Department of Psychology,Utah State University,Logan,UT,USA.
Department of Health Outcomes and Administrative Services,Binghamton University State University of New York,Binghamton,NY,USA.
Int Psychogeriatr. 2018 Oct;30(10):1499-1507. doi: 10.1017/S104161021800011X. Epub 2018 Mar 21.
UNLABELLED: ABSTRACTBackground:The use of FDA approved medications for Alzheimer's disease [AD; FDAAMAD; (cholinesterase inhibitors and N-methyl-D-aspartate receptor antagonists)] has been associated with symptomatic benefit with a reduction in formal (paid services) and total costs of care (formal and informal costs). We examined the use of these medications and their association with informal costs in persons with dementia. METHOD: Two hundred eighty participants (53% female, 72% AD) from the longitudinal, population-based Dementia Progression Study in Cache County, Utah (USA) were followed up to ten years. Mean (SD) age at baseline was 85.6 (5.5) years. Informal costs (expressed in 2015 dollars) were calculated using the replacement cost method (hours of care multiplied by the median wage in Utah in the visit year) and adjusted for inflation using the Medical Consumer Price Index. Generalized Estimating Equations with a gamma log-link function were used to examine the longitudinal association between use of FDAAMAD and informal costs. RESULTS: The daily informal cost for each participant at baseline ranged from $0 to $318.12, with the sample median of $9.40. Within the entire sample, use of FDAAMAD was not significantly associated with informal costs (expβ = 0.73, p = 0.060). In analyses restricted to participants with mild dementia at baseline (N = 222), use of FDAAMAD was associated with 32% lower costs (expβ = 0.68, p = 0.038). CONCLUSIONS: Use of FDAAMAD was associated with lower informal care costs in those with mild dementia only.
未加标签:
摘要
背景:FDA 批准的用于治疗阿尔茨海默病(AD)的药物(胆碱酯酶抑制剂和 N-甲基-D-天冬氨酸受体拮抗剂)已被证明具有症状缓解作用,可降低正规(付费)护理服务和总护理成本(正规和非正规护理成本)。我们研究了这些药物在痴呆患者中的使用情况及其与非正规护理成本的关系。
方法:来自犹他州卡顿县纵向人群为基础的痴呆进展研究(美国)的 280 名参与者(53%为女性,72%为 AD)进行了长达十年的随访。基线时的平均(SD)年龄为 85.6(5.5)岁。非正规护理成本(以 2015 年美元表示)采用重置成本法(护理时间乘以访问年份犹他州的中位数工资)计算,并使用医疗消费者价格指数进行通货膨胀调整。使用广义估计方程和伽马对数链接函数来检验 FDAAMAD 使用与非正规护理成本之间的纵向关联。
结果:每个参与者在基线时的每日非正规护理成本范围从 0 美元到 318.12 美元,样本中位数为 9.40 美元。在整个样本中,FDAAMAD 的使用与非正规护理成本无显著关联(expβ=0.73,p=0.060)。在仅基线时患有轻度痴呆的参与者(N=222)的分析中,FDAAMAD 的使用与成本降低 32%相关(expβ=0.68,p=0.038)。
结论:仅在轻度痴呆患者中,FDAAMAD 的使用与较低的非正规护理成本相关。
Alzheimers Dement. 2015-8
J Alzheimers Dis. 2016-10-18
J Prev Alzheimers Dis. 2018
J Gerontol B Psychol Sci Soc Sci. 2001-7
Molecules. 2023-1-28
Front Neurosci. 2020-6-30
Acta Pharmacol Sin. 2020-7
Alzheimers Dement. 2016-4
Alzheimers Dement. 2015-8
J Am Geriatr Soc. 2013-4-16
N Engl J Med. 2013-4-4
Alzheimers Dement. 2012-10-24
Int Psychogeriatr. 2012-6-12
Am J Manag Care. 2011-11