Toghanian Samira, Dibonaventura Marco, Järbrink Krister, Locklear Julie C
AstraZeneca R&D, Mölndal, Sweden.
Kantar Health, New York, NY, USA.
Clinicoecon Outcomes Res. 2014 Apr 2;6:151-63. doi: 10.2147/CEOR.S55429. eCollection 2014.
Whilst studies suggest that generalized anxiety disorder (GAD) represents a considerable health care burden in Europe, there is a paucity of published evidence. This study investigated the burden of illness associated with GAD across five European countries (France, Germany, Italy, Spain, and the UK).
Information from the 2008 European National Health and Wellness Survey database was analyzed. Bivariate, multivariate, and cost analyses were used to compare patients with GAD and propensity-matched controls.
Compared with non-GAD controls, patients with GAD had more comorbidities and were more likely to smoke but less likely to be employed, use alcohol, or take exercise. They also had significantly worse health-related quality of life, and significantly greater work impairment and resource use, which increased as GAD severity increased. Within-country analyses demonstrated results similar to those for the five European countries overall, with the largest differences in resource use between patients with GAD and non-GAD controls documented in France and Germany. The average mean differences in direct costs were relatively small between the GAD groups and controls; however, indirect costs differed substantially. Costs were particularly high in Germany, mainly due to higher salaries leading to higher costs associated with absence from work. The limitation of this study was that the data were from a self-reported Internet survey, making them subject to reporting bias and possibly sample bias.
Across all five European countries, GAD had a significant impact on work impairment, resource use, and economic costs, representing a considerable individual and financial burden that increased with severity of disease. These data may help us to understand better the burden and costs associated with GAD.
尽管研究表明广泛性焦虑障碍(GAD)在欧洲构成了相当大的医疗负担,但公开的证据却很少。本研究调查了五个欧洲国家(法国、德国、意大利、西班牙和英国)与GAD相关的疾病负担。
分析了2008年欧洲国民健康与幸福调查数据库中的信息。采用双变量、多变量和成本分析来比较GAD患者和倾向匹配的对照组。
与非GAD对照组相比,GAD患者有更多的合并症,吸烟的可能性更大,但就业、饮酒或锻炼的可能性更小。他们的健康相关生活质量也明显更差,工作障碍和资源利用也明显更大,且随着GAD严重程度的增加而增加。国内分析显示的结果与五个欧洲国家总体情况相似,法国和德国记录的GAD患者与非GAD对照组之间在资源利用方面的差异最大。GAD组与对照组之间的直接成本平均差异相对较小;然而,间接成本差异很大。德国的成本尤其高,主要是因为工资较高,导致与缺勤相关的成本较高。本研究的局限性在于数据来自自我报告的网络调查,因此存在报告偏差和可能的样本偏差。
在所有五个欧洲国家,GAD对工作障碍、资源利用和经济成本都有显著影响,代表了相当大的个人和经济负担,且随着疾病严重程度的增加而增加。这些数据可能有助于我们更好地理解与GAD相关的负担和成本。