Impact of Gastric Electrical Stimulation on Economic Burden of Refractory Vomiting: A French Nationwide Multicentre Study.
Cost-effectiveness
Enterra Therapy
Gastric Electrical Stimulation
Gastroparesis Symptoms
Journal
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
ISSN: 1542-7714
Titre abrégé: Clin Gastroenterol Hepatol
Pays: United States
ID NLM: 101160775
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
received:
14
05
2020
revised:
26
10
2020
accepted:
06
11
2020
pubmed:
16
11
2020
medline:
28
7
2022
entrez:
15
11
2020
Statut:
ppublish
Résumé
Medico-economic data of patients suffering from chronic nausea and vomiting are lacking. In these patients, gastric electrical stimulation (GES) is an effective, but costly treatment. The aim of this study was to assess the efficacy, safety and medico-economic impact of Enterra therapy in patients with chronic medically refractory nausea and vomiting. Data were collected prospectively from patients with medically refractory nausea and/or vomiting, implanted with an Enterra device and followed for two years. Gastrointestinal quality of life index (GIQLI) score, vomiting frequency, nutritional status and safety were evaluated. Direct and indirect expenditure data were prospectively collected in diaries. Complete clinical data were available for142 patients (60 diabetic, 82 non-diabetic) and medico-economic data were available for 96 patients (36 diabetic, 60 non-diabetic), 24 months after implantation. GIQLI score increased by 12.1 ± 25.0 points (p < .001), with a more significant improvement in non-diabetic than in diabetic patients (+15.8 ± 25.0 points, p < .001 versus 7.3 ± 24.5 points, p = .027, respectively). The proportion of patients vomiting less than once per month increased by 25.5% (p < .001). Hospitalisations, time off work and transport were the main sources of costs. Enterra therapy decreased mean overall healthcare costs from 8873 US$ to 5525 US$ /patient/year (p = .001), representing a saving of 3348 US$ per patient and per year. Savings were greater for diabetic patients (4096 US$ /patient/year) than for non-diabetic patients (2900 US$ /patient/year). Enterra therapy is an effective, safe and cost-effective option for patients with refractory nausea and vomiting. gov Identifier: NCT00903799.
Sections du résumé
BACKGROUND & AIMS
Medico-economic data of patients suffering from chronic nausea and vomiting are lacking. In these patients, gastric electrical stimulation (GES) is an effective, but costly treatment. The aim of this study was to assess the efficacy, safety and medico-economic impact of Enterra therapy in patients with chronic medically refractory nausea and vomiting.
METHODS
Data were collected prospectively from patients with medically refractory nausea and/or vomiting, implanted with an Enterra device and followed for two years. Gastrointestinal quality of life index (GIQLI) score, vomiting frequency, nutritional status and safety were evaluated. Direct and indirect expenditure data were prospectively collected in diaries.
RESULTS
Complete clinical data were available for142 patients (60 diabetic, 82 non-diabetic) and medico-economic data were available for 96 patients (36 diabetic, 60 non-diabetic), 24 months after implantation. GIQLI score increased by 12.1 ± 25.0 points (p < .001), with a more significant improvement in non-diabetic than in diabetic patients (+15.8 ± 25.0 points, p < .001 versus 7.3 ± 24.5 points, p = .027, respectively). The proportion of patients vomiting less than once per month increased by 25.5% (p < .001). Hospitalisations, time off work and transport were the main sources of costs. Enterra therapy decreased mean overall healthcare costs from 8873 US$ to 5525 US$ /patient/year (p = .001), representing a saving of 3348 US$ per patient and per year. Savings were greater for diabetic patients (4096 US$ /patient/year) than for non-diabetic patients (2900 US$ /patient/year).
CONCLUSIONS
Enterra therapy is an effective, safe and cost-effective option for patients with refractory nausea and vomiting.
CLINICALTRIALS
gov Identifier: NCT00903799.
Identifiants
pubmed: 33189854
pii: S1542-3565(20)31544-5
doi: 10.1016/j.cgh.2020.11.011
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT00903799']
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1857-1866.e1Investigateurs
Guillaume Gourcerol
(G)
Benoit Coffin
(B)
Bruno Bonaz
(B)
Helene Hanaire
(H)
Stanislas Bruley des Varannes
(S)
Frank Zerbib
(F)
Robert Caiazzo
(R)
Jean Charles Grimaud
(JC)
Francois Mion
(F)
Samy Hadjadj
(S)
Paul Valensi
(P)
Lucine Vuitton
(L)
Guillaume Charpentier
(G)
Alain Ropert
(A)
Romain Altwegg
(R)
Philippe Pouderoux
(P)
Etienne Dorval
(E)
Michel Dapoigny
(M)
Henri Duboc
(H)
Pierre Yves Benhamou
(PY)
Aurelie Schmidt
(A)
Nathalie Donadieu
(N)
Philippe Ducrotté
(P)
Bruno Guerci
(B)
Informations de copyright
Copyright © 2022. Published by Elsevier Inc.