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急性鼻窦炎的高成本与疾病负担:瑞典初级保健中的实际治疗模式与结果

High costs and burden of illness in acute rhinosinusitis: real-life treatment patterns and outcomes in Swedish primary care.

作者信息

Stjärne Pär, Odebäck Peter, Ställberg Björn, Lundberg Johan, Olsson Petter

机构信息

Department of Clinical Science, Intervention and Technology, Division of Otorhinolaryngology, Karolinska Institute, Stockholm, Sweden.

出版信息

Prim Care Respir J. 2012 Jun;21(2):174-9; quiz 10p following 179. doi: 10.4104/pcrj.2012.00011.

Abstract

BACKGROUND

Few studies have investigated the impact of acute rhinosinusitis on disease-specific quality of life, and disease costs have not been studied previously in Scandinavia.

AIMS

To study symptoms, treatment patterns, quality of life and costs in adults with acute rhinosinusitis.

METHODS

This was an observational study in primary care. Patients aged 18-80 years seeking care for acute rhinosinusitis were evaluated using the Major Symptom Score (MSS) on days 0 and 15. Recommended and used treatments, quality of life and costs were assessed by questionnaires including EQ-5D™ and a visual analogue scale (VAS) on the same days.

RESULTS

150 patients were enrolled; 143 provided follow-up data. The proportion of MSS responders was 91%. Mean MSS decreased from 8.4 on day 0 (N = 150) to 1.9 on day 15 (N = 143). Patients reporting pain/discomfort and problems with usual activities decreased from 88.4% to 31.5% and from 43.2% to 1.4%, respectively, and mean VAS increased from 58.7 to 79.5. Intranasal corticosteroids were the most recommended and/or prescribed drugs. Total cost for an episode was 10,260 SEK (€1,102), of which 75% were indirect costs.

CONCLUSIONS

With treatment dominated by intranasal corticosteroids, a high proportion of responders and good symptom relief were seen. Acute rhinosinusitis seems to cause a high burden on quality of life and also a high cost for society.

摘要

背景

很少有研究调查急性鼻窦炎对疾病特异性生活质量的影响,且此前斯堪的纳维亚地区尚未对疾病成本进行过研究。

目的

研究成年急性鼻窦炎患者的症状、治疗模式、生活质量和成本。

方法

这是一项在初级保健机构开展的观察性研究。对年龄在18 - 80岁因急性鼻窦炎就诊的患者,在第0天和第15天使用主要症状评分(MSS)进行评估。在同一天通过包括EQ - 5D™和视觉模拟量表(VAS)在内的问卷评估推荐和使用的治疗方法、生活质量及成本。

结果

共纳入150例患者;143例提供了随访数据。MSS有反应者的比例为91%。平均MSS从第0天的8.4(N = 150)降至第15天的1.9(N = 143)。报告疼痛/不适和日常活动有问题的患者分别从88.4%降至31.5%和从43.2%降至1.4%,平均VAS从58.7升至79.5。鼻内用糖皮质激素是最常被推荐和/或处方的药物。一次发作的总成本为10,260瑞典克朗(1,102欧元),其中75%为间接成本。

结论

治疗以鼻内用糖皮质激素为主,有反应者比例高且症状缓解良好。急性鼻窦炎似乎给生活质量带来了沉重负担,对社会而言成本也很高。

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