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探讨血友病治疗对健康相关生活质量的影响。

Examining the impact of haemophilia treatment on health-related quality of life.

机构信息

HCD Economics, Daresbury, UK.

Swedish Orphan Biovitrum Ltd., Cambridgeshire, UK.

出版信息

Haemophilia. 2022 Sep;28(5):796-805. doi: 10.1111/hae.14583. Epub 2022 May 10.

Abstract

INTRODUCTION

Haemophilia has substantial SD effects on health-related quality of life (HRQoL), particularly for people with severe haemophilia. How certain aspects of haemophilia influence HRQoL is not well understood.

AIM

To develop predictive models of variables influencing HRQoL in people with severe haemophilia A or B.

METHODS

We used data from 514 participants with haemophilia A or B who provided EQ-5D-3L responses in the 2015 CHESS study. Treatment was categorized as always been on-demand (POD), previously on prophylaxis and moved to on-demand regimen (SOD), on prophylaxis from diagnosis (PX), and prophylaxis, previously on-demand (PXOD). Target joints were defined as 'locations of chronic synovitis' as reported by the treating physician. Regression models were evaluated to assess the impact of demographic and clinical covariates on HRQoL scores.

RESULTS

Significant covariates were generally consistent across models, with number of target joints, number of hospital admissions, and any haemophilia treatment regimen other than PX all independently negatively impacting estimated EQ-5D score. Higher level of treatment adherence (high vs. low/medium) and use of a prophylaxis treatment regimen had positive effects on estimated EQ-5D scores. Target joints were associated with a 0.04 decrement in EQ-5D score, and high versus low/medium adherence was associated with a 0.06 increment. PXOD, POD, and SOD treatment regimens were associated with decrements in predicted scores of 0.07, 0.09, and 0.08, respectively, versus PX.

CONCLUSION

This study provides a model to estimate the impact of haemophilia interventions on HRQoL, to help assess the relative impact on patient-centric outcomes for this lifelong condition.

摘要

简介

血友病对健康相关生活质量(HRQoL)有显著的 SD 影响,尤其是对重度血友病患者。人们对哪些方面的血友病会影响 HRQoL 并不了解。

目的

建立影响重度 A 型或 B 型血友病患者 HRQoL 的变量预测模型。

方法

我们使用了 2015 年 CHESS 研究中 514 名患有 A 型或 B 型血友病患者的 EQ-5D-3L 应答数据。治疗方法分为按需治疗(POD)、之前使用预防治疗转为按需治疗(SOD)、从确诊开始就使用预防治疗(PX)和预防治疗,之前使用按需治疗(PXOD)。目标关节是根据治疗医生的报告确定的“慢性滑膜炎部位”。回归模型用于评估人口统计学和临床协变量对 HRQoL 评分的影响。

结果

在各个模型中,具有显著意义的协变量通常是一致的,即目标关节数量、住院次数和除 PX 以外的任何血友病治疗方案均独立地对估计的 EQ-5D 评分产生负面影响。更高水平的治疗依从性(高与低/中)和使用预防治疗方案对估计的 EQ-5D 评分有积极影响。目标关节与 EQ-5D 评分下降 0.04 分相关,高与低/中依从性相关与评分增加 0.06 分相关。与 PX 相比,PXOD、POD 和 SOD 治疗方案分别导致预测评分下降 0.07、0.09 和 0.08。

结论

本研究提供了一种估计血友病干预措施对 HRQoL 影响的模型,以帮助评估这种终生疾病对以患者为中心的结局的相对影响。

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