Badalona Serveis Assistencials, SA, Department of Planning, Badalona, Spain.
Curr Med Res Opin. 2010 Dec;26(12):2757-64. doi: 10.1185/03007995.2010.529430. Epub 2010 Nov 1.
Population based study to determine the clinical consequences and economic impact of using escitalopram (ESC) vs. citalopram (CIT) and venlafaxine (VEN) in patients who initiate treatment for a new episode of major depression (MD) in real life conditions of outpatient practice.
Observational, multicenter, retrospective study conducted using computerized medical records (administrative databases) of patients treated in six primary care centers and two hospitals between January 2003 and March 2007.
patients >20 years of age diagnosed with a new episode of MD who initiate treatment with ESC, CIT or VEN who had not received any antidepressant treatment within the previous 6 months, and were followed for 18 months or more.
socio-demographic variables, remission (defined as a patient completing 6 months of therapy), comorbidity, annual health care costs (medical visits, diagnostic and therapeutic tests, hospitalizations, emergency room and psychoactive drugs prescribed) and non-health care costs (productivity losses at work, mainly sick leave and disability).
logistic regression and ANCOVA models.
A total of 965 patients (ESC = 131; CIT = 491; VEN = 343) were identified and met study criteria. ESC-treated patients were younger, with a higher proportion of males, and had a lower specific comorbidity (p < 0.01). ESC-treated patients achieved higher remission rates compared to CIT (58.0% vs. 38.3%) or VEN patients (32.4%), p < 0.001, and had lower productivity work losses compared to VEN patients (32.7 vs. 43.8 days), p = 0.042. No differences in productivity work losses were observed between ESC and CIT patients. Compared to the ESC group, higher costs in average/unit of psychoactive drugs were found in the VEN group (€643.00), p = 0.003, whereas no differences were observed between the ESC and CIT groups (€294.70 vs. €265.20). In the corrected model, total costs (health care and non-health care cost) were lower with ESC (€2276.20) compared to CIT (€3093.80), p = 0.047 and VEN (€3801.20), p = 0.045.
ESC appears to be dominant in the treatment of new MD episodes when compared to CIT and VEN, resulting in higher remission rates and lower total costs.
在真实的门诊环境下，对新诊断为重度抑郁症（MD）患者进行新的发作治疗，研究基于人群的研究确定使用艾司西酞普兰（ESC）与西酞普兰（CIT）和文拉法辛（VEN）的临床后果和经济影响。
使用 2003 年 1 月至 2007 年 3 月期间在六家基层医疗中心和两家医院接受治疗的患者的计算机化医疗记录（管理数据库）进行观察性、多中心、回顾性研究。
年龄在 20 岁以上，新诊断为 MD 发作的患者，他们接受 ESC、CIT 或 VEN 治疗，且在过去 6 个月内未接受任何抗抑郁药物治疗，并随访 18 个月或更长时间。
社会人口统计学变量、缓解（定义为患者完成 6 个月的治疗）、合并症、年度医疗保健费用（医疗就诊、诊断和治疗测试、住院、急诊室和开处的精神活性药物）和非医疗保健费用（工作中的生产力损失，主要是病假和残疾）。
逻辑回归和协方差分析模型。
共确定了 965 名符合研究标准的患者（ESC=131；CIT=491；VEN=343）。ESC 治疗的患者年龄较小，男性比例较高，且特定合并症较低（p<0.01）。与 CIT（38.3%）或 VEN（32.4%）患者相比，ESC 治疗的患者缓解率更高（58.0%），p<0.001，与 VEN 患者相比，ESC 治疗的患者工作生产力损失更低（32.7 天与 43.8 天），p=0.042。ESC 与 CIT 患者之间的工作生产力损失没有差异。与 ESC 组相比，VEN 组的精神活性药物平均/单位成本更高（€643.00），p=0.003，而 ESC 与 CIT 组之间没有差异（€294.70 与 €265.20）。在校正模型中，与 CIT（€3093.80）和 VEN（€3801.20）相比，ESC（€2276.20）的总成本（医疗保健和非医疗保健成本）较低，p=0.047。
与 CIT 和 VEN 相比，ESC 似乎在治疗新的 MD 发作时具有优势，可提高缓解率并降低总成本。
