Adherence, persistence, healthcare utilization, and cost benefits of guideline-recommended hepatitis B pharmacotherapy.
Adherence, persistence, healthcare utilization, and cost benefits of guideline-recommended hepatitis B pharmacotherapy.
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DOI：
10.3111/13696998.2012.710690
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发表时间：
2012-01-01
影响因子：
2.4
通讯作者：
Juday, Timothy
中科院分区：
文献类型：
--
作者：
Han, Steven-Huy;Jing, Wuhua;Juday, Timothy
目的：比较美国慢性B型肝炎（CH B）患者开始口服抗病毒药物单药治疗与口服抗病毒药物不推荐作为一线单药治疗的药物治疗依从性、持久性和医疗保健利用/成本。研究设计和方法：在这项回顾性队列研究中，在2005年7月1日至2005年1月31日期间开始口服抗病毒药物单药治疗CHB的18-64岁患者，其中10例来自美国大型商业健康保险索赔数据库。患者连续入组6个月基线期和≥90天随访期。他们被分配到“目前推荐的一线治疗”（RT：恩替卡韦或替诺福韦）或“目前不推荐的一线治疗”主要观察指标：进行多变量分析以比较RT与NRT队列的治疗依从性、持久性、医疗保健利用率和成本。RT（n=825）和NRT（n=916）队列的基线特征相似。在多变量分析中，RT患者的依从性是NRT患者的两倍（OR=2.09; p
OBJECTIVE: To compare pharmacotherapy adherence, persistence, and healthcare utilization/costs among US patients with chronic hepatitis B (CHB) initiated on an oral antiviral monotherapy recommended as first-line treatment by current national (US) guidelines vs an oral antiviral not recommended as first-line monotherapy.RESEARCH DESIGN AND METHODS: In this retrospective cohort study, patients aged 18-64 with medical claims for CHB who initiated an oral antiviral monotherapy for CHB between 07/01/05 and 01/31/10 were identified from a large US commercial health insurance claims database. Patients were continuously enrolled for a 6-month baseline period and ≥90 days follow-up. They were assigned to 'currently recommended first-line therapy' (RT: entecavir or tenofovir) or 'not currently recommended first-line therapy' (NRT: lamivudine, telbivudine, or adefovir) cohorts.MAIN OUTCOME MEASURES: Multivariate analyses were conducted to compare treatment adherence, persistence, healthcare utilization, and costs for RT vs NRT cohorts.RESULTS: Baseline characteristics were similar between RT (n=825) and NRT (n=916) cohorts. In multivariate analyses, RT patients were twice as likely as NRT patients to be adherent (OR=2.09; p