Burden of lupus activity on health care resources utilization in Buenos Aires, Argentina.

Autor: Alvarado RN; Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Alle G; Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Tobar-Jaramillo MA; Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Palomino LC; Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Cáceres AG; Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Rosa JE; Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Machnicki G; Janssen LATAM, LLC, Ciudad Autónoma de Buenos Aires, Argentina., Zazzetti F; Janssen Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson and Johnson, Titusville, NJ, USA., Soriano E; Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Scolnik M; Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Jazyk: angličtina
Zdroj: Lupus [Lupus] 2023 Dec; Vol. 32 (14), pp. 1656-1665. Date of Electronic Publication: 2023 Nov 13.
DOI: 10.1177/09612033231215386
Abstrakt: Objective: The aim is to analyze health care resource utilization (HCRU) of patients with lupus (SLE) from a health management organization (HMO) in Buenos Aires, Argentina, compared with matched controls and comparing periods of flare, low disease activity, and remission.
Methods: This is a retrospective observational study including all SLE incident cases (ACR 1997/SLICC 2012 criteria) between 2000 and 2020 and 5 matched controls. Clinical data and HCRU (medical and nonmedical consultations, lab and imaging tests performed, emergency room visits, hospitalizations, and drugs prescribed) were obtained from administrative databases and electronic medical records. For each patient with SLE, an activity state was determined in every month of follow-up: flare (BILAG A or 2 BILAG B); low disease activity (LLDAS); remission (DORIS definition); or intermediate activity (not fulfilling any of previous). Incidence rates for each HCRU item and incidence rate ratios between SLE and control patients were and between remission and flare periods were calculated. Multivariate negative binomial logistic regression analyses were performed for identification of variables associated with major resource use.
Results: A total of 62 SLE and 310 control patients were included, 88.7% were women, the median age at diagnosis was 46 years, and were followed for more than 8 years. Patients with SLE contributed with 537.2 patient-years (CI 95% 461.1-613.3) and controls with 2761.9 patient-years (CI 95% 2600.9-2922.8). HCRU in patients with SLE was significantly higher than in controls in all items, even in remission periods. Patients with SLE remained 74.4% of the time in remission, 12.1% in LLDAS, 12.2% in intermediate activity, and 1.3% in flare (there were 64 flares in 36 patients). HCRU was significantly higher during flare periods compared with remission periods. Number of flares was independently associated with emergency department consultations, lab tests and X-ray performed, number of drugs prescribed, and hospitalizations.
Conclusion: Significantly more HCRU was observed in patients with SLE in flare compared to remission periods.
Competing Interests: Declaration of conflicting interestsThe Hospital Italiano authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Gerardo Machnicki was an employee of Janssen LATAM LLC at the time of planning and executing this study. Federico Zazzetti is a current Janssen Global Medical Affairs employee.
Databáze: MEDLINE
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