Healthcare Cost and Loss of Productivity in a Canadian Population of Patients with and without Lupus Nephritis

Aghdassi, Elaheh; ZHANG, WENDY; St-Pierre, Yvan; Clarke, Ann E.; Morrison, Stacey; Peeva, Valentina; Landolt-Marticorena, Carolina; Su, Jiandong; Reich, Heather N.; Scholey, James W.; Herzenberg, Andrew M.; Pope, Janet; Peschken, Christine A.; Wither, Joan; Fortin, Paul R

doi:10.3899/jrheum.100482

Cited by 36 publications

(42 citation statements)

References 35 publications

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“…Substantial levels of inpatient care, medication/prescriptions and visits to healthcare professionals (HCP), which are all increased by ‘flares’, are the main drivers of direct costs in the treatment of SLE [43]. The conceptual model also shows that SLE is associated with high indirect costs due to lost productivity [5] resulting from unemployment and absenteeism, [44], with ‘in-flare’ patients with SLE having increased frequency and duration of time off work [45],[46]. …”

Section: Resultsmentioning

confidence: 99%

Patient-reported outcome measures for systemic lupus erythematosus clinical trials: a review of content validity, face validity and psychometric performance

Holloway

Humphrey

Heron

et al. 2014

Health Qual Life Outcomes

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BackgroundDespite overall progress in treatment of autoimmune diseases, patients with systemic lupus erythematosus (SLE) experience many inflammatory symptoms representing an unmet medical need. This study aimed to create a conceptual model of the humanistic and economic burden of SLE, and review the patient-reported outcomes (PROs) used to measure such concepts in SLE clinical trials.MethodsA conceptual model for SLE was developed from structured review of published articles from 2007 to August 2013 identified from literature databases (MEDLINE, EMBASE, PsycINFO, EconLit) plus other sources (PROLabels, FDA/EMA websites, Clinicaltrials.gov). PROs targeting key symptoms/impacts were identified from the literature. They were reviewed in the context of available guidance and assessed for face and content validity and psychometric properties to determine appropriateness for use in SLE trials.ResultsThe conceptual model identified fatigue, pain, cognition, daily activities, emotional well-being, physical/social functioning and work productivity as key SLE concepts. Of the 68 articles reviewed, 38 reported PRO data. From these and the other sources, 15 PROs were selected for review, including SLE-specific health-related quality of life (HRQoL) measures (n = 5), work productivity (n = 1), and generic measures of fatigue (n = 3), pain (n = 2), depression (n = 2) and HRQoL (n = 2). The Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-Fatigue), Brief Pain Inventory (BPI-SF) and LupusQoL demonstrated the strongest face validity, conceptual coverage and psychometric properties measuring key concepts in the conceptual model. All PROs reviewed, except for three Lupus-specific measures, lacked qualitative SLE patient involvement during development. The Hospital Anxiety and Depression Scale (HADS), Short Form [36 item] Health Survey version 2 (SF-36v2), EuroQoL 5-dimensions (EQ-5D-3L and EQ-5D-5L) and Work Productivity and Activity Impairment Questionnaire: Lupus (WPAI:Lupus) showed suitability for SLE economic models.ConclusionsBased on the identification of key symptoms and impacts of SLE using a scientifically sound conceptual model, we conclude that SLE is a condition associated with high unmet need and considerable burden to patients. This review highlights the availability and need for disease-specific and generic patient-reported measures of relevant domains of disease signs and symptoms, HRQoL and work productivity, providing useful insight for SLE clinical trial design.

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Section: Resultsmentioning

confidence: 99%

Patient-reported outcome measures for systemic lupus erythematosus clinical trials: a review of content validity, face validity and psychometric performance

Holloway

Humphrey

Heron

et al. 2014

Health Qual Life Outcomes

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“…Systemic autoimmune rheumatic diseases (SARDs) are complex chronic inflammatory disorders (such as systemic lupus, SLE) characterized by multi-system inflammation 1-3 and high disease burden. 4 Although there is some evidence that SARDs may be triggered by environmental factors 5-8 there remain considerable knowledge gaps regarding mechanisms through which the environment may trigger these autoimmune diseases.…”

Section: Introductionmentioning

confidence: 99%

Fine particulate air pollution, nitrogen dioxide, and systemic autoimmune rheumatic disease in Calgary, Alberta

Bernatsky

Smargiassi

Johnson

et al. 2015

Environmental Research

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Objective To estimate the association between fine particulate (PM2.5) and nitrogen dioxide (NO2) pollution and systemic autoimmune rheumatic diseases (SARDs). Methods Associations between ambient air pollution (PM2.5 and NO2) and SARDs were assessed using land-use regression models for Calgary, Alberta and administrative health data (1993-2007). SARD case definitions were based on ≥2 physician claims, or ≥1 rheumatology billing code; or ≥1 hospitalization code (for systemic lupus, Sjogren's Syndrome, scleroderma, polymyositis, dermatomyositis, or undifferentiated connective tissue disease). Bayesian hierarchical latent class regression models estimated the probability that each resident was a SARD case, based on these case definitions. The sum of individual level probabilities provided the estimated number of cases in each area. The latent class model included terms for age, sex, and an interaction term between age and sex. Bayesian logistic regression models were used to generate adjusted odds ratios (OR) for NO2 and PM2.5. pollutant models, adjusting for neighborhood income, age, sex, and an interaction between age and sex. We also examined models stratified for First-Nations (FN) and non-FN subgroups. Results Residents that were female and/or aged > 45 had a greater probability of being a SARD case, with the highest OR estimates for older females. Independently, the odds of being a SARDs case increased with PM2.5 levels, but the results were inconclusive for NO2. The results stratified by FN and Non-FN groups were not distinctly different. Conclusion In this urban Canadian sample, adjusting for demographics, exposure to PM2.5 was associated with an increased risk of SARDs. The results for NO2 were inconclusive.

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“…In this study, we investigated the costs and resource utilization associated with lupus nephritis and NPSLE in a US insurance claims database. While a few studies have reported on costs associated with lupus nephritis [10][11][12][13][14] , little data exist on costs and resource use associated with NPSLE 15 . To ensure that results from this study would be representative of all stages of disease (and not just the initial stage), we used a prevalent approach to identify subjects.…”

mentioning

confidence: 97%

Medical costs and healthcare resource use in patients with lupus nephritis and neuropsychiatric lupus in an insured population

Fürst

Clarke

Fernandes³

et al. 2013

Journal of Medical Economics

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Healthcare Cost and Loss of Productivity in a Canadian Population of Patients with and without Lupus Nephritis

Abstract: Healthcare cost and loss of productivity were similar between patients with LN and patients who were LNN; the loss of productivity for caregivers is higher for patients with LN; and the healthcare cost is greater in ALN than in ILN.

Cited by 36 publications

References 35 publications

Patient-reported outcome measures for systemic lupus erythematosus clinical trials: a review of content validity, face validity and psychometric performance

Patient-reported outcome measures for systemic lupus erythematosus clinical trials: a review of content validity, face validity and psychometric performance

Fine particulate air pollution, nitrogen dioxide, and systemic autoimmune rheumatic disease in Calgary, Alberta

Medical costs and healthcare resource use in patients with lupus nephritis and neuropsychiatric lupus in an insured population

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