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新生血管性年龄相关性黄斑变性的疾病负担与医疗资源利用:一项多国研究的结果

Burden and health care resource utilization in neovascular age-related macular degeneration: findings of a multicountry study.

作者信息

Soubrane Gisèle, Cruess Alan, Lotery Andrew, Pauleikhoff Daniel, Monès Jordi, Xu Xiao, Zlateva Gergana, Buggage Ronald, Conlon John, Goss Thomas F

机构信息

Department of Ophthalmology, University Paris XII, Centre Hospitalier Intercommunal de Créteil, 40 Avenue de Verdun, Créteil, France.

出版信息

Arch Ophthalmol. 2007 Sep;125(9):1249-54. doi: 10.1001/archopht.125.9.1249.

Abstract

OBJECTIVE

To describe the burden of bilateral neovascular age-related macular degeneration (NV-AMD) on patient-reported functioning and health resource utilization.

METHODS

A cross-sectional study of 401 patients with bilateral NV-AMD and 471 elderly control subjects without AMD was conducted in 5 countries. Subjects completed a telephone survey, including the National Eye Institute 25-Item Visual Function Questionnaire, the EuroQol instrument, the Hospital Anxiety and Depression Scale, and history of falls, fractures, and health care resource utilization.

RESULTS

The mean age for patients with NV-AMD was 78.1 years, and 65% were women. The patients reported 45% worse vision-related functioning, 13% worse overall well-being, and 30% more anxiety and 42% more depression symptoms than controls after adjusting for covariates (all, P < .001). The effect of NV-AMD was also observed as a doubled fall rate (16% vs 8% [P < .001]) and a quadrupled need for assistance with daily activities (29% vs 7% [P < .001]) in the patients compared with controls.

CONCLUSIONS

The evidence of extensive decline in quality of life and increased need of daily living assistance for patients with NV-AMD compared with a control population substantiates the need for new treatments that prevent vision loss and progression to blindness.

摘要

目的

描述双侧新生血管性年龄相关性黄斑变性(NV-AMD)对患者报告的功能和健康资源利用的负担。

方法

在5个国家对401例双侧NV-AMD患者和471例无AMD的老年对照者进行了一项横断面研究。受试者完成了一项电话调查,包括美国国立眼科研究所25项视觉功能问卷、欧洲五维度健康量表、医院焦虑抑郁量表,以及跌倒、骨折和医疗资源利用史。

结果

NV-AMD患者的平均年龄为78.1岁,65%为女性。在调整协变量后,患者报告的与视力相关的功能比对照组差45%,总体幸福感差13%,焦虑症状多30%,抑郁症状多42%(均P<0.001)。与对照组相比,还观察到NV-AMD患者的跌倒率增加了一倍(16%对8%[P<0.001]),日常生活需要协助的需求增加了两倍(29%对7%[P<0.001])。

结论

与对照人群相比,NV-AMD患者生活质量大幅下降且日常生活协助需求增加的证据,证实了需要有预防视力丧失和失明进展的新治疗方法。

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