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利用韩国6年的国民健康保险理赔数据研究药物过敏反应的流行病学。

Epidemiology of drug hypersensitivity reactions using 6-year national health insurance claim data from Korea.

作者信息

Han JaeEun, Ye Young-Min, Lee Sukhyang

机构信息

Division of Clinical Pharmacy, College of Pharmacy, Ajou University, Suwon, Republic of Korea.

Department of Pharmacy, Ajou University Hospital, Suwon, Republic of Korea.

出版信息

Int J Clin Pharm. 2018 Oct;40(5):1359-1371. doi: 10.1007/s11096-018-0625-9. Epub 2018 Apr 2.

Abstract

Background Drug hypersensitivity reactions (DHRs) constitute a large portion of adverse drug reactions (ADRs), but studies for DHR incidence based on national data are scarce. Objective This study aimed to estimate the incidence and patterns of DHRs in a Korean population and the associated utilization of medical resources using the national claims data. Setting The retrospective cohort study performed using the national insurance claim database of the Health Insurance Review and Assessment (HIRA) in Korea. Methods The International Classification of Disease 10th revision code was used to identify DHRs with 20 drug induced DHR codes. The claim data with a diagnosis of DHR in the 2009-2014 periods were analyzed. Main outcome and measure The annual incidence and the 6-year incidence rates were calculated. Incidence rate coefficients were analyzed by sex, age, and year. DHRs following with visits of emergency department (ED) or intensive care unit (ICU) were assessed for utilization of medical resources and risk of ER or ICU visits by sex and age Results A total of 535,049 patients with 1,083,507 claims were assessed in the HIRA database for 6 years. DHR incidence was high in the elderly. The risk of ED and ICU visit with DHR was also higher in the elderly than in the young [highest relative risk, RR of ED 2.59 (1.65-4.07), ICU 5.04 (2.50-10.18)]. DHRs related to blood were high in the young age. Conclusion Incidence of DHRs in the real-world clinical practice was higher in the elderly and female. Clinical consequence was more severe in the elderly.

摘要

背景 药物过敏反应(DHRs)在药物不良反应(ADRs)中占很大比例,但基于全国数据的DHRs发病率研究却很少。目的 本研究旨在利用全国索赔数据估计韩国人群中DHRs的发病率、模式以及相关医疗资源的利用情况。设置 使用韩国健康保险审查与评估机构(HIRA)的国民保险索赔数据库进行回顾性队列研究。方法 使用国际疾病分类第10版代码,通过20个药物诱导的DHR代码来识别DHRs。对2009 - 2014年期间诊断为DHR的索赔数据进行分析。主要结局和指标 计算年发病率和6年发病率。按性别、年龄和年份分析发病率系数。对因DHR就诊于急诊科(ED)或重症监护病房(ICU)的情况,评估其医疗资源利用情况以及按性别和年龄划分的急诊或ICU就诊风险。结果 在HIRA数据库中,6年共评估了535,049例患者的1,083,507份索赔。老年人中DHR发病率较高。老年人因DHR就诊于ED和ICU的风险也高于年轻人[最高相对风险,ED的RR为2.59(1.65 - 4.07),ICU的RR为5.04(2.50 - 10.18)]。年轻人中与血液相关的DHRs较多。结论 在现实世界的临床实践中,DHRs的发病率在老年人和女性中较高。老年人的临床后果更严重。

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