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药物遗传学检测对减少双相情感障碍患者急诊就诊次数和住院天数的影响:一项为期两年的对照分析

Pharmacogenetic Tests in Reducing Accesses to Emergency Services and Days of Hospitalization in Bipolar Disorder: A 2-Year Mirror Analysis.

作者信息

Callegari Camilla, Isella Celeste, Caselli Ivano, Poloni Nicola, Ielmini Marta

机构信息

Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, 21100 Varese, Italy.

出版信息

J Pers Med. 2019 Apr 30;9(2):22. doi: 10.3390/jpm9020022.

Abstract

Despite the enormous costs associated to mood disorders', few studies evaluate potential cost saving from the use of pharmacogenetic tests (PGT). This study compares 12 months before the execution of the PGT versus 12 months after, in terms of number and days of hospitalization and accesses to emergency services, in a sample of 30 patients affected by bipolar disorder. Secondarily, the study gives an economic value to the data based on the diagnosis-related group (DRG). Patients included in the study were required to be aged ≥18 years, sign an informed consent, have a score of Clinical Global Impression item Severity (CGIs) ≥3, and have a discordant therapy compared to the PGT in the 12 months preceding it and a therapy consistent with it for the following 12 months. Cost saving has been evaluated by paired -tests in a mirror analysis. Statistically significant differences in all the comparisons ( < 0.0001) emerged. Important cost saving emerged after the use of PGT (€148,920 the first year versus €39,048 the following year). Despite the small sample size and lack of a control group in this study, the potential role of PGT in cost saving for the treatment of bipolar disorder treatment emerged. To confirm this result, larger and clinical trials are needed.

摘要

尽管情绪障碍相关成本巨大,但很少有研究评估使用药物遗传学检测(PGT)可能节省的成本。本研究比较了30例双相情感障碍患者在进行PGT前12个月与之后12个月的住院次数、住院天数以及急诊服务使用情况。其次,该研究根据诊断相关组(DRG)对数据赋予经济价值。纳入研究的患者要求年龄≥18岁,签署知情同意书,临床总体印象严重程度(CGIs)评分≥3,且在进行PGT前12个月的治疗与PGT结果不一致,而在之后12个月的治疗与PGT结果一致。通过配对检验在镜像分析中评估成本节省情况。所有比较均出现统计学显著差异(<0.0001)。使用PGT后出现了显著的成本节省(第一年为148,920欧元,次年为39,048欧元)。尽管本研究样本量小且缺乏对照组,但PGT在双相情感障碍治疗成本节省方面的潜在作用显现出来。为证实这一结果,需要开展更大规模的临床试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1591/6617043/39c3ee8d108c/jpm-09-00022-g001.jpg

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