Aygören-Pürsün Emel, Bygum Anette, Beusterien Kathleen, Hautamaki Emily, Sisic Zlatko, Wait Suzanne, Boysen Henrik B, Caballero Teresa
Department for Children and Adolescents, Angioedema Centre, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany.
Orphanet J Rare Dis. 2014 Jul 4;9:99. doi: 10.1186/1750-1172-9-99.
Hereditary angioedema (HAE) due to C1 inhibitor deficiency is a rare but serious and potentially life-threatening disease marked by spontaneous, recurrent attacks of swelling. The study objective was to characterize direct and indirect resource utilization associated with HAE from the patient perspective in Europe.
The study was conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE via a cross-sectional survey of HAE patients, including direct and indirect resource utilization during and between attacks for patients and their caregivers over the past 6 months. A regression model examined predictors of medical resource utilization.
Overall, 164 patients had an attack in the past 6 months and were included in the analysis. The most significant predictor of medical resource utilization was the severity of the last attack (OR 2.6; p < 0.001). Among patients who sought medical care during the last attack (23%), more than half utilized the emergency department. The last attack prevented patients from their normal activities an average of 4-12 hours. Patient and caregiver absenteeism increased with attack severity and frequency. Among patients who were working or in school (n = 120), 72 provided work/school absenteeism data, resulting in an estimated 20 days missing from work/school on average per year; 51% (n = 84) indicated that HAE has hindered their career/educational advancement.
HAE poses a considerable burden on patients and their families in terms of direct medical costs and indirect costs related to lost productivity. This burden is substantial at the time of attacks and in between attacks.
由于C1抑制剂缺乏导致的遗传性血管性水肿(HAE)是一种罕见但严重且可能危及生命的疾病,其特征为自发性、复发性肿胀发作。本研究的目的是从患者角度描述欧洲与HAE相关的直接和间接资源利用情况。
该研究在西班牙、德国和丹麦进行,通过对HAE患者的横断面调查评估HAE的实际情况,包括患者及其护理人员在过去6个月发作期间及发作间隔的直接和间接资源利用情况。采用回归模型检验医疗资源利用的预测因素。
总体而言,164例患者在过去6个月内有发作并纳入分析。医疗资源利用的最显著预测因素是上次发作的严重程度(比值比2.6;p < 0.001)。在上次发作时寻求医疗护理的患者中(23%),超过一半的人使用了急诊科。上次发作使患者平均有4 - 12小时无法进行正常活动。患者和护理人员的缺勤率随发作严重程度和频率增加。在工作或上学的患者中(n = 120),72例提供了工作/学校缺勤数据,平均每年估计有20天缺勤;51%(n = 84)表示HAE阻碍了他们的职业/教育发展。
HAE在直接医疗费用以及与生产力损失相关的间接费用方面给患者及其家庭带来了相当大的负担。这种负担在发作时和发作间隔期间都很大。