BMJ:HCV早发现早治疗策略 (HepCATT)的成本效益研究

2020-02-28 MedSci MedSci原创

在初级保健过程中实现HCV感染人群的早发现早治疗是一种低成本干预手段

近日研究人员评估了在初级保健中,实现丙型肝炎病毒(HCV)病例早发现和早治疗的成本效益。

HepCATT研究在英格兰开展,包含45种常规疗法研究(22种随机干预,23种随机对照),总计识别风险人群24473例,通过电子算法和标记实践系统识别高HCV风险人群,例如阿片类药物依赖史。研究人员通过HCV培训、实践和海报/传单,以提高患者的意识。标记人群通过信件被邀请进行HCV检测,干预持续了一年。研究的主要终点为高危人群接受HCV测试。次要终点为HCV检测阳性的数量和比例、HCV治疗评估以及成本效益。

研究开始前6个月为基线过渡期,干预组608人接受了HCV检测(4.6%),而对照组380人接受了检测(3.3%)。研究期间,干预组2071人(16%)接受了HCV检测,而对照组中1163人(10%)进行检测,总体干预效果为1.59。在129名干预组和51名对照患者中检测到HCV抗体,确诊率略有增加(6.2%v 4.4%;调整后的风险比率为1.405)。与对照组相比,干预组转诊和检测率增加,风险差异为1.3/1000人,并且每792人中额外增加1名需接受HCV诊断、转诊和评估的患者。每个风险患者的HCV病例发现的平均成本为4.03英镑,每个额外肝病患者的平均成本为3165英镑。每质量调整寿命年(QALY)的增量成本效益比为6212英镑,92.5%的概率低于每QALY 20000英镑。

研究认为,在初级保健过程中实现HCV感染人群的早发现早治疗是一种低成本干预手段。

原始出处:


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    2020-06-28 gaoxiaoe
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    2020-03-01 ymljack
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