Article type
Year
Abstract
Background: At the time of outbreak of SARS in China, the largest SARS hospital in the world (XTS Hospital) was built in Beijing. In total, 680 cases had been admitted from May 1 to the end of diseases, of which 666 cases were merely treated with drugs, 14 received non-invasive ventilation concomitantly and 672 were healed. Along with the treatment, a well-designed and maintained database (XTS Hospital Information System, HIS) was established, which collected 1.09 million patient records.
Objective: To study utility, effects and costs of drug treatment on SARS, and to summarize experiences for management of SARS.
Methods: We searched HIS for all requested records of patients. Both critical and non-critical patients were included on the basis that they were clinically diagnosed of SARS. The most frequently used drugs for critical and non-critical patients were studied.
Efficacy was assessed by healing rate and hospital days, and rationality of utilization by daily defined doses (DDDs) and Drug Utility Index (DUI). The severity of ADRs was graded according to the standards of the WHO. The costs were calculated from the perspectives of healthcare payers. The factors to influence the costs were analyzed by multi-linear regression.
Results: The overall healing rate was 98.8%. The demographic background and overall efficacy were listed in table 1. Three hundred and fifty drugs of 17 pharmacological categories were prescribed, of which antiviral and immunomodulating agents, antibitotics and traditional Chinese medicine were the most frequently used. Seven types of drug combinations were used in 269 cases, accounting for 39.56% of total cases. Thymosin, Ribavirin and Methylprednisolone were among the most frequently used drugs, with 924, 432 and 319 times of prescription, DDDs of 63471.9, 4500.0, and 9039.8, and DUI of 18.07, 1.43 and 0.86.
Medical and pharmaceutical costs of SARS were listed in table 1. There was no significant difference between patients with and without underlying diseases, either in critical or non-critical group. The costs of biological products, antiviral agents, antibiotics and corticosteroids accounted 89.99 percent and 78.02 percent of pharmaceutical costs in non-critical and critical patients. The linear-regression analysis indicated that age and severity of diseases were factors to influence costs.
Two hundred and fifty-one ADRs were identified, of which 156 cases were in grade II ADRs, 29 in grade III, and 66 in grad IV. Ninety-one cases occurred in hematological system, followed by gastroenterological disorders (40 cases), endocrinopathy (33 cases) and hepatobilory and cardiovascular diseases (21 cases). Gluco-corticosteriods caused 180 cases of ADRs, followed by antibiotics (25 cases), and antiviral agents (12 cases). Methylprednisolone caused the most serious ADRs (123 cases, with occurrence of 28.47%), followed by predisolone, (13 cases, and 24.07%).
Conclusions: Drug treatment on SARS in XTS Hospital was generally well-regulated. Antiviral agents, antibitotics, biological products and corticosteroids were frequently administrated and might improve treatment. However, irrational use of drugs might cause severe ADRs and unnecessarily high costs. A study on the cost-effectiveness of drug treatment will be reported soon.
Objective: To study utility, effects and costs of drug treatment on SARS, and to summarize experiences for management of SARS.
Methods: We searched HIS for all requested records of patients. Both critical and non-critical patients were included on the basis that they were clinically diagnosed of SARS. The most frequently used drugs for critical and non-critical patients were studied.
Efficacy was assessed by healing rate and hospital days, and rationality of utilization by daily defined doses (DDDs) and Drug Utility Index (DUI). The severity of ADRs was graded according to the standards of the WHO. The costs were calculated from the perspectives of healthcare payers. The factors to influence the costs were analyzed by multi-linear regression.
Results: The overall healing rate was 98.8%. The demographic background and overall efficacy were listed in table 1. Three hundred and fifty drugs of 17 pharmacological categories were prescribed, of which antiviral and immunomodulating agents, antibitotics and traditional Chinese medicine were the most frequently used. Seven types of drug combinations were used in 269 cases, accounting for 39.56% of total cases. Thymosin, Ribavirin and Methylprednisolone were among the most frequently used drugs, with 924, 432 and 319 times of prescription, DDDs of 63471.9, 4500.0, and 9039.8, and DUI of 18.07, 1.43 and 0.86.
Medical and pharmaceutical costs of SARS were listed in table 1. There was no significant difference between patients with and without underlying diseases, either in critical or non-critical group. The costs of biological products, antiviral agents, antibiotics and corticosteroids accounted 89.99 percent and 78.02 percent of pharmaceutical costs in non-critical and critical patients. The linear-regression analysis indicated that age and severity of diseases were factors to influence costs.
Two hundred and fifty-one ADRs were identified, of which 156 cases were in grade II ADRs, 29 in grade III, and 66 in grad IV. Ninety-one cases occurred in hematological system, followed by gastroenterological disorders (40 cases), endocrinopathy (33 cases) and hepatobilory and cardiovascular diseases (21 cases). Gluco-corticosteriods caused 180 cases of ADRs, followed by antibiotics (25 cases), and antiviral agents (12 cases). Methylprednisolone caused the most serious ADRs (123 cases, with occurrence of 28.47%), followed by predisolone, (13 cases, and 24.07%).
Conclusions: Drug treatment on SARS in XTS Hospital was generally well-regulated. Antiviral agents, antibitotics, biological products and corticosteroids were frequently administrated and might improve treatment. However, irrational use of drugs might cause severe ADRs and unnecessarily high costs. A study on the cost-effectiveness of drug treatment will be reported soon.