Anlitiks Inc., Windermere, FL USA.
Medical Affairs, Acadia Pharmaceuticals Inc., San Diego, CA USA.
J Comp Eff Res. 2024 Jul;13(7):e240038. doi: 10.57264/cer-2024-0038. Epub 2024 Jun 8.
Real-world healthcare resource use (HCRU) burden among patients with Parkinson's disease psychosis (PDP) treated with pimavanserin (PIM) versus other atypical antipsychotics (other-AAPs) including quetiapine (QUE) in long term care (LTC) and nursing home (NH) settings are lacking. This analysis examines HCRU differences among residents in LTC/NH settings who initiate PIM versus QUE or other-AAPs. A retrospective analysis of LTC/NH residents with PDP from the 100% Medicare claims between 1 April 2015 and 31 December 2021 was conducted. Treatment-naive residents who initiated ≥6 months continuous monotherapy with PIM or QUE or other-AAPs between 04/01/16 and 06/30/2021 were propensity score matched (PSM) 1:1 using 31 variables (age, sex, race, region and 27 Elixhauser comorbidity characteristics). Post-index (i.e., 6 months) HCRU outcomes included: proportion of residents with ≥1 all-cause inpatient (IP) hospitalizations and emergency room (ER) visits. HCRU differences were assessed via log binomial regression and reported as relative risk ratios (RR) and 95% confidence intervals after controlling for dementia, insomnia and index year. From a total of PIM (n = 1827), QUE (n = 7770) or other-AAPs (n = 9557), 1:1 matched sample (n = 1827) in each cohort were selected. All-cause IP hospitalizations (PIM [29.8%]) versus QUE [36.7%]) and ER visits (PIM [47.3%] versus QUE [55.8%]), respectively, were significantly lower for PIM. PIM versus QUE cohort also had significantly lower RR for all-cause IP hospitalizations and ER visits, respectively, (IP hospitalizations RR: 0.82 [0.75. 0.9]; ER visits RR: 0.85 [0.8. 0.9]). PIM versus other-AAPs also had lower likelihood of HCRU outcomes. In this analysis, LTC/NH residents on PIM monotherapy (versus QUE) had a lower likelihood of all-cause hospitalizations (18%) and ER (15%) visits. In this setting, PIM also had lower likelihood of all-cause HCRU versus other-AAPs.
在长期护理（LTC）和养老院（NH）环境中，接受吡莫烷（PIM）治疗的帕金森病精神病（PDP）患者与接受喹硫平（QUE）等其他非典型抗精神病药物（other-AAPs）治疗的患者相比，其真实世界的医疗资源使用（HCRU）负担缺乏相关研究。本分析考察了在 LTC/NH 环境中，起始接受 PIM 治疗的患者与起始接受 QUE 或其他 AAPs 治疗的患者之间的 HCRU 差异。 本研究对 2015 年 4 月 1 日至 2021 年 12 月 31 日期间 100%医疗保险索赔中的 LTC/NH 居民进行了一项回顾性分析，纳入了 PDP 治疗初治患者，这些患者在 2016 年 4 月 1 日至 2021 年 6 月 30 日期间，至少接受了 6 个月的连续单药治疗，治疗药物为 PIM 或 QUE 或其他 AAPs。使用 31 个变量（年龄、性别、种族、地区和 27 个 Elixhauser 合并症特征）对患者进行倾向评分匹配（PSM）1:1 分析。索引后（即 6 个月）的 HCRU 结局包括：≥1 次全因住院（IP）和急诊室（ER）就诊的患者比例。通过对数二项式回归评估 HCRU 差异，并在控制痴呆、失眠和索引年后，以相对风险比（RR）和 95%置信区间（CI）报告。 在 PIM（n=1827）、QUE（n=7770）或其他 AAPs（n=9557）中，每个队列均选择了 1:1 匹配的样本（n=1827）。与 QUE 队列相比，PIM 队列的全因 IP 住院（PIM [29.8%] 与 QUE [36.7%]）和 ER 就诊（PIM [47.3%] 与 QUE [55.8%]）的比例均显著降低。与 QUE 队列相比，PIM 队列的全因 IP 住院和 ER 就诊的 RR 也显著降低，分别为（IP 住院 RR：0.82 [0.75. 0.9]；ER 就诊 RR：0.85 [0.8. 0.9]）。与其他 AAPs 相比，PIM 也降低了 HCRU 结局的发生风险。 在这项分析中，接受 PIM 单药治疗的 LTC/NH 居民（与 QUE 相比）全因住院（18%）和 ER（15%）就诊的可能性较低。在这种情况下，与其他 AAPs 相比，PIM 发生全因 HCRU 的可能性也较低。
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