INCREASED BURDEN ON PRIMARY CARE PHYSICIANS PRECEDING DIAGNOSIS OF ALZHEIMER'S DISEASE IN THE UK
Author(s)
Chen L*1;Reed C2;Happich M3;Nyhuis A1;Faries DE1;Ascher-Svanum H1, Lenox-Smith A2 1Eli Lilly and Company, Indianapolis, IN, USA, 2Eli Lilly and Company, Windlesham, United Kingdom, 3Eli Lilly and Company, Bad Homburg, Germany
OBJECTIVES: To examine medical resource utilization patterns prior to and post Alzheimer’s disease (AD) diagnosis in UK primary care. METHODS: Newly diagnosed patients with non-early onset AD between January 1, 2008 and December 31, 2010 were identified from the UK CPRD-GOLD database. The index date was defined as the first AD diagnosis. Eligible patients had a continuous record for the 3-year prior (index) period and 1-year post period, and were ≥65 years of age. Controls were identified by matching to AD patients on year of birth, gender, region, and Charlson co-morbidity index with a 2:1 matching ratio. Medical resource utilization was calculated over the 4-year study period at 6-monthly intervals. T-tests, chi-square tests, and Wilcoxon sum-rank tests (depending on the data type and distribution) were used comparing between AD and control. RESULTS: Cohorts of 3896 AD patients and 7792 controls were extracted. At index date, patients had a mean age (SD) of 79.8 (6.5) years and 65% were female. The mean primary care consultation rate per 6-month was higher in the AD cohort than the control cohort over the total study period (p<0.05) and showed a gradual increase in the controls over the 4 years (from 5 - 7 consultations), while the AD cohort showed a clear increase in the 6-months prior to the index (10 consultations) and stayed at this high rate over the 1-year post-diagnosis period. The proportion of patients with a secondary care referral was higher within the AD cohort than the control cohort (37% vs. 25% over the 4-year period, p<0.05), with the difference peaking in the 6-month prior to AD diagnosis (17% vs. 5%, p<0.05). CONCLUSIONS: A clear increase in primary care consultations in the 6-month period prior to AD diagnosis and its continuation in the year post-diagnosis suggest AD imposes a substantial burden on UK primary care.
Conference/Value in Health Info
2013-05, ISPOR 2013, New Orleans, LA, USA
Value in Health, Vol. 16, No. 3 (May 2013)
Code
PHS91
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Mental Health, Neurological Disorders