مورد إلكتروني
Lupus Low Disease Activity State and Reduced Direct Health Care Costs in Patients With Systemic Lupus Erythematosus.
| العنوان: | Lupus Low Disease Activity State and Reduced Direct Health Care Costs in Patients With Systemic Lupus Erythematosus. |
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| بيانات النشر: | John Wiley and Sons Inc (E-mail: info@wiley.com) United States 2020-10-15 |
| تفاصيل مُضافة: | Kandane-Rathnayake R. Huq M. Yeo A.L. Hammond E. Nab H. Nikpour M. Morand E.F. Hoi A. Golder V. Koelmeyer R. |
| نوع الوثيقة: | Electronic Resource |
| مستخلص: | Objective: Treat-to-target end points for systemic lupus erythematosus (SLE) have been assessed for their impact on damage accrual and flare, but whether they have an impact on the high health care utilization and costs in SLE has not been studied. The purpose of this study was to examine our hypothesis that the recently described lupus low disease activity state (LLDAS) would be associated with reduced health care cost. Method(s): Data from a single tertiary hospital longitudinal SLE cohort were assessed. Baseline demographics, disease activity (Systemic Lupus Erythematosus Disease Activity Index 2000 [SLEDAI-2K], physician global assessment [PhGA], and flare index), and medication use were evaluated, and direct health care utilization and cost data were obtained from hospital information systems. LLDAS was defined as previously published: briefly, SLEDAI-2K <=4 with no new activity, PhGA <=1, prednisolone <=7.5 mg/day, and optimal standard immunosuppressive agents. Analysis was performed using multivariable linear regression. Result(s): Two hundred SLE patients, contributing 357.8 person-years of observation, were included. A history of lupus nephritis was present in 42% of patients, and damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index >0) was present at study commencement in 57.3% of patients. The mean +/- SD annual direct medical cost per patient was US$7,413 +/- 13,133/year. In multivariable analysis, increased cost was associated with the presence of baseline organ damage (41.7% increase; P = 0.009) and corticosteroid use (>7.5-15 mg/day: 55.7% increase; P = 0.02; and >15 mg/day: 202% increase; P < 0.001). In contrast, spending >=50% of the observation period in LLDAS was associated with a 25.9% reduction in annual direct medical cost (P = 0.04). Conclusion(s): Greater time spent in LLDAS was associated with significantly reduced direct hospital health care costs among patients with SLE.Copyright © 2019 |
| مصطلحات الفهرس: | immunosuppressive agent/pe [Pharmacoeconomics], prednisolone/dt [Drug Therapy], prednisolone/pe [Pharmacoeconomics], American College of Rheumatology Damage Index, flare index, lupus low disease activity state, Physician Global Assessment, Systemic Lupus International Collaborating Clinic, human, adult, article, cohort analysis, controlled study, demography, drug cost, drug use, female, health care cost, health care utilization, hospital information system, longitudinal study, lupus erythematosus nephritis, major clinical study, male, medical history, scoring system, SLEDAI, systemic lupus erythematosus/dm [Disease Management], systemic lupus erythematosus/dt [Drug Therapy], tertiary care center, immunosuppressive agent/dt [Drug Therapy], Article |
| URL: | Arthritis Care and Research LibKey Link |
| الإتاحة: | Open access content. Open access content Copyright 2020 Elsevier B.V., All rights reserved. |
| أرقام أخرى: | AUSHL oai:repository.monashhealth.org:1/29084 Arthritis Care and Research. 72 (9) (pp 1289-1295), 2020. Date of Publication: 01 Sep 2020. 2151-464X https://repository.monashhealth.org/monashhealthjspui/handle/1/29084 31282076 [http://www.ncbi.nlm.nih.gov/pubmed/?term=31282076] 2006019821 (Yeo, Golder, Hoi, Morand) Monash University and Monash Health, Clayton, VIC, Australia (Koelmeyer, Kandane-Rathnayake) Monash University, Clayton, VIC, Australia (Huq) University of Melbourne, Parkville, Monash University, Clayton, and St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia (Hammond, Nab) AstraZeneca, Gaithersburg, Maryland, and AstraZeneca, Cambridge, United Kingdom (Nikpour) University of Melbourne, Parkville, and St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia Yeo A.L.; aili.yeo@monash.edu 1305120061 |
| المصدر المساهم: | MONASH HEALTH LIBRS From OAIster®, provided by the OCLC Cooperative. |
| رقم الأكسشن: | edsoai.on1305120061 |
| قاعدة البيانات: | OAIster |
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