Health Outcomes Research, Decision Resources Group, Burlington, Massachusetts, USA.
Analytics, Decision Resources Group, Boston, Massachusetts, USA.
JPEN J Parenter Enteral Nutr. 2021 Nov;45(8):1729-1735. doi: 10.1002/jpen.2074. Epub 2021 Mar 18.
Peptide -based (PB) enteral tube feeding (ETF) formulas have been shown to reduce gastrointestinal (GI) intolerance in patients receiving enteral nutrition. However, limited data exist in relation to their use in the postacute/home care setting. We sought to assess the real-world GI tolerance, healthcare utilization, and resource use costs of 100% whey-protein PB ETF in adults in a postacute care setting and describe their demographic, clinical, and treatment characteristics.
Using medical claims data from the United States, we analyzed GI intolerance events occurring in adults receiving 100% whey-protein PB ETF (Peptamen adult formulas) for one year before and after initiation of ETF. Resource use costs were subsequently estimated using a multivariate general linearized model and adjusted for age, gender, and Charlson Comorbidity Index score.
The proportion of adults experiencing no GI intolerance events increased from 41% (418/1022) to 59% (601/1022) in the one-year period after initiation of 100% whey PB ETF (P < .001). The proportion of patients with at least one hospital inpatient visit also decreased from 100% (1022/1022) to 72% (737/1022) over the same period, and the mean number of inpatient visits per patient decreased from 15.6 to 13.0. Cost modeling revealed that outpatient visits accounted for 42% ($1174/$2820) of total estimated healthcare resource costs in the first 30 days after 100% whey PB ETF initiation, with only 9% ($255/$2820) due to emergency room visits.
These 100% whey-protein PB ETF formulas are a valuable nutrition treatment option for patients with or at risk of malnutrition who show intolerance to standard ETF formulas and may reduce hospital inpatient visits and associated costs.
基于肽的(PB)肠内管饲(ETF)配方已被证明可减少接受肠内营养的患者的胃肠道(GI)不耐受。然而,关于其在急性后期/家庭护理环境中的使用,数据有限。我们旨在评估 100%乳清蛋白 PB ETF 在急性后期护理环境中的成年人中的真实世界的 GI 耐受性、医疗保健利用情况和资源使用成本,并描述他们的人口统计学、临床和治疗特征。
使用来自美国的医疗索赔数据,我们分析了在开始 ETF 前一年和后一年接受 100%乳清蛋白 PB ETF(Peptamen 成人配方)的成年人中发生的 GI 不耐受事件。随后使用多元线性广义模型估算资源使用成本,并根据年龄、性别和 Charlson 合并症指数评分进行调整。
在开始使用 100%乳清 PB ETF 的一年内,经历无 GI 不耐受事件的成年人比例从 41%(418/1022)增加到 59%(601/1022)(P<.001)。同一时期,至少有一次住院就诊的患者比例也从 100%(1022/1022)下降到 72%(737/1022),每位患者的平均住院就诊次数从 15.6 次减少到 13.0 次。成本模型显示,在开始使用 100%乳清 PB ETF 后的 30 天内,门诊就诊占总估计医疗资源成本的 42%($1174/$2820),而急诊就诊仅占 9%($255/$2820)。
对于对标准 ETF 配方不耐受或有不耐受风险的营养不良患者,这些 100%乳清蛋白 PB ETF 配方是一种有价值的营养治疗选择,可能会减少住院就诊次数和相关费用。