Epidemiology, comorbidities, and healthcare utilization of patients with chronic urticaria in Germany
Epidemiology, comorbidities, and healthcare utilization of patients with chronic urticaria in Germany
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DOI：
10.1111/jdv.17724
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发表时间：
2021-11-12
影响因子：
9.2
通讯作者：
Staubach, P.
中科院分区：
文献类型：
--
作者：
Weller, K.;Maurer, M.;Staubach, P.
背景综合德国慢性荨麻疹(CU)的流行病学和共病的数据有限，或不是当代的。目的利用匿名的法定医疗保险(SHI)数据库，调查德国慢性溃疡病的流行病学、患者的总体合并症和医疗资源利用情况。方法使用柏林应用卫生研究所的匿名SHI索赔研究数据库(2015年1月1日-2018年9月30日)对确诊为CU(ICD-10-GM代码)的参保个人进行分析。12个月的确诊患病率和发病率、合并症(与特应性皮炎和牛皮癣)以及慢性溃疡病患者的医疗保健利用情况进行了调查。结果在数据库中登记的4693772名所有年龄段的个人中，在2017年可观察到3538540人。CU、慢性自发性荨麻疹(CSU：71.2%)、慢性诱导性荨麻疹(CINDU：19.7%)、CSU+CINDU(9.1%)。在所有患者中，女性比男性有更高的CU确诊患病率(0.62%比0.37%)和确诊发病率(0.18%比0.11%)。患者就诊次数最多的是全科医生(占就诊总数的41.3%)。高血压病(43.5%)、脂蛋白代谢紊乱(32.1%)和情感性精神障碍(26.0%)是最常见的特殊关注合并症。大多数特殊人群的合并症与特应性皮炎和牛皮癣患者相似，且均高于总体人群。超过一半(54.1%)的CU患者没有开出任何治疗处方。第二代H-1-抗组胺药是成人(17.9%)和儿科(27.9%)患者最常用的处方药物。Cindu患者(儿科，15.5%；成人，7.8%)比CSU患者(儿科，9.9%；成人，4.6%)更常住院。结论在德国，慢性尿道炎的流行以及多种合并症可能会给医疗保健系统带来更大的负担。需要推动人们意识到遵守治疗指南，并以完全控制荨麻疹为目标，并可能改善结果。
Background Comprehensive data on the epidemiology and comorbidities of chronic urticaria (CU) in Germany are either limited, or not contemporary. Objectives To investigate the epidemiology of CU, overall comorbidities and healthcare resource utilized by patients with CU in Germany, using an anonymized statutory health insurance (SHI) database. Methods Anonymized SHI claims research database of the Institute for Applied Health Research, Berlin [InGef] (01 January 2015-30 September 2018) was used to analyse insured individuals with a confirmed diagnosis of CU (ICD-10-GM codes). Twelve-month diagnosed prevalence and incidence, comorbidities (vs. atopic dermatitis and psoriasis), and healthcare utilization by patients with CU were investigated. Results Of 4 693 772 individuals of all ages listed in the database, 3 538 540 were observable during 2017. Overall, 17 524 patients (similar to 0.5%) were diagnosed with CU; chronic spontaneous urticaria (CSU: 71.2%), chronic inducible urticaria (CIndU: 19.7%), CSU+CIndU (9.1%). Females, vs. males, had higher diagnosed prevalence (0.62% vs. 0.37%) and diagnosed incidence (0.18% vs. 0.11%) of CU among all patients. Patients most frequently visited general practitioners (41.3% of total visits). Hypertensive diseases (43.5%), lipoprotein metabolism disorders (32.1%) and affective disorders (26.0%) were the most frequently reported comorbidities of special interest. Rates of most comorbidities of special interests were similar to atopic dermatitis and psoriasis patients, and all higher vs. overall population. More than half (54.1%) of all CU patients were not prescribed any treatment. Second-generation H-1-antihistamines were the most commonly prescribed medication for adult (17.9%) and paediatric (27.9%) patients. Patients with CIndU (paediatric, 15.5%; adult, 7.8%) were more often hospitalized versus patients with CSU (paediatric, 9.9%; adult, 4.6%). Conclusions In Germany, prevalence of CU along with multiple comorbidities may pose increased burden on the healthcare system. Awareness of adhering to treatment guidelines, and aiming for complete control of urticaria, needs to be driven and may improve outcomes.