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【medical-news】Insulin Pen可以改善胰岛素病人的临床
Switch To Insulin Pen Improves Clinical Outcomes And Reduces Medical Costs For Diabetes
Diabetes mellitus, a chronic medical condition often requiring lifelong treatment, is one of the leading causes of morbidity and mortality in the United States. In 2002, the cost of diabetes was estimated at $132 billion in the U.S. Tight glycemic control, as defined by the American Diabetes Association, is the cornerstone of effective diabetes management and can be achieved by medication adherence, that is, patients following the treatment prescribed by their physicians. Accordingly, one of the primary goals of any insulin delivery method is to reduce the risk of complications from inadequate glycemic control by facilitating better patient adherence.
Won Chan Lee, Ph.D., Abt Associates' Director of Health Economics, recently led a first of its kind study to evaluate the clinical and economic effects of the conversion from conventional vial and syringe delivery to an insulin analogue pen device in patients with type 2 diabetes. The results, published in the journal, Clinical Therapeutics, show that switching to an insulin pen led to improved medication adherence, fewer claims for hypoglycemic events, reduced emergency department and physician visits, and, ultimately, lower treatment costs.
Pen devices which combine the insulin cartridge and syringe in a single unit have been reported to improve dosing accuracy, increase mealtime flexibility and convenience of insulin delivery, with resulting positive effects on patient preference and treatment. Additional advantages of pre-filled insulin pens include improved user confidence, ease of training, and greater stability of the device during injection. Reduction of injection-related pain has obvious benefits as far as health-related quality of life. This study by Dr. Lee and colleagues documents an important impact on clinical and economic outcomes.
Using the PharMetrics database, with medical and pharmacy claims of individuals in managed care plans throughout the United States, Dr. Lee and his team retrospectively analyzed 1,156 adults with type 2 diabetes who converted from vial and syringe injection to a pre-filled insulin analogue pen from July 2001 through December 2002. The researchers looked at adherence, hypoglycemic events, the relationship between adherence and hypoglycemic events, and associated health care costs.
The proportion of patients who were adherent was significantly higher after converting to insulin pen therapy, increasing from 36% to 55%. The likelihood of experiencing a hypoglycemic event was also significantly reduced after conversion, by as much as two-thirds for patients with at least 80% adherence. There were significant decreases in hypoglycemia-attributable (HA) emergency department visits and physician visits which led to a reduction in annual HA costs per patient of $788. Other annual diabetes-attributable costs were reduced by $600 per patient and total all-cause annual treatment costs by $1590 per patient.
"The implications of our research are readily apparent," said Dr. Lee. "As evidenced by the marked improvement in medication adherence rates, patients who switched to the insulin pen found that its convenience and ease of use gave them a new ability to self-manage their condition and a resulting freedom from complications and visits to the emergency room. But our study also demonstrated a true 'win-win' situation, for individuals with diabetes and for society as a whole, due to significant decreases in the costs associated with hypoglycemic events -- events that can be kept at a manageable level or avoidable, as long as a patient adheres to his or her treatment."
For more information, see: Lee WC, Balu S, Cobden D, Joshi AV, Pashos CL. Medication adherence and the associated health-economic impact among patients with Type 2 diabetes mellitus converting to insulin pen therapy: An analysis of third-party managed care claims data. Clinical Therapeutics 2006 (October); 28(10). 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 胰岛素笔可以改善胰岛素病人的临床症状并且减少医疗费用
注：胰岛素笔不是一支可以写字的笔，而是一种用来注射胰岛素的针。
糖尿病，一种需要终身治疗的疾病，现已成为美国发病率和死亡率最高的疾病之一。2002年，美国用于治疗糖尿病的费用估计有1320亿美元。美国糖尿病协会确定的药物控制法是糖尿病治疗的有效基石，即患者按照医生的药方进行治疗就可以得到疗效。同样的，胰岛素治疗的主要目的之一是减少疗效较好的患者因药物不足而导致的并发症的风险性。
Won Chan Lee博士，卫生经济学主任，最近开展了一项研究，对2型糖尿病患者从常规的药物和注射治疗转变到胰岛素治疗所得到的临床上的和经济上的效益进行评估。发表在《临床治疗》杂志上的结果显示：胰岛素治疗提高了医疗效果，减少了低血糖事件，急诊就诊次数，最重要的，减少了医疗费用。
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作者:admin@医学,生命科学 2010-10-25 17:11
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