Pitt Andrew D, Smith Andrew F, Lindsell Lynda, Voon Li Wern, Rose Peter W, Bron Anthony J
Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford, England, UK.
Ophthalmic Epidemiol. 2004 Feb;11(1):17-33. doi: 10.1076/opep.11.1.17.26437.
The purpose of this study was to examine the economic and quality-of-life (QoL) impact of seasonal allergic conjunctivitis (SAC) from the individual patient perspective.
The study population was drawn from the general public of Oxfordshire, England.
Participants were recruited from either general practices or the casualty department of the Oxford Eye Hospital (OEH). All persons who were between 16 and 80 years of age and English speaking were eligible for enrollment in the study. The inclusion criteria for cases was that participants: 1) experienced itchy, bloodshot and watering eyes at some time between February and August every year since 1999, and 2) considered it likely that this was in response to seasonal allergens. Controls were drawn from the same sources and were age- and sex-matched to cases. Participants completed the EQ-5D Health Questionnaire, the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), the National Eye Institute (U.S.) Visual Functioning Questionnaire 25 (VFQ-25), and a specially developed Health Economic and Demographic Questionnaire.
Most participants in both groups were female (67.5% in the SAC and 70% in the control group, P=0.565). Weekly earnings were lower in the SAC group (P<0.001), as the SAC group also worked fewer hours per week (P<0.001). Participants with SAC also experienced a greater degree of pain and discomfort as measured by the EQ-5D (P=0.018) and a lower perception of health using the EQ-VAS (P=0.039). Statistically significant differences between both groups were detected in all domains of the VFQ-25, except general and colour vision, although the differences were thought to be clinically significant only for the ocular pain domain. The RQLQ scores were also all found to differ significantly between groups (P<0.001). The total of both the public health care and private out-of-pocket costs of SAC in our study population ranged on average between pound sterling 64.61 for a pensioner to pound sterling 123.69 for a person with SAC in paid employment.
SAC is a costly, highly prevalent, chronic condition associated with significant reductions in both ocular and general quality of life, as well as ongoing out-of-pocket expenses and health care costs. Medications that reduce this demand on health care systems and out-of-pocket expenses by patients could be of potential importance in reducing the overall economic and health burden of illness posed by SAC.
本研究旨在从个体患者角度探讨季节性变应性结膜炎（SAC）对经济和生活质量（QoL）的影响。
研究人群来自英国牛津郡的普通公众。
参与者从普通诊所或牛津眼科医院（OEH）的急诊科招募。所有年龄在16至80岁且讲英语的人均有资格纳入本研究。病例的纳入标准为参与者：1）自1999年以来每年2月至8月间的某些时候出现眼睛瘙痒、充血和流泪，且2）认为这可能是对季节性过敏原的反应。对照组从相同来源选取，并与病例进行年龄和性别匹配。参与者完成了EQ - 5D健康问卷、鼻结膜炎生活质量问卷（RQLQ）、美国国立眼科研究所视觉功能问卷25（VFQ - 25）以及一份专门编制的健康经济和人口统计学问卷。
两组中的大多数参与者为女性（SAC组为67.5%，对照组为70%，P = 0.565）。SAC组的周收入较低（P < 0.001），因为SAC组每周工作时间也较少（P < 0.001）。用EQ - 5D衡量，SAC患者还经历了更大程度的疼痛和不适（P = 0.018），用EQ - VAS衡量对健康的感知较低（P = 0.039）。在VFQ - 25的所有领域中，除了一般视觉和色觉外，两组之间均检测到统计学上的显著差异，不过这些差异仅在眼痛领域被认为具有临床意义。两组之间的RQLQ得分也均有显著差异（P < 0.001）。在我们的研究人群中，SAC的公共医疗保健和私人自付费用总计平均范围为，退休人员64.61英镑，有带薪工作的SAC患者123.69英镑。
SAC是一种代价高昂、高度流行的慢性疾病，与眼部和总体生活质量的显著下降以及持续的自付费用和医疗保健成本相关。能够减少医疗保健系统的这种需求以及患者自付费用的药物，对于减轻SAC所带来的总体经济和健康负担可能具有潜在重要性。
