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疼痛性糖尿病周围神经病变患者所经历的临床和经济负担:一项使用日本索赔数据库的观察性研究。

Clinical and economic burdens experienced by patients with painful diabetic peripheral neuropathy: An observational study using a Japanese claims database.

作者信息

Ebata-Kogure Nozomi, Nozawa Kazutaka, Murakami Aya, Toyoda Tetsumi, Haga Yuri, Fujii Koichi

机构信息

Pfizer Japan, Tokyo, Japan.

Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan.

出版信息

PLoS One. 2017 Oct 27;12(10):e0187250. doi: 10.1371/journal.pone.0187250. eCollection 2017.

Abstract

BACKGROUND

Diabetic peripheral neuropathy (DPN) may often be painful. Despite the high prevalence of painful DPN (pDPN) among patients with diabetes mellitus (DM), understanding of its clinical and economic burden is limited. This study aimed to describe the clinical and economic burdens faced by patients with pDPN in Japan, and compared them with those experienced by patients with DPN but without painful symptoms (non-pDPN).

METHODS

This retrospective, observational study used data from a large-scale, hospital-based Japanese claims database collected from April 2008 to June 2015. Comorbidities, clinical departments visited, length of hospital stay, and medical costs for the period of ± 6 months from the diagnosis of pDPN or non-pDPN were described for each group. Glycemic control status was examined for each group for patients with glycated hemoglobin data.

RESULTS

The data of 8,740 patients with pDPN (mean age 70.0 years, 53.4% male) and 12,592 patients with non-pDPN (mean age 67.7 years, 55.7% male) were analyzed. Patients with pDPN had more comorbidities than patients with non-pDPN; 48.7% and 30.9% of patients in the respective groups had 20 or more comorbidities. The median length of hospital stay was 5 days longer in patients with pDPN. The median total medical costs were higher in patients with pDPN (\517,762) than in patients with non-pDPN (\359,909). Patients with pDPN spent higher median costs for medications, but the costs for glycemic control drugs were similar in both groups. For 3,372 patients with glycated hemoglobin data, glycemic control was similar between the two groups.

CONCLUSION

Patients with pDPN experienced greater clinical and economic burdens than patients with non-pDPN, suggesting that patients who develop pDPN may suffer not only from the complications of DM and pain, but also from other comorbid disorders.

摘要

背景

糖尿病周围神经病变(DPN)常伴有疼痛。尽管糖尿病(DM)患者中疼痛性DPN(pDPN)的患病率很高,但对其临床和经济负担的了解有限。本研究旨在描述日本pDPN患者所面临的临床和经济负担,并将其与无疼痛症状的DPN患者(非pDPN)所经历的负担进行比较。

方法

这项回顾性观察性研究使用了2008年4月至2015年6月期间从一个基于医院的大型日本索赔数据库中收集的数据。描述了每组从pDPN或非pDPN诊断起±6个月期间的合并症、就诊临床科室、住院时间和医疗费用。对有糖化血红蛋白数据的患者,检查了每组的血糖控制状况。

结果

分析了8740例pDPN患者(平均年龄70.0岁,男性占53.4%)和12592例非pDPN患者(平均年龄67.7岁,男性占55.7%)的数据。pDPN患者的合并症比非pDPN患者更多;各组中分别有48.7%和30.9%的患者有20种或更多合并症。pDPN患者的中位住院时间长5天。pDPN患者的中位总医疗费用(517,762日元)高于非pDPN患者(359,909日元)。pDPN患者的药物中位费用更高,但两组的血糖控制药物费用相似。对于3372例有糖化血红蛋白数据的患者,两组的血糖控制情况相似。

结论

pDPN患者比非pDPN患者承受着更大的临床和经济负担,这表明发生pDPN的患者可能不仅遭受DM并发症和疼痛之苦,还会受到其他合并症的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a76/5659791/61325526568c/pone.0187250.g001.jpg

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