Stefan N Willich1, Ling-Hsiang Chuang2, Ben van Hout3, Pearl Gumbs4, David Jimenez5, Sonja Kroep2, Rupert Bauersachs6, Manuel Monreal7, Giancarlo Agnelli8, Alexander Cohen9. 1. Charité - Universitätsmedizin Berlin, Berlin, Germany. 2. Pharmerit International, Rotterdam, Netherlands. 3. University of Sheffield, Sheffield, United Kingdom. 4. Daiichi-Sankyo Europe GmbH, Munich, Germany. 5. Ramon y Cajal Hospital IRYCIS, Madrid, Spain; Alcala de Henares University, Madrid, Spain. 6. University of Mainz, Mainz, Germany. 7. Hospital Universitari Germans Trias I Pujol, Barcelona, Spain. 8. University of Perugia, Italy, Perugia, Italy. 9. Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom. Electronic address: alexander.cohen@kcl.ac.uk.
Abstract
OBJECTIVES: Pulmonary embolism (PE) is associated with a substantial economic burden. However evidence from patients in Europe is scarce. The aim of this study was to report the impacts of PE on healthcare resource utilization (HCRU) and return to work using the PREFER in VTE registry. METHODS: The PREFER in VTE registry was a prospective, observational, multicenter study in seven European countries, aiming to provide data concerning treatment patterns, HCRU, mortality, quality of life and work-loss. Patients with a first-time or recurrent PE were included and followed up at 1, 3, 6 and 12 months. Treatment patterns, re-hospitalization rates, length of hospital stays (LOS), and ambulatory/office visits, as well as proportion of patients returning to work, were assessed. Subgroups by country and with/without active cancer were examined separately. Zero-inflated negative binomial and Cox regression were applied to investigate the relationship between baseline characteristics and LOS and return to work, respectively. RESULTS: Amongst 1399 patients with PE, 53.2% were male and the average age was 62.3 ± 17.1 years old. Overall, patients were treated with combinations of heparin, vitamin K antagonists (VKA) and the non-VKA oral anticoagulants (NOACs) (50.0% treated with the combination of heparin with VKA). Patients with active cancer were primarily treated with heparin (84.9%). NOACs were used more frequently in DACH (Germany, Austria and Switzerland) and France (55.2% and 32.6%) compared to Italy and Spain (4.5% and 6.1%). The VTE-related re-hospitalization rate within 12 months and the average LOS varied substantially between countries, from 26.2% in UK to 12.3% in France, and from 12.9 days in Italy to 3.9 days in France. PE patients were often co-managed by general practitioners in France and DACH (>84%), and less frequently in other countries (<47%). The regression results confirmed the country variation of HCRU. Of the employed patients (n = 385), 60% returned to work at 1 month but 27.8% had not after one year. PE patients with DVT were more likely to return to work. Active cancer was a significant predictor for not returning to work, as well as smoking history. CONCLUSIONS: Medical treatment of PE differed between patients with active cancer and patients without active cancer. VTE-related resource utilization differed markedly between countries. While the reported 'not return to work' was high for patients with PE, this may at least in part reflect the presence of co-morbidities such as cancer.
OBJECTIVES:Pulmonary embolism (PE) is associated with a substantial economic burden. However evidence from patients in Europe is scarce. The aim of this study was to report the impacts of PE on healthcare resource utilization (HCRU) and return to work using the PREFER in VTE registry. METHODS: The PREFER in VTE registry was a prospective, observational, multicenter study in seven European countries, aiming to provide data concerning treatment patterns, HCRU, mortality, quality of life and work-loss. Patients with a first-time or recurrent PE were included and followed up at 1, 3, 6 and 12 months. Treatment patterns, re-hospitalization rates, length of hospital stays (LOS), and ambulatory/office visits, as well as proportion of patients returning to work, were assessed. Subgroups by country and with/without active cancer were examined separately. Zero-inflated negative binomial and Cox regression were applied to investigate the relationship between baseline characteristics and LOS and return to work, respectively. RESULTS: Amongst 1399 patients with PE, 53.2% were male and the average age was 62.3 ± 17.1 years old. Overall, patients were treated with combinations of heparin, vitamin K antagonists (VKA) and the non-VKA oral anticoagulants (NOACs) (50.0% treated with the combination of heparin with VKA). Patients with active cancer were primarily treated with heparin (84.9%). NOACs were used more frequently in DACH (Germany, Austria and Switzerland) and France (55.2% and 32.6%) compared to Italy and Spain (4.5% and 6.1%). The VTE-related re-hospitalization rate within 12 months and the average LOS varied substantially between countries, from 26.2% in UK to 12.3% in France, and from 12.9 days in Italy to 3.9 days in France. PE patients were often co-managed by general practitioners in France and DACH (>84%), and less frequently in other countries (<47%). The regression results confirmed the country variation of HCRU. Of the employed patients (n = 385), 60% returned to work at 1 month but 27.8% had not after one year. PE patients with DVT were more likely to return to work. Active cancer was a significant predictor for not returning to work, as well as smoking history. CONCLUSIONS: Medical treatment of PE differed between patients with active cancer and patients without active cancer. VTE-related resource utilization differed markedly between countries. While the reported 'not return to work' was high for patients with PE, this may at least in part reflect the presence of co-morbidities such as cancer.
Authors: Sonja Kroep; Ling-Hsiang Chuang; Alexander Cohen; Pearl Gumbs; Ben van Hout; Manuel Monreal; Stefan N Willich; Anselm Gitt; Rupert Bauersachs; Giancarlo Agnelli Journal: J Thromb Thrombolysis Date: 2018-11 Impact factor: 2.300
Authors: Geert-Jan Geersing; Janneke M T Hendriksen; Nicolaas P A Zuithoff; Kit C Roes; Ruud Oudega; Toshihiko Takada; Roger E G Schutgens; Karel G M Moons Journal: PLoS Med Date: 2020-06-26 Impact factor: 11.069
Authors: Ling-Hsiang Chuang; Pearl Gumbs; Ben van Hout; Giancarlo Agnelli; Sonja Kroep; Manuel Monreal; Rupert Bauersachs; Stephen N Willich; Anselm Gitt; Patrick Mismetti; Alexander Cohen; David Jimenez Journal: Qual Life Res Date: 2019-04-04 Impact factor: 4.147
Authors: Geert-Jan Geersing; Toshihiko Takada; Frederikus A Klok; Harry R Büller; D Mark Courtney; Yonathan Freund; Javier Galipienzo; Gregoire Le Gal; Waleed Ghanima; Jeffrey A Kline; Menno V Huisman; Karel G M Moons; Arnaud Perrier; Sameer Parpia; Helia Robert-Ebadi; Marc Righini; Pierre-Marie Roy; Maarten van Smeden; Milou A M Stals; Philip S Wells; Kerstin de Wit; Noémie Kraaijpoel; Nick van Es Journal: PLoS Med Date: 2022-01-25 Impact factor: 11.069
Authors: David Jiménez; Carmen Rodríguez; Beatriz Pintado; Andrea Pérez; Luis Jara-Palomares; Raquel López-Reyes; Pedro Ruiz-Artacho; Alberto García-Ortega; Behnood Bikdeli; José Luis Lobo Journal: Front Cardiovasc Med Date: 2022-04-12