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了解在PARADOX研究中报告的甲状旁腺功能减退症患者的疾病负担。

Understanding the burden of illness associated with hypoparathyroidism reported among patients in the PARADOX study.

作者信息

Hadker Nandini, Egan Jacqueline, Sanders James, Lagast Hjalmar, Clarke Bart L

机构信息

Trinity Partners, Waltham, Massachusetts.

Hypoparathyroidism Association, Inc., Idaho Falls, Idaho.

出版信息

Endocr Pract. 2014 Jul;20(7):671-9. doi: 10.4158/EP13328.OR.

Abstract

OBJECTIVE

Hypoparathyroidism is a rare disease caused by lack of parathyroid hormone (PTH) leading to hypocalcemia, hyperphosphatemia, and a variety of symptoms. This study aimed to quantify the clinical and social burden of illness from the perspective of affected patients.

METHODS

A web-based instrument was developed with input from patients, clinical experts, and the Hypoparathyroidism Association. Qualifying participants were ≥18 years old, diagnosed with hypoparathyroidism for ≥6 months, and U.S. residents. Questions focused on demographics, diagnosis perceptions, current attitudes, medical management, current symptoms, acute episodes, comorbidities, personal life, and employment.

RESULTS

A total of 374 adults (mean age, 49 ± 12 years; female, 85%) with hypoparathyroidism (mean duration, 13 ± 12 years; severe condition, 30.5%) completed the survey. Patients reported visiting a mean of 6 ± 8 physicians before and after their diagnosis. The majority strongly agreed with feeling unprepared to manage the condition at diagnosis (56%), that controlling their hypoparathyroidism is harder than expected (60%), and that they were concerned about long-term complications of their current medications (75%). More than 10 symptoms were experienced by 72% of patients in the preceding 12 months, despite current management regimens. Symptoms were experienced for a mean of 13 ± 9 hours/day. Hospital stays or emergency department visits were required by 79% of patients. 45% reported significant interference with their lives, 85% reported an inability to perform household activities, and 20% experienced a disease-associated change in employment status.

CONCLUSION

Patients with hypoparathyroidism have a high burden of illness and experience a broad spectrum of symptoms, with a multidimensional impact on their lives.

摘要

目的

甲状旁腺功能减退症是一种罕见疾病,由甲状旁腺激素(PTH)缺乏导致低钙血症、高磷血症及多种症状。本研究旨在从受影响患者的角度量化该疾病的临床和社会负担。

方法

在患者、临床专家和甲状旁腺功能减退症协会的参与下开发了一种基于网络的工具。符合条件的参与者年龄≥18岁,被诊断为甲状旁腺功能减退症≥6个月,且为美国居民。问题集中在人口统计学、诊断认知、当前态度、医疗管理、当前症状、急性发作、合并症、个人生活和就业方面。

结果

共有374名甲状旁腺功能减退症成人患者(平均年龄49±12岁;女性占85%)完成了调查(平均病程13±12年;重症患者占30.5%)。患者报告在诊断前后平均看了6±8位医生。大多数患者强烈同意在诊断时对管理病情毫无准备(56%),控制甲状旁腺功能减退症比预期更难(60%),并且担心当前药物的长期并发症(75%)。尽管有当前的治疗方案,但72%的患者在过去12个月中经历了10多种症状。症状平均每天出现13±9小时。79%的患者需要住院或去急诊科就诊。45%的患者报告对其生活有重大干扰,85%的患者报告无法进行家务活动,20%的患者经历了与疾病相关的就业状态变化。

结论

甲状旁腺功能减退症患者疾病负担高,症状范围广泛,对其生活有多方面影响。

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