Retrospective Observational Studies, Evidera, London, UK.
Ipsen Pharma, Boulogne-Billancourt, France.
Neuropsychiatr Dis Treat. 2015 Mar 9;11:647-55. doi: 10.2147/NDT.S78618. eCollection 2015.
Cervical dystonia (CD) is a hypertonic condition caused by damage to the central nervous system. Very few studies have assessed the overall economic burden of the disease. The objective of this study was to describe the utilization of health care resources of patients with CD in the UK primary care setting, using a large population-based database.
Adults with a first diagnosis of CD between January 1, 2007 and January 31, 2011, who were registered to a general practitioner (GP) practice contributing to The Health Improvement Network (THIN), were included. Sociodemographic and clinical characteristics were assessed at the time of diagnosis. Health care resource utilization and pharmacological treatment were investigated at the end of the first and second year after diagnosis.
Overall, 4,024 newly diagnosed patients with CD were identified, with average age at diagnosis of 45 years old; 65.3% were female. Depression in the year prior to diagnosis was the most common comorbidity. Primary care utilization was high in the first year, with 99.2% of patients visiting their GP (on average 6.2 times), and 43% visiting a nurse (on average 2.5 times). Patients were most commonly referred to an orthopedic surgeon, and 15.9% reported at least one physiotherapy visit. In the second year, utilization was similar. Prescriptions of at least one of the investigated treatments were found in 82.0% and 45.3%, in the first and second year, respectively.
Findings suggest a high number of new CD cases are being identified in primary care, but not all will be referred to secondary care. Health care resource utilization was compared with that of all patients registered in THIN, which is representative of the UK, and the adjusted usage of primary care resources was found to be similar to that of the THIN population.
颈肌张力障碍(CD)是一种由中枢神经系统损伤引起的高紧张状态。很少有研究评估该疾病的总体经济负担。本研究的目的是使用大型基于人群的数据库描述英国初级保健环境中 CD 患者的卫生保健资源利用情况。
纳入了 2007 年 1 月 1 日至 2011 年 1 月 31 日期间首次被诊断为 CD 且登记在为健康改进网络(THIN)提供服务的全科医生(GP)执业机构的成年人。在诊断时评估了社会人口统计学和临床特征。在诊断后的第一年和第二年结束时,调查了卫生保健资源利用情况和药物治疗情况。
总体而言,共确定了 4024 例新诊断的 CD 患者,诊断时的平均年龄为 45 岁;65.3%为女性。在诊断前一年,抑郁是最常见的合并症。第一年初级保健的利用率很高,99.2%的患者就诊于他们的 GP(平均就诊 6.2 次),43%就诊于护士(平均就诊 2.5 次)。患者最常被转诊给矫形外科医生,15.9%的患者报告至少接受过一次物理治疗。第二年的利用率相似。在第一年和第二年,分别有 82.0%和 45.3%的患者至少使用了一种所调查的治疗方法之一。
研究结果表明,在初级保健中发现了大量新的 CD 病例,但并非所有患者都会被转诊至二级保健。与 THIN 注册的所有患者相比,卫生保健资源的利用情况,THIN 是英国的一个代表性数据库,初级保健资源的调整使用情况与 THIN 人群相似。