Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey.
Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey.
复制标题
DOI：
10.2147/dmso.s37415
复制
发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Tuchman M
中科院分区：
文献类型：
--
作者：
Sadosky A;Schaefer C;Mann R;Bergstrom F;Baik R;Parsons B;Nalamachu S;Nieshoff E;Stacey BR;Anschel A;Tuchman M
本研究的目的是了解在美国寻求治疗的患有疼痛性糖尿病周围神经病变 (pDPN) 的成年受试者的疾病负担。这项观察性研究招募了 112 名患有 pDPN 的受试者，这些受试者是在全科医生和专科机构的例行访视中进行的。受试者完成了一份一次性问卷，其中包括人口统计数据、症状持续时间、医疗保健资源使用、自付费用、就业状况以及评估疼痛、功能、睡眠、焦虑和抑郁、健康状况和生产力的有效措施。研究人员根据 6 个月的回顾性图表审查填写了病例报告表，以获取过去 6 个月的临床信息、pDPN 相关治疗以及其他 pDPN 相关医疗资源使用情况。年化费用是根据报告的 6 个月医疗保健资源使用情况推断的。受试者的平均年龄为 61.1 岁，其中 52.7% 为女性，17.9% 从事有偿工作。最常见的合并症是睡眠障碍/失眠（43.8%）、抑郁症状（41.1%）和焦虑（35.7%）。平均疼痛严重程度评分为 5.2（0-10 分），79.5% 的患者报告中度或重度疼痛。疼痛对功能的平均干扰评分总体为 5.0（0-10 级），其中轻度为 2.0，中度为 5.1，重度为 7.0。医疗结果研究睡眠问题指数平均得分为 48.5（0-100 分）。平均健康状态效用得分为 0.61。在受薪对象中，平均总体工作障碍为 43.6%。在所有受试者中，平均总体活动障碍为 52.3%。总共，81.3% 的人为其 pDPN 至少开了一种药物； 50.9% 的人报告至少服用一种非处方药。每个受试者的调整后平均年化总直接和间接成本分别为 4841 美元和 9730 美元。疼痛较严重的受试者中，与疼痛对功能、睡眠、健康状况、活动障碍、处方药使用以及直接和间接成本的干扰相关的结果显着更差（P < 0.0020）。患有 pDPN 的受试者表现出较高的疼痛水平，这与睡眠、功能和生产力不佳有关。 pDPN 中医疗保健资源的利用很普遍，并且成本随着疼痛严重程度的增加而增加。疼痛严重程度较高的受试者的 pDPN 负担更大。
The purpose of this study was to characterize the burden of illness among adult subjects with painful diabetic peripheral neuropathy (pDPN) seeking treatment in the US. This observational study recruited 112 subjects with pDPN during routine visits from general practitioner and specialist sites. Subjects completed a one-time questionnaire, which included demographics, symptom duration, health care resource use, out-of-pocket costs, employment status, and validated measures that assessed pain, functioning, sleep, anxiety and depression, health status, and productivity. Investigators completed a case report form based on a 6-month retrospective chart review to capture clinical information, pDPN-related treatments, and other pDPN-related health care resource use over the past 6 months. Annualized costs were extrapolated based on reported 6-month health care resource use. The mean age of the subjects was 61.1 years, 52.7% were female, and 17.9% were in paid employment. The most common comorbid conditions were sleep disturbance/insomnia (43.8%), depressive symptoms (41.1%), and anxiety (35.7%). The mean pain severity score was 5.2 (0–10 scale), and 79.5% reported moderate or severe pain. The mean pain interference with function score was 5.0 (0–10 scale) overall, with 2.0 among mild, 5.1 among moderate, and 7.0 among severe. The mean Medical Outcomes Study sleep problems index score was 48.5 (0–100 scale). The mean health state utility score was 0.61. Among subjects employed for pay, mean overall work impairment was 43.6%. Across all subjects, mean overall activity impairment was 52.3%. In total, 81.3% were prescribed at least one medication for their pDPN; 50.9% reported taking at least one nonprescription medication. Adjusted mean annualized total direct and indirect costs per subject were $4841 and $9730, respectively. Outcomes related to pain interference with function, sleep, health status, activity impairment, prescription medication use, and direct and indirect costs were significantly worse among subjects with more severe pain (P < 0.0020). Subjects with pDPN exhibited high pain levels, which were associated with poor sleep, function, and productivity. Health care resource utilization in pDPN was prevalent and costs increased with greater pain severity. The burden of pDPN was greater among subjects with greater pain severity.