The impact of rifaximin-α on the hospital resource use associated with the management of patients with hepatic encephalopathy: a retrospective observational study (IMPRESS)
The impact of rifaximin-α on the hospital resource use associated with the management of patients with hepatic encephalopathy: a retrospective observational study (IMPRESS)
OBJECTIVE: To compare all-cause and liver-related hospital resource use in the 6 and 12 months pre-rifaximin-α and post-rifaximin-α initiation in UK patients with hepatic encephalopathy (HE).
DESIGN: A UK multicentre, retrospective, observational study. Patients' medical records were reviewed for demographics, clinical outcomes and adverse events (AEs) to rifaximin-α. Details of hospital admissions/attendances in the 6 and 12 months pre-rifaximin-α and post-rifaximin-α initiation were extracted from hospital electronic databases.
SETTING: 13 National Health Service centres.
PATIENTS: 207 patients with HE who initiated rifaximin-α between July 2008 and May 2014. Hospital resource use data were available for 145/207 patients.
MAIN OUTCOME MEASURE: Change in mean number of liver-related hospital bed days/patient (total and critical care) between the 6 months pre-rifaximin-α and post-rifaximin-α initiation.
RESULTS: Comparing the 6 months pre-rifaximin-α and post-rifaximin-α initiation in alive patients at the end of the observation period (N=114): there were significant reductions in the mean number of hospitalisations/patient (liver-related 1.3 to 0.5, p<0.001; all-cause 1.9 to 0.9, p<0.001), hospital bed days/patient (liver-related 17.8 to 6.8, p<0.001; all-cause 25.4 to 10.6, p<0.001), 30-day hospital readmissions/patient (liver-related 0.5 to 0.2, p=0.039; all-cause 0.8 to 0.4, p=0.024) and emergency department (ED) attendances/patient (all-cause, 1.0 to 0.5, p<0.001). The mean critical care bed days/patient reduced significantly for all-cause admissions (1.3 to 0.3, p=0.049); non-significant reduction for liver-related admissions. 4% of patients (9/207) developed AEs.
CONCLUSIONS: In UK clinical practice, treatment with rifaximin-α for HE is well-tolerated and associated with significant reductions in hospitalisations, bed days (including critical care), ED attendances and 30-day readmissions.
243-251
Hudson, Mark
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Radwan, Amr
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Di Maggio, Paola
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Cipelli, Riccardo
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Ryder, Stephen D
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Dillon, John F
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Cash, William Jonathan
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Przemioslo, Robert T
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Wright, Mark
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Shawcross, Debbie L
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Jalan, Rajiv
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Saksena, Sushma
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Allison, Michael
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Richardson, Paul
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Farrington, Elizabeth
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Aspinall, Richard J
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11 September 2017
Hudson, Mark
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Radwan, Amr
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Di Maggio, Paola
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Cipelli, Riccardo
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Ryder, Stephen D
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Dillon, John F
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Cash, William Jonathan
dad16d9e-d52e-4213-9bf1-ac1b14817996
Przemioslo, Robert T
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Wright, Mark
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Shawcross, Debbie L
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Jalan, Rajiv
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Saksena, Sushma
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Allison, Michael
d4822379-801a-44ff-bcb2-53c53bed362e
Richardson, Paul
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Farrington, Elizabeth
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Aspinall, Richard J
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Hudson, Mark, Radwan, Amr, Di Maggio, Paola, Cipelli, Riccardo, Ryder, Stephen D, Dillon, John F, Cash, William Jonathan, Przemioslo, Robert T, Wright, Mark, Shawcross, Debbie L, Jalan, Rajiv, Saksena, Sushma, Allison, Michael, Richardson, Paul, Farrington, Elizabeth and Aspinall, Richard J
(2017)
The impact of rifaximin-α on the hospital resource use associated with the management of patients with hepatic encephalopathy: a retrospective observational study (IMPRESS).
Frontline Gastroenterology, 8 (4), .
(doi:10.1136/flgastro-2016-100792).
Abstract
OBJECTIVE: To compare all-cause and liver-related hospital resource use in the 6 and 12 months pre-rifaximin-α and post-rifaximin-α initiation in UK patients with hepatic encephalopathy (HE).
DESIGN: A UK multicentre, retrospective, observational study. Patients' medical records were reviewed for demographics, clinical outcomes and adverse events (AEs) to rifaximin-α. Details of hospital admissions/attendances in the 6 and 12 months pre-rifaximin-α and post-rifaximin-α initiation were extracted from hospital electronic databases.
SETTING: 13 National Health Service centres.
PATIENTS: 207 patients with HE who initiated rifaximin-α between July 2008 and May 2014. Hospital resource use data were available for 145/207 patients.
MAIN OUTCOME MEASURE: Change in mean number of liver-related hospital bed days/patient (total and critical care) between the 6 months pre-rifaximin-α and post-rifaximin-α initiation.
RESULTS: Comparing the 6 months pre-rifaximin-α and post-rifaximin-α initiation in alive patients at the end of the observation period (N=114): there were significant reductions in the mean number of hospitalisations/patient (liver-related 1.3 to 0.5, p<0.001; all-cause 1.9 to 0.9, p<0.001), hospital bed days/patient (liver-related 17.8 to 6.8, p<0.001; all-cause 25.4 to 10.6, p<0.001), 30-day hospital readmissions/patient (liver-related 0.5 to 0.2, p=0.039; all-cause 0.8 to 0.4, p=0.024) and emergency department (ED) attendances/patient (all-cause, 1.0 to 0.5, p<0.001). The mean critical care bed days/patient reduced significantly for all-cause admissions (1.3 to 0.3, p=0.049); non-significant reduction for liver-related admissions. 4% of patients (9/207) developed AEs.
CONCLUSIONS: In UK clinical practice, treatment with rifaximin-α for HE is well-tolerated and associated with significant reductions in hospitalisations, bed days (including critical care), ED attendances and 30-day readmissions.
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Published date: 11 September 2017
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Local EPrints ID: 481069
URI: http://eprints.soton.ac.uk/id/eprint/481069
ISSN: 2041-4137
PURE UUID: 9c032953-6062-44f9-a8e6-61b1111b4b7e
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Date deposited: 15 Aug 2023 16:44
Last modified: 17 Mar 2024 02:14
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Contributors
Author:
Mark Hudson
Author:
Amr Radwan
Author:
Paola Di Maggio
Author:
Riccardo Cipelli
Author:
Stephen D Ryder
Author:
John F Dillon
Author:
William Jonathan Cash
Author:
Robert T Przemioslo
Author:
Mark Wright
Author:
Debbie L Shawcross
Author:
Rajiv Jalan
Author:
Sushma Saksena
Author:
Michael Allison
Author:
Paul Richardson
Author:
Elizabeth Farrington
Author:
Richard J Aspinall
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