对重症未控制的哮喘患者住院和门诊使用奥马珠单抗的成本和临床疗效之间的比较
2016/06/20
摘要
目的：比较奥马珠单抗治疗的两种管理策略的的临床疗效和成本之间的差异。
方法：我们在1年时间内评估了2组患有未控制的严重哮喘病人。患者在医院A的基层医疗中心接受治疗，或在医院B接受常规管理。
结果：我们研究了130例患者，86例在医院A，44例在医院B，30例为男性（24%），100例为女性（76%），年龄为50岁±15岁，FEV1 % 67±22%，身体质量指数（BMI）28±6 kg/m2，639±747 UI IgE/ml，随访24±11个月（12-45），哮喘控制测试（ACT）评分为12±4，哮喘控制问卷（ACQ）评分为3±2。在过去的一年中，在医院住院和急诊室就诊的群体之间没有显着的预处理差异，接受口服类固醇的患者的比例也没有差异。分别在基线和治疗12个月后进行评估，结果显示哮喘控制测试评分（ACT）（P＜0.001）、哮喘控制问卷评分（ACQ）(P＜0.001）、FEV1%改善程度（P＜0.001）、总就诊数的降低（P＜0.001）、住院天数（P＜0.001）、急救室就诊次数（P < 0.001）、口服类固醇周期和剂量（P＜0.001）较上年相比都有显著差异。住院费用、急救室就诊次数、不定期拜访基层医疗中心和肺科医生在每个医院和总体上都明显减少，但在医院A采用的门诊策略，其管理和交通费用降低了35%。
结论：在门诊医疗中心使用奥马珠单抗治疗取得了和医院治疗相同的临床效果，但成本更低。
（苏欣 审校）
Arch Bronconeumol. 2016 Apr;52(4):211-216. doi: 10.1016/j.arbres.2015.10.004. Epub 2015 Dec 3.
Comparison of Costs and Clinical Outcomes Between Hospital and Outpatient Administration of Omalizumab in Patients With Severe Uncontrolled Asthma.
[Article in English, Spanish]
Chiner E1, Fernández-Fabrellas E2, Landete P3, Novella L2, Ramón M2, Sancho-Chust JN3, Senent C3, Berraondo J2.
Author information
Abstract
OBJECTIVES:To compare clinical outcomes and costs between two administration strategies of omalizumab treatment.
METHOD:We evaluated two cohorts of patients with uncontrolled severe asthma over a 1-year period. Patients received the treatment in the primary care center in Hospital A and conventional hospital administration in Hospital B.
RESULTS:We studied 130 patients, 86 in Hospital A and 44 in Hospital B, 30 men (24%) and 100 women (76%), age 50±15 years, FEV1% 67±22%, body mass index (BMI) 28±6kg/m2, 639±747 UI IgE/mL, followed for 24±11 months (12-45), Asthma Control Test (ACT) score 12±4 andAsthma Control Questionnaire (ACQ) 3±2. There were no significant pretreatment differences between the groups in hospital admissions and emergency room visits in the previous year, nor in proportion of patients receiving oral steroids. Evaluations were performed at baseline and after 12 months of treatment, revealing significant differences in ACT (P<0.001), ACQ (P<0.001), improvement in FEV1% (P<0.001), reduction in total admissions (P<0.001), days of hospitalization (P<0.001), emergency room visits (P<0.001), cycles and doses of oral steroids (P<0.001) compared to the previous year. Hospitalization costs, emergency room visits, unscheduled visits to primary care and to the pulmonologist were significantly reduced in each hospital and on the whole, but administration and travel costs were 35% lower in the ambulatory strategy adopted in Hospital A.
CONCLUSION:The administration of omalizumab in ambulatory health centers achieved the same clinical results as a hospital administration strategy, but with lower costs.
Copyright © 2015 SEPAR. Published by Elsevier Espana. All rights reserved.
KEYWORDS: Administración ambulatoria; Ambulatory administration; Asma grave no controlada; Costes; Costs; Omalizumab; Uncontrolled severe asthma
Arch Bronconeumol. 2016 Apr;52(4):211-216. doi: 10.1016/j.arbres.2015.10.004. Epub 2015 Dec 3.
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