Ruiz-Moreno José María, Coco Rosa María, García-Arumí José, Xu Xiao, Zlateva Gergana
University of Castilla La Mancha, Albacete, Spain.
Curr Med Res Opin. 2008 Jul;24(7):2103-11. doi: 10.1185/03007990802214300. Epub 2008 Jun 10.
The burden of illness, including health resource utilization and costs associated with bilateral neovascular age-related macular degeneration (Nv-AMD), was assessed in Spain.
As part of an international prospective, case-controlled study, 89 Spanish patients with bilateral Nv-AMD were recruited by retina specialists and 96 Spanish control subjects were recruited by general practitioners and ophthalmologists. Physicians recorded clinical data and visual acuity (VA). In a subsequent telephone interview, Nv-AMD patients and controls completed the National Eye Institute Visual Function Questionnaire (NEI VFQ)-25, the EuroQol (EQ-5D), and the Hospital Anxiety and Depression Scale (HADS) questionnaire. Annual vision-related and non-vision-related medical costs and non-medical-related costs were calculated from study-specific questions.
The mean age was 76.2 years for Nv-AMD patients and 61.9 years for control subjects. The adjusted mean (95% CI) NEI VFQ-25 summary score was 51.9 (48.5; 55.4) for Nv-AMD patients and 87.7 (85.5; 89.9) for control subjects (p<0.05). The summary score of Nv-AMD patients decreased significantly with VA declination. Mean direct vision-related medical and non-medical-related costs were significantly greater for Nv-AMD patients than the control subjects, whereas non-vision-related medical costs were similar between groups. The total mean annual resource utilization cost was euro5733 for Nv-AMD patients compared to euro1070 for control subjects (p<0.0001).
Although the study design is subject to a number of limitations, patients with Nv-AMD in Spain have worse quality of life outcomes, greater depression, and higher healthcare costs as compared with similarly-aged individuals who are not affected by this disease.
在西班牙评估了包括与双侧新生血管性年龄相关性黄斑变性（Nv-AMD）相关的健康资源利用和成本在内的疾病负担。
作为一项国际前瞻性病例对照研究的一部分，视网膜专家招募了89名西班牙双侧Nv-AMD患者，全科医生和眼科医生招募了96名西班牙对照受试者。医生记录了临床数据和视力（VA）。在随后的电话访谈中，Nv-AMD患者和对照受试者完成了美国国立眼科研究所视觉功能问卷（NEI VFQ）-25、欧洲生活质量量表（EQ-5D）和医院焦虑抑郁量表（HADS）问卷。根据特定研究问题计算年度视力相关和非视力相关医疗成本以及非医疗相关成本。
Nv-AMD患者的平均年龄为7６.2岁，对照受试者为61.9岁。Nv-AMD患者调整后的平均（95%CI）NEI VFQ-25总分是51.9（48.5；55.4），对照受试者为87.7（85.5；89.9）（p<0.05）。Nv-AMD患者的总分随视力下降而显著降低。Nv-AMD患者的平均直接视力相关医疗和非医疗相关成本显著高于对照受试者，而两组间非视力相关医疗成本相似。Nv-AMD患者的年资源利用总成本平均为5733欧元，对照受试者为1070欧元（p<0.0001）。
尽管该研究设计存在一些局限性，但与未受该疾病影响的同龄个体相比，西班牙的Nv-AMD患者生活质量更差、抑郁程度更高且医疗成本更高。
