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首页> 美国卫生研究院文献>Diabetes Technology Therapeutics >Healthcare Resource Waste Associated with Patient Nonadherence and Early Discontinuation of Traditional Continuous Glucose Monitoring in Real-World Settings: A Multicountry Analysis
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Healthcare Resource Waste Associated with Patient Nonadherence and Early Discontinuation of Traditional Continuous Glucose Monitoring in Real-World Settings: A Multicountry Analysis

机译：与患者的不依从相关的医疗资源浪费和现实环境中传统连续血糖监测的早期停用：多国分析

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>Background: Traditional continuous glucose monitoring (CGM) provides detailed information on glucose patterns and trends to inform daily diabetes management decisions, which is particularly beneficial for patients with a history of hypoglycemia unawareness. However, a high level of patient adherence (≥70%) is required to achieve clinical benefits. The aim of this study was to assess the impact of real-world patient nonadherence and early discontinuation on healthcare resource use.>Methods: A cost calculator was designed to evaluate monthly healthcare resource waste within the first year of traditional CGM initiation by combining estimates of real-world nonadherence and early discontinuation from the literature with the wholesale acquisition costs of the current technology in the United States (for a commercial payer and for Medicare), or its equivalent in Sweden, Germany, or the Netherlands.>Results: Based on an early discontinuation rate of 27% and nonadherence rates of 13.9%–31.1% over the 12 months following initiation, the healthcare resource waste associated with nonadherence and early discontinuation was $220,289 and $21,775, respectively, for every 100 patients initiating CGM in the U.S. commercial payer scenario. In the Medicare scenario, the corresponding figures were $72,648 and $5,675, respectively. In both scenarios, nonadherence and early discontinuation accounted for ∼24% of resources being wasted within the first year of CGM initiation. Similar results were observed using the local costs in the other countries analyzed.>Conclusions: The healthcare resource waste associated with traditional CGM nonadherence and early discontinuation warrants deliberate consideration when selecting suitable patients for this technology.
机译：>背景：传统的连续血糖监测（CGM）提供有关血糖模式和趋势的详细信息，以指导日常的糖尿病管理决策，这对没有低血糖病史的患者特别有用。但是，需要高水平的患者依从性（≥70％）才能获得临床收益。这项研究的目的是评估现实世界中患者的不依从和提早停药对医疗资源的使用的影响。>方法：设计了一种成本计算器来评估传统医疗保健第一年内每月的医疗资源浪费通过结合文献中对现实世界的不遵守和早期停产的估计，以及美国（针对商业付款人和医疗保险）或瑞典，德国或荷兰的等价货币的当前技术的批发购买成本，来启动CGM。 。>结果：基于在启动后的12个月内，早期停药率27％和不依从率13.9％–31.1％，与不依从和早停药相关的医疗资源浪费为220,289美元和21,775美元在美国商业付款人场景中，每100位发起CGM的患者分别出现。在Medicare情景中，相应的数字分别为72,648美元和5,675美元。在这两种情况下，不遵守和提前终止约占CGM启动第一年内浪费资源的24％。使用其他国家/地区的本地成本，也观察到了类似的结果。>结论：在选择适合该技术的患者时，与传统的CGM不依从和早期停药相关的医疗资源浪费值得深思。

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