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以色列迟发性运动障碍的临床和经济负担:真实世界数据分析。

The Clinical and Economic Burden of Tardive Dyskinesia in Israel: Real-World Data Analysis.

机构信息

From the Maccabi Institute for Research and Innovation, Maccabi Healthcare Services.

Teva Pharmaceutical Industries, Ltd, Global Health Economics and Outcomes Research.

出版信息

J Clin Psychopharmacol. 2022;42(5):454-460. doi: 10.1097/JCP.0000000000001597. Epub 2022 Aug 20.

Abstract

PURPOSE/BACKGROUND: Tardive dyskinesia (TD) is a hyperkinetic movement disorder caused by exposure to dopamine-receptor blockers. Data on TD burden in Israel are scarce. This analysis assesses the clinical and economic burden of TD in Israeli patients.

METHODS/PROCEDURES: This retrospective analysis used a national health plan database (Maccabi Healthcare Services), representing 25% of the Israeli population. The study included adults alive at index date with an International Classification of Diseases, Ninth Revision, Clinical Modification TD diagnosis before 2018 and more than or equal to 1-year enrollment before diagnosis. Tardive dyskinesia patients were matched to non-TD patients (1:3) by underlying psychiatric condition, birth year, and sex. Treatment patterns and 2018 annual health care resource utilization and costs were assessed.

FINDINGS/RESULTS: Of 454 TD patients alive between 2013 and 2018, 333 alive on January 1, 2018, were matched to 999 non-TD patients. At baseline, TD patients had lower socioeconomic status and higher proportion of chronic kidney disease and antipsychotic medication use; all analyses were adjusted accordingly. Tardive dyskinesia patients had significantly more visits to general physicians, neurologists, psychiatrists, physiotherapists, and emergency departments versus non-TD patients (all P < 0.05). Tardive dyskinesia patients also had significantly longer hospital stays than non-TD patients ( P = 0.003). Total healthcare and medication costs per patient were significantly higher in the TD versus non-TD population (US $11,079 vs US $7145, P = 0.018).

IMPLICATIONS/CONCLUSIONS: Israeli TD patients have higher clinical and economic burden than non-TD patients. Understanding real-world health care resource utilization and costs allows clinicians and decision makers to quantify TD burden and prioritize resources for TD patients' treatment.

摘要

目的/背景:迟发性运动障碍(TD)是一种由多巴胺受体阻滞剂暴露引起的多动障碍。以色列关于 TD 负担的数据很少。本分析评估了以色列患者 TD 的临床和经济负担。

方法/程序:本回顾性分析使用了一个国家健康计划数据库(Maccabi Healthcare Services),该数据库代表了以色列 25%的人口。研究包括在索引日期之前患有国际疾病分类第 9 修订版临床修正版 TD 诊断的成年人,且在诊断前有至少 1 年的登记。TD 患者与非 TD 患者(1:3)按潜在精神疾病、出生年份和性别匹配。评估了 2018 年的治疗模式和年度医疗资源利用和成本。

结果/发现:在 2013 年至 2018 年期间存活的 454 名 TD 患者中,有 333 名患者在 2018 年 1 月 1 日存活,与 999 名非 TD 患者相匹配。在基线时,TD 患者的社会经济地位较低,慢性肾脏病和抗精神病药物使用比例较高;所有分析均相应调整。与非 TD 患者相比,TD 患者看全科医生、神经科医生、精神科医生、物理治疗师和急诊部的次数明显更多(所有 P < 0.05)。TD 患者的住院时间也明显长于非 TD 患者(P = 0.003)。TD 组患者的每位患者总医疗和药物费用明显高于非 TD 组(US $11,079 比 US $7145,P = 0.018)。

结论

以色列 TD 患者的临床和经济负担比非 TD 患者高。了解实际医疗资源的利用和成本使临床医生和决策者能够量化 TD 负担,并为 TD 患者的治疗优先分配资源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8db/9426751/437fd93b3688/jcp-42-454-g001.jpg

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