Xue Han, Seth C Hopkins, Zhen Zhang, Shivanshu Awasthi
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引用次数: 0
Abstract
Introduction: Metabolic comorbidities, including central adiposity, dyslipidemia, insulin resistance, and hypertension, are common in individuals with schizophrenia and contribute to an increased risk of cardiovascular disease and related mortality. There is limited evidence quantifying the economic burden of metabolic comorbidities in schizophrenia. This study aimed to assess the impact of cumulative metabolic comorbidity burden on medical costs in individuals with schizophrenia using claims data.
Methods: A retrospective cohort study was conducted using the STATinMED Real World Data Insights database covering the period 2018-2024 in the United States (US). Adults with schizophrenia were grouped by number of metabolic comorbidities (obesity, hyperlipidemia, hypercholesterolemia, diabetes, and/or hypertension). Propensity score matching was applied to balance selected baseline characteristics in individuals with and without metabolic comorbidities. The primary outcome was all-cause medical costs, during a 12-month follow-up, adjusted for insurance status and inflation.
Results: Overall, 122,248 individuals were eligible. After matching, the numbers for metabolic comorbidities and individuals in each group were: 0, n = 40,552; 1, n = 15,840; 2, n = 11,833; 3, n = 8119; 4, n = 4074; and 5, n = 686. Estimated total medical costs increased with the number of metabolic comorbidities; individuals with five metabolic comorbidities incurred mean costs of US$34,441 per person per year, over 4 times higher than the $8396 cost for individuals with none. A similar pattern was observed for estimated outpatient, inpatient, and stay-related costs, with 3.5-, 2.3- and 1.7-fold increases, respectively.
Conclusion: There is a substantial economic burden associated with cumulative metabolic comorbidities in individuals with schizophrenia. Prevention and management of metabolic comorbidities in this population includes early risk assessments, lifestyle modification, and the selection of antipsychotic medications with few metabolic adverse effects. Addressing metabolic comorbidities should be a key component of multidisciplinary care to reduce health-related and economic impacts in schizophrenia.
代谢合并症，包括中枢性肥胖、血脂异常、胰岛素抵抗和高血压，在精神分裂症患者中很常见，并导致心血管疾病和相关死亡率的风险增加。有有限的证据量化精神分裂症代谢合并症的经济负担。本研究旨在利用索赔数据评估累积代谢共病负担对精神分裂症患者医疗费用的影响。方法：使用美国STATinMED Real World Data Insights数据库进行回顾性队列研究，研究时间为2018-2024年。根据代谢合并症（肥胖、高脂血症、高胆固醇血症、糖尿病和/或高血压）的数量对成年精神分裂症患者进行分组。倾向评分匹配用于平衡有或无代谢合并症个体的选定基线特征。主要结果是在12个月的随访期间，根据保险状况和通货膨胀调整的全因医疗费用。结果：总共有122248人符合条件。匹配后，各组代谢合并症和个体数为：0，n = 40,552；1, n = 15,840；2, n = 11,833；3, n = 8119；4, n = 4074；5, n = 686。估计总医疗费用随着代谢合并症数量的增加而增加；患有五种代谢合并症的个体平均每人每年的费用为34,441美元，比没有代谢合并症的个体的费用（8,396美元）高出4倍以上。在估计的门诊、住院和住院相关费用中也观察到类似的模式，分别增加了3.5倍、2.3倍和1.7倍。结论：在精神分裂症患者中存在与累积代谢合并症相关的巨大经济负担。在这一人群中，代谢合并症的预防和管理包括早期风险评估、生活方式改变和选择代谢不良反应少的抗精神病药物。解决代谢合并症应该是多学科护理的关键组成部分，以减少精神分裂症对健康和经济的影响。
期刊介绍：
Aims and Scope
Neurology and Therapy aims to provide reliable and inclusive, rapid publication for all therapy related research for neurological indications, supporting the timely dissemination of research with a global reach, to help advance scientific discovery and support clinical practice.
Neurology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of neurological and psychiatric therapies, (also covering surgery and devices). Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed.
The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial designs, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Neurology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
Rapid Publication
The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted, it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model, this allows for the rapid and efficient communication of the latest research and reviews to support scientific discovery and clinical practice.
Open Access
All articles published by Neurology and Therapy are open access.
Personal Service
The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning that authors will always have a personal point of contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. We also encourage pre-submission enquiries and are always happy to provide a confidential assessment of manuscripts.
Digital Features and Plain Language Summaries
Neurology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’.
For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/
Publication Fees
Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of €5250/$6000/£4300. The journal will consider fee discounts and waivers for developing countries and this is decided on a case-by-case basis.
Peer Review Process
Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria.
At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials and Letters which are generally reviewed by one member of the Editorial Board. Where reviews conflict, an Editorial Board Member will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed. Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised, it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case-by-case basis and should be sent to the journal editor, and authors are welcome to make rebuttals against individual reviewer comments, if appropriate.
Preprints
We encourage posting of preprints of primary research manuscripts on preprint servers, authors'' or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals.
Please see here for further information on preprint sharing: https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550
Copyright
Neurology and Therapy is published under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0.
Contact
For more information about the journal, including pre-submission enquiries, please contact managing editor Lydia Alborn at lydia.alborn@springer.com.
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