Lawrie, A. orcid.org/0000-0003-4192-9505, Hamilton, N., Wood, S. et al. (8 more authors) (2024) Association of risk assessment at diagnosis with healthcare resource utilization and health‐related quality of life outcomes in pulmonary arterial hypertension. Pulmonary Circulation, 14 (3). e12399. ISSN 2045-8940
Abstract
We aimed to describe the clinical characteristics, healthcare resource utilization (HCRU) and costs, health‐related quality of life (HRQoL), and survival for patients with pulmonary arterial hypertension (PAH), stratified by 1‐year mortality risk at diagnosis. Adults diagnosed with PAH at the Sheffield Pulmonary Vascular Disease Unit between 2012 and 2019 were included. Patients were categorized as low, intermediate, or high risk for 1‐year mortality at diagnosis. Demographics, clinical characteristics, comorbidities, HCRU, costs, HRQoL, and survival were analyzed. Overall, 1717 patients were included: 72 (5%) at low risk, 941 (62%) at intermediate risk, and 496 (33%) at high risk. Low‐risk patients had lower HCRU prediagnosis and 1‐year postdiagnosis than intermediate‐ or high‐risk patients. Postdiagnosis, there were significant changes in HCRU, particularly inpatient hospitalizations and accident and emergency (A&E) visits among high‐risk patients. At 3 years postdiagnosis, HCRU for all measures was similar across risk groups. Low‐risk patients had lower EmPHasis‐10 scores (indicating better HRQoL) at diagnosis and at 1‐year follow‐up compared with intermediate‐ and high‐risk patients; only the score in the high‐risk group improved. Median overall survival decreased as risk category increased in analyzed subgroups. Low‐risk status was associated with better 1‐year survival and HRQoL compared with intermediate‐ and high‐risk patients. HCRU decreased in high‐risk patients postdiagnosis, with the most marked reduction in A&E admissions. The pattern of decreased per‐patient inpatient hospitalizations and A&E visits at 3 years postdiagnosis suggests that a diagnosis of PAH helps to decrease HCRU in areas that are key drivers of costs.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 Actelion Pharmaceuticals Ltd and The Author(s). Pulmonary Circulation published by John Wiley & Sons Ltd on behalf of Pulmonary Vascular Research Institute. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes: https://creativecommons.org/licenses/by-nc/4.0/ |
Keywords: | healthcare resource utilization; health‐related quality of life; pulmonary arterial hypertension; real‐world evidence; risk assessment |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 16 Jul 2024 13:10 |
Last Modified: | 16 Jul 2024 13:10 |
Published Version: | http://dx.doi.org/10.1002/pul2.12399 |
Status: | Published |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1002/pul2.12399 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:214783 |