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Drug treatment patterns and work productivity in chronic kidney disease patients with anemia in China: Cross sectional analysis of real-world data

Kidney Research and Clinical Practice 2020년 39권 3호 p.318 ~ 333
van Haalen Heleen, Sloand James, Moon Rebecca, Palaka Eirini, Milligan Gary, Allum Alaster, Jackson James,
소속 상세정보
 ( van Haalen Heleen ) - AstraZeneca
 ( Sloand James ) - AstraZeneca
 ( Moon Rebecca ) - Adelphi Real World
 ( Palaka Eirini ) - AstraZeneca
 ( Milligan Gary ) - Adelphi Real World
 ( Allum Alaster ) - AstraZeneca
 ( Jackson James ) - Adelphi Real World

Abstract


Background: We explored the association of anemia severity in patients with chronic kidney disease (CKD) and anemia treatment with work productivity in China.

Methods: Cross-sectional survey data from Chinese physicians and their CKD patients were collected in 2015. Physicians recorded demographics, disease characteristics, and treatment. Patients completed the Work Productivity and Activity Impairment questionnaire. Data were stratified by dialysis-dependence, hemoglobin (Hb) level, and anemia treatment.

Results: Based on data from 1,052 patients (704 non-dialysis-dependent [NDD] and 348 dialysis-dependent [DD] patients), prescribed anemia treatment differed significantly across Hb levels (P < 0.001). In NDD patients, anemia treatment also differed significantly by on-treatment Hb level (P < 0.001). In treated NDD patients with Hb < 10 g/ dL, Hb 10 to 12 g/dL, and Hb > 12 g/dL, 31%, 59%, and 38% of patients, respectively, were prescribed oral iron, and 34%, 19%, and 0% of patients, respectively, were prescribed oral iron with erythropoiesis-stimulating agents (ESA). NDD patients were less likely to be prescribed any anemia treatment, and ESA specifically, than DD patients. When treated, 67% and 45% of NDD and DD patients, respectively, had Hb ≥ 10 g/dL (P < 0.001). Overall work and activity impairment differed significantly across Hb levels in NDD and DD patients, with the least impairment observed at the highest Hb level.

Conclusion: Approximately 40% of NDD patients and 60% of DD patients receiving anemia treatment had Hb < 10 g/dL. Compared with mild anemia patients, severe anemia patients were more likely to be treated for anemia and have impaired work productivity. Chinese CKD patients could benefit from improved anemia treatment.

키워드

Anemia; China; Chronic kidney diseases; Hematinics; Iron; Observational study

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