患者支持计划对接受生物疗法治疗的重症哮喘患者的影响：系统文献综述和间接治疗比较

IF 3.6 3区医学 Q1 RESPIRATORY SYSTEM

BMJ Open Respiratory Research Pub Date : 2024-05-01 DOI:10.1136/bmjresp-2023-001799

Adrian P J Rabe, Wei J Loke, Danuta Kielar, Tamsin Morris, Vivian H Shih, Lynda Olinger, Mihaela G Musat, Zhiyi Lan, Sharada Harricharan, Olivia Fulton, Azeem Majeed, Liam G Heaney

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引用次数: 0

摘要

导言：重症哮喘的有效治疗需要患者坚持吸入和生物药物治疗。以往的研究表明，患者支持计划（PSP）可提高慢性病患者的依从性，但 PSP 对接受生物制剂治疗的重症哮喘患者的影响尚未得到深入研究。方法我们进行了一项系统性文献综述，以了解 PSP 对重症哮喘患者治疗依从性、哮喘控制和健康相关生活质量（HRQoL）的影响。我们在 Embase、MEDLINE 和 EconLit 数据库中检索了从 2003 年（首个用于重症哮喘的生物制剂获批的年份）到 2023 年 6 月期间发表的、描述重症哮喘患者在接受生物制剂治疗时参与 PSP 的研究。由于各研究之间存在异质性，因此无法直接汇总研究结果，因此进行了间接治疗比较 (ITC)，以确定参与 PSP 对停止治疗的影响。ITC使用的是患者层面的数据，这些数据来自在英国接受苯拉利珠单抗治疗的患者，这些患者有的参加了PSP（VOICE研究、Connect 360 PSP），有的没有参加PSP（苯拉珠单抗患者获取计划研究）。研究结果选出了 21 项研究中的 25 份记录。六项研究调查了 PSP 对治疗依从性、哮喘控制或 HRQoL 的影响。所有六项研究都报告了参与 PSP 的患者取得的积极成果；每项 PSP 的益处都与所提供的服务密切相关。ITC 显示，与非 PSP 组相比，Connect 360 PSP 组患者中断治疗的可能性较低（OR 0.26，95% CI 0.11 至 0.57，p<0.001）。结论 PSP 对接受生物治疗的重症哮喘患者的临床疗效有积极作用。未来的分析将受益于对 PSP 服务的全面描述，以及能够直接比较有无 PSP 的患者疗效的研究设计。数据可能来自第三方，不对外公开。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Impact of patient support programmes among patients with severe asthma treated with biological therapies: a systematic literature review and indirect treatment comparison

Introduction Effective treatment of severe asthma requires patient adherence to inhaled and biological medications. Previous work has shown that patient support programmes (PSP) can improve adherence in patients with chronic diseases, but the impact of PSPs in patients with severe asthma treated with biologics has not been thoroughly investigated. Methods We conducted a systematic literature review to understand the impact of PSPs on treatment adherence, asthma control and health-related quality of life (HRQoL) in patients with severe asthma. Embase, MEDLINE and EconLit databases were searched for studies published from 2003 (the year of the first biological approval for severe asthma) to June 2023 that described PSP participation among patients with severe asthma on biological treatment. Direct pooling of outcomes was not possible due to the heterogeneity across studies, so an indirect treatment comparison (ITC) was performed to determine the effect of PSP participation on treatment discontinuation. The ITC used patient-level data from patients treated with benralizumab either enrolled in a PSP (VOICE study, Connect 360 PSP) or not enrolled in a PSP (Benralizumab Patient Access Programme study) in the UK. Findings 25 records of 21 studies were selected. Six studies investigated the impact of PSPs on treatment adherence, asthma control or HRQoL. All six studies reported positive outcomes for patients enrolled in PSPs; the benefits of each PSP were closely linked to the services provided. The ITC showed that patients in the Connect 360 PSP group were less likely to discontinue treatment compared with the non-PSP group (OR 0.26, 95% CI 0.11 to 0.57, p<0.001). Conclusions PSPs contribute to positive clinical outcomes in patients with severe asthma on biological treatment. Future analyses will benefit from thorough descriptions of PSP services, and study designs that allow direct comparisons of patient outcomes with and without a PSP. Data may be obtained from a third party and are not publicly available.

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来源期刊

BMJ Open Respiratory Research RESPIRATORY SYSTEM-

CiteScore

6.60

自引率

2.40%

发文量

审稿时长

12 weeks

期刊介绍： BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.