哮喘联盟

   摘要
   背景：现今的哮喘护理指南是建立在哮喘控制水平之上的。哮喘控制对于医疗资源和生活质量所产生的影响并没有得到人们足够的研究和重视。EUCOAST研究旨在阐明法国和西班牙不同哮喘控制水平的成年患者的医疗花费情况和生活质量。
   方法：在这两个国家同时进行长达12月以上的疾病费用观察性研究，研究对象为诊断为哮喘的18岁或以上患者。为了避免季节性偏差，全科医师预先在2010年分四批招募患者。研究入组前3个月，通过医师调查问卷汇集医保资源使用的相关信息。根据2009年全球哮喘防治创议标准评估3个月期间的哮喘控制情况。采用EQ-5D-3L(R)评估生活质量。
   结果：参与研究注册的共计2671例患者（法国：1154例；西班牙：1517例）。法国和西班牙的哮喘控制率分别为40.6%[95% CI: 37.7% - 43.4%]和29.9%[95% CI: 27.6% - 32.3%]。根据哮喘控制水平的不同，患者使用的医保资源比例也有明显差异。在法国，相比较哮喘部分控制花费的314欧元(SD: 2,160.4)和哮喘未控制花费的537.9欧元(SD: 2,355.7)，哮喘控制的平均花费为85.4欧元(SD: 153.5)（/3个月/每个患者）(p<0.0001)。在西班牙，相应数据依次为152.6欧元 (SD: 162.1)、241.2 欧元(标准偏差: 266.8) 和556.8 欧元(SD: 762.4)。两个国家中，哮喘控制患者的EQ-5D-3L(R)得分均高于哮喘部分控制和未控制患者（法国依次是： 0.88、0.78、0.63 ，西班牙依次是：0.89、0.82、 0.69）(p<0.0001)。
   结论：在这两个国家，哮喘未控制的患者的成本费用远远高于其他患者，且生活质量评分也更低。
 

（苏楠 审校）
BMC Pulm Med. 2013 Mar 22;13(1):15. [Epub ahead of print]

 

The association between asthma control, health care costs, and quality of life in France and Spain.
 

Doz M, Chouaid C, Com-Ruelle L, Calvo E, Brosa M, Robert J, Decuypère L, Pribil C, Huerta A, Detournay B.

Abstract
BACKGROUND:Current asthma management guidelines are based on the level of asthma control. The impact of asthma control on health care resources and quality of life (QoL) is insufficiently studied. EUCOAST study was designed to describe costs and QoL in adult patients according to level of asthma control in France and Spain.
METHODS:An observational cost of illness study was conducted simultaneously in both countries among patients age greater or equal to 18 with a diagnosis of asthma for at least 12 months. Patients were recruited prospectively by GPs in 2010 in four waves to avoid a seasonal bias. Health care resources utilization of the three months before the inclusion was collected through physician questionnaires. Asthma control was evaluated using 2009 GINA criteria over a 3-month period. QoL was assessed using EQ-5D-3L(R).
RESULTS:2,671 patients (France: 1,154; Spain: 1,517) were enrolled. Asthma was controlled in 40.6% [95% CI: 37.7% - 43.4%] and 29.9% [95% CI: 27.6% - 32.3%] of French and Spanish patients respectively. For all types of costs, the percentage of patients using health care resources varied significantly according to the level of asthma control. The average cost (euros/3-months/patient) of controlled asthma was [euro sign]85.4 (SD: 153.5) in France compared with [euro sign]314.0 (SD: 2,160.4) for partially controlled asthma and [euro sign]537.9 (SD: 2,355.7) for uncontrolled asthma (p<0.0001). In Spain, the corresponding figures were [euro sign]152.6 (SD: 162.1), [euro sign]241.2 (SD: 266.8), and [euro sign]556.8 (SD: 762.4). EQ-5D-3L(R) score was higher (p<0.0001) in patients with controlled asthma compared to partially controlled and uncontrolledasthma in both countries (respectively 0.88; 0.78; 0.63 in France and 0.89; 0.82; 0.69 in Spain).
CONCLUSIONS:In both countries, patients presenting with uncontrolled asthma had a significantly higherasthma costs and lower scores of Qol compared to the others.
 

BMC Pulm Med. 2013 Mar 22;13(1):15. [Epub ahead of print]