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生长激素缺乏的成年人接受两年生长激素替代治疗期间的医疗保健利用情况、生活质量及患者报告结局——瑞典、荷兰和德国之间的比较

Healthcare utilization, quality of life and patient-reported outcomes during two years of GH replacement therapy in GH-deficient adults--comparison between Sweden, The Netherlands and Germany.

作者信息

Saller Bernhard, Mattsson Anders F, Kann Peter H, Koppeschaar Hans P, Svensson Johan, Pompen Marjolein, Koltowska-Häggström Maria

机构信息

Medical Department, Pfizer GmbH, Karlsruhe, Karlsruhe, Germany.

出版信息

Eur J Endocrinol. 2006 Jun;154(6):843-50. doi: 10.1530/eje.1.02149.

DOI:10.1530/eje.1.02149
PMID:16728544
Abstract

OBJECTIVE

This study set out to determine the change in quality of life (QoL) and healthcare utilization during 2 years of growth hormone (GH) replacement therapy in adults with GH deficiency. Data were compared from three European countries.

DESIGN

Analysis was made from KIMS, the Pfizer International Metabolic Database on adult GH deficiency.

METHODS

QoL and healthcare utilization were measured at baseline and after 1 and 2 years of GH replacement in patient cohorts from Sweden (n = 302), The Netherlands (n = 103) and Germany (n = 98). QoL was assessed by the QoL-Assessment in Growth Hormone Deficient Adults (QoL-AGHDA) questionnaire, and the KIMS Patient Life Situation Form was used to evaluate healthcare utilization.

RESULTS

QoL improved significantly (P < 0.0001) and comparably in all three cohorts. The improvement was seen during the first year of treatment and QoL remained improved during the second year. The number of days in hospital was reduced by 83% (P < 0.0001) during GH replacement. There were no country-specific differences either at baseline or during follow-up. The same was true for the number of days of sick leave (reduction of 63%; P = 0.0004). Significant reductions were recorded in the number of doctor visits in each of the three cohorts after 2 years of GH replacement (P < 0.05).

CONCLUSIONS

This study provides a detailed comparative analysis of GH replacement therapy in GHD patients in three European countries. Despite some differences in treatment strategies, the beneficial effects on QoL, patient-reported outcomes and healthcare utilization are essentially similar in the healthcare environment of Western European countries.

摘要

目的

本研究旨在确定生长激素(GH)替代疗法对成年生长激素缺乏症患者生活质量(QoL)和医疗保健利用情况在2年期间的变化。对来自三个欧洲国家的数据进行了比较。

设计

分析来自辉瑞国际代谢数据库KIMS中有关成年生长激素缺乏症的数据。

方法

对来自瑞典(n = 302)、荷兰(n = 103)和德国(n = 98)的患者队列在基线时以及GH替代治疗1年和2年后的QoL和医疗保健利用情况进行了测量。通过成年生长激素缺乏症患者生活质量评估(QoL - AGHDA)问卷评估QoL,并使用KIMS患者生活状况表评估医疗保健利用情况。

结果

在所有三个队列中,QoL均有显著改善(P < 0.0001)且相当。这种改善在治疗的第一年就已出现,并且在第二年QoL仍然保持改善。在GH替代治疗期间,住院天数减少了83%(P < 0.0001)。在基线时或随访期间均没有国家特异性差异。病假天数也有同样的情况(减少63%;P = 0.0004)。在GH替代治疗2年后,三个队列中的每一个队列的医生就诊次数均显著减少(P < 0.05)。

结论

本研究对三个欧洲国家的生长激素缺乏症患者的GH替代疗法进行了详细的比较分析。尽管治疗策略存在一些差异,但在西欧国家的医疗环境中,对QoL、患者报告的结果和医疗保健利用的有益影响基本相似。

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