Cemka-Eval, 43 Boulevard du Maréchal Joffre, Bourg-la-Reine, F-92340, France.
BMC Pulm Med. 2013 Mar 22;13:15. doi: 10.1186/1471-2466-13-15.
Current asthma management guidelines are based on the level of asthma control. The impact of asthma control on health care resources and quality of life (QoL) is insufficiently studied. EUCOAST study was designed to describe costs and QoL in adult patients according to level of asthma control in France and Spain.
An observational cost of illness study was conducted simultaneously in both countries among patients age greater or equal to 18 with a diagnosis of asthma for at least 12 months. Patients were recruited prospectively by GPs in 2010 in four waves to avoid a seasonal bias. Health care resources utilization of the three months before the inclusion was collected through physician questionnaires. Asthma control was evaluated using 2009 GINA criteria over a 3-month period. QoL was assessed using EQ-5D-3L®.
2,671 patients (France: 1,154; Spain: 1,517) were enrolled. Asthma was controlled in 40.6% [95% CI: 37.7%-43.4%] and 29.9% [95% CI: 27.6%-32.3%] of French and Spanish patients respectively.For all types of costs, the percentage of patients using health care resources varied significantly according to the level of asthma control. The average cost (euros/3-months/patient) of controlled asthma was €85.4 (SD: 153.5) in France compared with €314.0 (SD: 2,160.4) for partially controlled asthma and €537.9 (SD: 2,355.7) for uncontrolled asthma (p<0.0001). In Spain, the corresponding figures were €152.6 (SD: 162.1), €241.2 (SD: 266.8), and €556.8 (SD: 762.4). EQ-5D-3L® score was higher (p<0.0001) in patients with controlled asthma compared to partially controlled and uncontrolled asthma in both countries (respectively 0.88; 0.78; 0.63 in France and 0.89; 0.82; 0.69 in Spain).
In both countries, patients presenting with uncontrolled asthma had a significantly higher asthma costs and lower scores of Qol compared to the others.
目前的哮喘管理指南是基于哮喘控制水平制定的。哮喘控制对医疗资源和生活质量（QoL）的影响尚未得到充分研究。EUCOAST 研究旨在描述法国和西班牙根据哮喘控制水平，成年患者的医疗成本和生活质量。
在这两个国家同时开展了一项观察性疾病经济负担研究，入组的患者为年龄大于或等于 18 岁，哮喘诊断至少 12 个月。通过全科医生在 2010 年分四批前瞻性招募患者，以避免季节性偏倚。通过医生问卷收集纳入前三个月的医疗资源使用情况。在三个月内使用 2009 年 GINA 标准评估哮喘控制情况。使用 EQ-5D-3L®评估 QoL。
共纳入 2671 例患者（法国：1154 例；西班牙：1517 例）。法国和西班牙分别有 40.6%[95%可信区间：37.7%-43.4%]和 29.9%[95%可信区间：27.6%-32.3%]的患者哮喘得到控制。对于所有类型的成本，根据哮喘控制水平，使用医疗资源的患者比例差异显著。法国控制良好哮喘患者的平均（欧元/3 个月/患者）费用为 85.4（SD：153.5）欧元，部分控制哮喘为 314.0（SD：2160.4）欧元，未控制哮喘为 537.9（SD：2355.7）欧元（p<0.0001）。在西班牙，相应的数字分别为 152.6（SD：162.1）欧元、241.2（SD：266.8）欧元和 556.8（SD：762.4）欧元。两国控制良好哮喘患者的 EQ-5D-3L®评分均高于部分控制和未控制哮喘患者（分别为法国 0.88；0.78；0.63 和西班牙 0.89；0.82；0.69）（p<0.0001）。
在这两个国家，与其他患者相比，未控制哮喘患者的哮喘费用显著较高，生活质量评分较低。
