ABSTRACT
BACKGROUND: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice and associated with a high risk of stroke, heart failure and hospitalization. This study examines the indication-specific costs of illness of AF patients in Germany. METHODS: The study was conducted nationwide with 54 general practitioners and internists, as well as 12 practicing cardiologists. The observational period per patient was one year. Costs were calculated from the perspective of the German statutory health insurance. The study collected the annual direct indication-specific costs and additional patient relevant outcomes. RESULTS: Indication-specific services of 361 patients (age: 75, male: 55%) documented by general practitioners and internists cause average costs of 582 per patient. The highest cost are caused by hospitalization (289 ), followed by outpatient treatment costs (151 ) and costs of anticoagulation with 52 per patient. Additional consulting of a cardiologist (115 patients) causes average costs of 81 . Assuming that a patient with AF is treated once a year by a resident cardiologist, the average annual cost amounted to 664 . CONCLUSION: The results of this prospectively cost of illness analysis for AF patients under real life conditions in Germany indicate a high socio-economic burden of AF.
Subject(s)
Ambulatory Care/economics , Anticoagulants/economics , Atrial Fibrillation/economics , Atrial Fibrillation/epidemiology , Cost of Illness , Hospitalization/economics , Aged , Anticoagulants/therapeutic use , Atrial Fibrillation/therapy , Female , Germany/epidemiology , Health Care Costs/statistics & numerical data , Humans , Male , Prevalence , Prospective StudiesABSTRACT
The clinical success of a 5-day course of oral moxifloxacin (administered once daily at a dose of 400 mg) was evaluated in 328 patients with acute exacerbations of chronic bronchitis (Anthonisen type 1) in a non-comparative study conducted by chest physicians in private practice. Results were assessed on the basis of clinical parameters and, for the first time in a trial involving oral moxifloxacin, by the surrogate marker of patient satisfaction. Improvement in (and severity of) cough, dyspnoea, chest pain and sputum were scored daily by patients. Cough, chest pain and purulent sputum production improved rapidly within the first 5 days of treatment. At least 90% of patients were satisfied with the antibiotic. The clinical success rate (cure and improvement) for all patients involved (intent-to-treat analysis) was 90.5%. The most commonly experienced adverse events were gastrointestinal related, with diarrhoea the most frequent of these (2.7% of all patients).
Subject(s)
Anti-Infective Agents/therapeutic use , Aza Compounds , Bronchitis/drug therapy , Fluoroquinolones , Quinolines , Acute Disease , Adult , Aged , Aged, 80 and over , Anti-Infective Agents/adverse effects , Bronchitis/physiopathology , Chronic Disease , Female , Humans , Male , Middle Aged , Moxifloxacin , Patient Satisfaction , Respiratory Function Tests , Surveys and Questionnaires , Treatment OutcomeABSTRACT
Moxifloxacin, a new respiratory quinolone, was compared with the macrolides azithromycin, clarithromycin and roxithromycin in a cohort study to assess clinical, safety and health-related outcomes of these antimicrobials in general practice settings. In total 332 patients with acute exacerbations of chronic bronchitis (AECB) each received one of the antimicrobial agents for a standard short course of therapy. Random allocation of therapeutic agents occurred by centre, not individuals, and the drugs were prescribed in an open manner. In addition to clinical evaluation by their physicians, all patients kept daily diaries to assess AECB symptoms over the study period, therapy received and quality of life. The overall clinical response rate was 96% and all four regimens were well tolerated. After 14 days there were no significant differences between the study groups, but analyses of patients' daily evaluations of certain AECB specific symptoms showed a faster response rate in the moxifloxacin group.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Anti-Infective Agents/therapeutic use , Aza Compounds , Bronchitis/drug therapy , Fluoroquinolones , Quinolines , Acute Disease , Adolescent , Adult , Aged , Aged, 80 and over , Azithromycin/therapeutic use , Chronic Disease , Clarithromycin/therapeutic use , Cohort Studies , Female , Humans , Male , Middle Aged , Moxifloxacin , Roxithromycin/therapeutic use , Treatment OutcomeSubject(s)
Anti-Infective Agents/administration & dosage , Aza Compounds , Bronchitis/drug therapy , Chest Pain/drug therapy , Cough/drug therapy , Fluoroquinolones , Quinolines , Chest Pain/etiology , Chronic Disease , Cough/etiology , Drug Administration Schedule , Humans , Moxifloxacin , Treatment OutcomeABSTRACT
BACKGROUND AND METHOD: The aim of this trial conducted in the offices of pneumologists was to evaluate the clinical success of a 5-day course of oral moxifloxacin administered once daily at a dose of 400 mg in 328 patients with acute exacerbation of chronic bronchitis (Anthonisen type 1). In this non-comparative study, the results of treatment were assessed not merely on the basis of the clinical parameters, but also, for the first time, by the surrogate marker of patient satisfaction and the improvement in cough, dyspnea, chest pain and sputum, the severity of which was scored daily by the patient himself. RESULTS: Cough, chest pain and the purulence of the sputum improved rapidly within the first five days of treatment. At least 90% of the patients reported their satisfaction with the antibiotic. The clinical success rate (cure and improvement) for all the patients involved (ITT analysis) was 90.5%. The most common side effect was diarrhea, while the other side effects showed no specific pattern.
