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在一项III期临床试验中随机分配的加拿大患者中,偏头痛症状对医疗保健利用和工作损失的影响。

Impact of migraine symptoms on health care use and work loss in Canada in patients randomly assigned in a phase III clinical trial.

作者信息

Lambert Jean, Carides George W, Meloche Jacques P, Gerth William C, Marentette Michael A

机构信息

Department of Social and Preventive Medicine, University of Montreal, Quebec.

出版信息

Can J Clin Pharmacol. 2002 Fall;9(3):158-64.

Abstract

BACKGROUND

Migraine is prevalent and associated with substantial direct and indirect costs that may vary across geographic and national boundaries. The effects of migraine, self-reported by Canadians, on health care resource use as well as paid and unpaid work loss were examined.

PATIENTS AND METHODS

The Migraine Background Questionnaire (MBQ) was self-administered during the screening visit of a phase III clinical trial of rizatriptan (a potent, selective 5-hydroxytryptamine(1B/1D)-receptor agonist or 'triptan'). Patients suffering from moderate to severe migraine in the previous six months were offered the opportunity to participate. Migraine frequency was determined and costs were estimated and assigned based on known direct costs of health care resource utilization, and indirect costs of paid and unpaid work and productivity loss.

RESULTS

One hundred thirty-four patients completed the MBQ. In the previous year, 89% of those patients reported visiting a clinic, 23% reported visiting an emergency room and 5% reported being hospitalized for migraine. Patients reported an average of 6.5 days absent from work, 44 days working with migraine headache and 10.4 reduced workday equivalents due to ineffectiveness at work with migraine. Based on data obtained from the Ontario, the average overall annual cost due to migraine was estimated to be 3,025 dollars/patient; most of this (87%) due to indirect costs.

CONCLUSION

In Canada, patients with moderate to severe migraine, as identified in a phase III clinical trial, reported lost work days and reduced effectiveness while at work, as well as increased health care resource utilization due to migraine. The associated cost was estimated to be substantial.

摘要

背景

偏头痛很常见,且会产生大量直接和间接成本,这些成本可能因地域和国家的不同而有所差异。本研究调查了加拿大人自我报告的偏头痛对医疗资源使用以及有偿和无偿工作损失的影响。

患者与方法

在一项利扎曲普坦(一种强效、选择性5-羟色胺(1B/1D)受体激动剂或“曲坦类药物”)的III期临床试验的筛查访视期间,患者自行填写偏头痛背景调查问卷(MBQ)。向前六个月患有中度至重度偏头痛的患者提供参与机会。确定偏头痛发作频率,并根据已知的医疗资源利用直接成本以及有偿和无偿工作及生产力损失的间接成本估算并分配成本。

结果

134名患者完成了MBQ。在过去一年中,这些患者中有89%报告去过诊所,23%报告去过急诊室,5%报告因偏头痛住院。患者报告平均误工6.5天,因偏头痛头痛仍工作44天,因偏头痛导致工作效率低下相当于减少了10.4个工作日。根据从安大略省获得的数据,估计偏头痛导致的平均每年总成本为每位患者3025美元;其中大部分(87%)是间接成本。

结论

在加拿大,一项III期临床试验中确定的中度至重度偏头痛患者报告了误工天数以及工作时效率降低,同时因偏头痛导致医疗资源利用增加。估计相关成本很高。

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