哮喘联盟

   摘要
   前言：哮喘门诊是医院针对门诊哮喘患者开设的专科服务。本研究旨在通过与标准门诊服务进行比较，来评估哮喘门诊对哮喘管理的影响及成本-效果分析。
   方法：本研究为病例交叉研究，纳入对象为2012年西班牙卢戈市哮喘门诊的所有新病人。病例期为哮喘门诊初诊后的一年；对照期为之前的一年。计算哮喘管理临床质量相关指标的变化，评估每额外治疗一位患者和每获得一个质量调整生命年(QALY)的增量成本-效果比(ICER)。
   结果：哮喘门诊患者数量（83例，平均年龄49±15.2岁，其中女性有60.2%）从41%增加至86%。哮喘控制测试(ACT)评分从18.7±4.6增加至22.6±2.3 (p<0.05)，FEV1 从81.4%±17.5上升至84.4%±16.6 (p<0.05)。哮喘急性发作、住院及急诊就诊次数下降75%。LABA与ICS联合治疗的患者数量从79.5%减少至41%。其它治疗药物增加情况：抗胆碱能药物从3.6%增加至16.9%；ICS单药治疗从3.6%增加至45.8%；奥玛珠单抗从0增加至6%。从社会视角分析，每诊治一例患者、每获得一个生命质量调整年的增量成本-效果比分别为1,399欧元和6,876欧元。
   结论：哮喘门诊治疗是经济、有效的，且有益于哮喘的进一步管理。
 

（杨冬 审校）
ArchBronconeumol. 2015Nov5.pii:S0300-2896(15)00376-2.doi:10.1016/j.arbres.2015.09.009. [Epub ahead of print]
 

Cost Effectiveness of Outpatient Asthma Clinics.
 

[Article in English, Spanish]
Pérez de Llano LA1, Villoro R2, Merino M2, Gómez Neira MD3, Muñiz C3, Hidalgo Á4.
 

Abstract
INTRODUCTION:Asthma clinics (AC) are hospital outpatient services specialising in the management ofasthma. In this study, we analysed the impact of these clinics on asthma management and their cost effectiveness in comparison with standard outpatient services.
METHODS:A case cross-over study in which all new patients seen in the AC of Lugo in 2012 were included. The case period was defined as one year following the first visit to the AC; the control period was defined as the preceding year. We calculated changes in clinical quality indicators for asthma management, and estimated the incremental cost-effectiveness ratio (ICER) for each additional patient treated and for each quality-adjusted life year (QALY)
RESULTS: The number of patients (n=83, mean age 49±15.2years; 60.2% women) managed in the AC increased from 41% to 86%. The Asthma Control Test score increased from 18.7±4.6 to 22.6±2.3 (p<0.05) and FEV1 increased from 81.4%±17.5 to 84.4%±16.6 (p<0.05). The number of exacerbations, hospitalisations and visits to accident and emergency fell by 75%. The number of patients given combination LABA+ICS therapy fell from 79.5% to 41%. The use of other drug therapy increased: anticholinergics, from 3.6% to 16.9%; ICS in monotherapy, from 3.6% to 45.8%; and omalizumab, from 0% to 6%. ICERs per patient managed and per QALY gained were €1,399 and €6,876, respectively (social perspective).
CONCLUSIONS:Treatment in ACsiscost-effectiveandbeneficialin asthma management.
 

ArchBronconeumol. 2015Nov5.pii:S0300-2896(15)00376-2.doi:10.1016/j.arbres.2015.09.009. [Epub ahead of print]