糖尿病足溃疡治疗的药物经济学评价研究

R. George, E. Niranjani, M. Rekha, Golla Sai Teja, Sarangan Nithya Lakshmi, E. S. Kumar
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摘要

背景:糖尿病足溃疡(DFU)是糖尿病的大血管并发症之一,其患病率估计约为8-11%的长期未控制的糖尿病患者。DFU的致病级联是外周动脉血管并发症、外周神经病变和血糖升高的组合,使其成为无法愈合的溃疡,随后继发感染,最终发展为截肢。糖尿病足溃疡的复发性会影响患者的健康状况和经济稳定,并与高费用的主要医疗保健消费有关。方法:以Mono为中心,在普外科进行为期6个月的前瞻性观察性比较研究。结果:共纳入100例糖尿病足溃疡患者,其中男性74例(74%),女性26例(26%)。51-60岁和61-70岁年龄组的比例最高,为27%(27)。无(无任何合并症)患者比例最高的为42%(42),其次是合并(HTN、CKD、CAD等一种以上合并症)患者32(32%),最大比例为周围神经病变(43%)。23例确诊为坏疽,23例行大截肢,保守治疗的糖尿病足溃疡经济负担略高于截肢患者。结论:研究认为保守组糖尿病足溃疡患者的经济负担略高于截肢组,即使统计分析差异不显著。因为与截肢患者相比,保守治疗(清创、筋膜切开术、切开引流)的额外住院和医疗服务的必要性更高。而在药物经济学方面,截肢患者与保守患者之间差异不显著。
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Study to Evaluate the Pharmacoeconomics in Diabetic Foot Ulcer Management
Background: Diabetic foot ulceration (DFU) is one of the macrovascular complications of diabetes, its prevalence was estimated to be about 8-11% of individuals with uncontrolled diabetes experience for long time. The pathogenic cascade of DFU is a combination of vascular complications of peripheral arteries, Peripheral neuropathy and the raised blood glucose makes it as a non-healing ulcer followed by secondary infection which will progress to end with leg Amputation. The recurrent nature of Diabetic foot ulcer can impact on the health status as well as the economical stability of the affected patients and are associated with the major health care consumption with high cost. Methodology: It was a Mono centered prospective observational comparative study conducted in the department of general surgery for 6 months duration. Results: Total samples of 100 diabetic foot ulcer patients were enrolled into the study, 74 (74%) were males and 26 (26%) were females. The age group between51-60 and 61-70 years was observed as the highest percentage 27% (27). Highest percentage 42% (42) of patients were none (without any comorbidities) followed by 32(32%) patients are with combined (more than one comorbidity like HTN, CKD, CAD…etc.) with utmost percentage of 43% was peripheral neuropathy. 23 patients were diagnosed with gangrene and23 patients underwent major amputation, The economic burden of diabetic foot ulcer for conservative treatment was slightly more when compared to amputated patients. Conclusion: Study concludes that, economic burden on diabetic foot ulcer in conservative patients was slightly more while compared to amputated patients by descriptive statistics even the statistical analysis shown less significant difference. Because the necessity rate for extra hospitalization and medical services was more for conservative treatment (Debridement, Fasciotomy, Incision and Drainage) when compared to amputation patients with diabetic foot ulcer. whereas in the pharmaco-economics there was not much significant difference among both amputated and conservative patients.
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