Global Patient Outcomes and Real-World Evidence, Eli Lilly and Company, Indianapolis, IN, USA.
Real-World Evidence, Cerner Enviza, Malvern, PA, USA.
Curr Med Res Opin. 2022 Apr;38(4):541-551. doi: 10.1080/03007995.2022.2043655. Epub 2022 Mar 4.
Few studies have examined the association between inflammatory bowel disease (IBD) severity, and humanistic, and economic burden. We addressed this gap using a unique real-world data source that links self-reported patient data from the US National Health and Wellness Survey (NHWS) to claims data.
This cross-sectional study linked the 2015-2018 US NHWS data with medical, and pharmacy claims. Patients (≥18 years) who self-reported a physician diagnosis of IBD (ulcerative colitis [UC], or Crohn's disease [CD]) in the NHWS, and had a medical or pharmacy claim indicating a possible diagnosis of IBD were included. Disease symptom severity was defined by a weighted symptom score and main outcomes include health-related quality of life (HRQoL), work productivity (WPAI), healthcare resource use (HRU), and associated costs.
Overall, 687 patients with IBD were included, of which 347 were identified with UC and 340 with CD. Validation analysis showed that 94.7% of UC and 88.7% of patients with CD who self-reported diagnosis of CD or UC in NHWS had evidence of diagnosis and/or treatment patterns in claims. Patients with both UC and CD with moderate or severe symptoms had significantly lower HRQoL, increased work productivity loss, greater HRU, and associated costs compared with patients with mild symptoms.
Patients with moderate/severe UC or CD experience substantial humanistic, and economic burden compared with patients with mild UC or CD. These factors should be considered within treatment goals for patients in order to provide holistic care beyond the treatment of objective markers or disease severity and symptoms alone.
很少有研究探讨炎症性肠病(IBD)的严重程度与人文和经济负担之间的关系。我们利用一个独特的真实世界数据源来解决这一差距,该数据源将来自美国国家健康和健康调查(NHWS)的自我报告患者数据与索赔数据联系起来。
这项横断面研究将 2015-2018 年美国 NHWS 数据与医疗和药房索赔数据相联系。在 NHWS 中自我报告有医生诊断为 IBD(溃疡性结肠炎[UC]或克罗恩病[CD])的患者,并且有医疗或药房索赔表明可能诊断为 IBD 的患者被纳入研究。疾病症状严重程度由加权症状评分定义,主要结局包括健康相关生活质量(HRQoL)、工作生产力(WPAI)、医疗资源利用(HRU)和相关成本。
共有 687 例 IBD 患者被纳入研究,其中 347 例被诊断为 UC,340 例被诊断为 CD。验证性分析显示,在 NHWS 中自我报告诊断为 UC 或 CD 的 UC 患者中有 94.7%和 CD 患者中有 88.7%有诊断和/或治疗模式的证据。与轻度症状患者相比,中重度症状的 UC 和 CD 患者的 HRQoL 显著降低,工作生产力损失增加,HRU 增加,相关成本增加。
与轻度 UC 或 CD 患者相比,中重度 UC 或 CD 患者经历了更大的人文和经济负担。在为患者制定治疗目标时,应考虑这些因素,以便提供超越单纯治疗客观标志物或疾病严重程度和症状的整体护理。