a mean QHES score of 73.7 (SD=9.7), and had good quality of evidence sources.
CONCLUSION: Despite the overall fair quality of economic evaluations but good quality of evidence sources for all data components, this review showed that the delivered enhanced asthma managements, whether as single or mixed modes, were overall effective and cost-reducing. Whilst the availability and accessibility are an equally important factor to consider, the sustainability of the cost-effective management has to be further investigated using a longer time horizon especially for chronic diseases such as asthma.
 

Pharm Pract (Granada). 2014 Oct;12(4):493. Epub 2014 Mar 15.