Flores Natalia M, Villa Kathleen F, Black Jed, Chervin Ronald D, Witt Edward A
Kantar Health, Foster City, CA.
Jazz Pharmaceuticals, Palo Alto, CA.
J Clin Sleep Med. 2016 Mar;12(3):401-7. doi: 10.5664/jcsm.5594.
To evaluate the burden of narcolepsy--with respect to psychiatric comorbidities, Health-Related Quality of Life (HRQoL), direct costs for healthcare resource utilization, and indirect costs for reported work loss-through comparison of patients to matched controls.
This analysis was conducted on data from the 2011, 2012, and 2013 US National Health and Wellness Survey (NHWS; 2011 NHWS n = 75,000, 2012 NHWS n = 71,157, and 2013 NHWS n = 75,000). Patients who reported a narcolepsy diagnosis (n = 437) were matched 1:2 with controls (n = 874) on age, sex, race/ethnicity, marital status, education, household income, body mass index, smoking status, alcohol use, exercise, and physical comorbidity. Chi-square tests and one-way analyses of variance were used to assess whether the narcolepsy and control groups differed on psychiatric comorbidities, HRQoL, labor force participation, work productivity, and healthcare resource utilization.
Patients with narcolepsy, in comparison to matched controls, reported substantially (two to four times) greater psychiatric comorbidity, HRQoL impairment, prevalence of long-term disability, absenteeism, and presenteeism, and greater resource use in the past 6 mo as indicated by higher mean number of hospitalizations, emergency department visits, traditional healthcare professional visits, neurologist visits, and psychiatrist visits (each p < 0.05).
These population-based data suggest that a narcolepsy diagnosis is associated with substantial adverse impact on mental health, HRQoL, and key economic burdens that include work impairment, resource use, and both direct and indirect costs. Although this study is cross-sectional, the results highlight the magnitude of the potential opportunity to improve mental health, lower costs, and augment work-related productivity through effective assessment and treatment of narcolepsy.
通过将发作性睡病患者与匹配的对照组进行比较,评估发作性睡病在精神疾病共病、健康相关生活质量(HRQoL)、医疗资源利用的直接成本以及报告的工作损失间接成本方面的负担。
本分析使用了2011年、2012年和2013年美国国家健康与健康调查(NHWS;2011年NHWS n = 75,000,2012年NHWS n = 71,157,2013年NHWS n = 75,000)的数据。报告有发作性睡病诊断的患者(n = 437)在年龄、性别、种族/民族、婚姻状况、教育程度、家庭收入、体重指数、吸烟状况、饮酒情况、运动和身体合并症方面与对照组(n = 874)按1:2进行匹配。使用卡方检验和单因素方差分析来评估发作性睡病组和对照组在精神疾病共病、HRQoL、劳动力参与、工作效率和医疗资源利用方面是否存在差异。
与匹配的对照组相比,发作性睡病患者报告的精神疾病共病、HRQoL损害、长期残疾患病率、旷工率和出勤主义显著更高(两到四倍),并且在过去6个月中资源使用更多,表现为住院、急诊就诊、传统医疗专业人员就诊、神经科医生就诊和精神科医生就诊的平均次数更高(每项p < 0.05)。
这些基于人群的数据表明,发作性睡病诊断与对心理健康、HRQoL以及包括工作障碍、资源使用以及直接和间接成本在内的关键经济负担有重大不利影响。尽管本研究是横断面研究,但结果突出了通过对发作性睡病进行有效评估和治疗来改善心理健康、降低成本以及提高与工作相关的生产力的潜在机会的规模。