ESPE Abstracts (2016) 86 P-P2-73

ESPE2016 Poster Presentations Adrenal P2 (49 abstracts)

Patients with Congenital Adrenal Hyperplasia have Significantly Higher Healthcare Utilisation than the General Paediatric Population

Sara Jenkins-Jones b , Sarah Holden b , Christopher Morgan b , Craig Currie b , Martin Whitaker a , Richard Ross a , Mike Withe a & John Porter a

aDiurnal Ltd, Cardiff, UK; bPharmatelligence, Cardiff, UK

Background: Congenital adrenal hyperplasia (CAH) is a rare disorder of steroid synthesis. Patients have multiple health problems. Healthcare utilisation has not previously been assessed in the paediatric population with CAH.

Objective and hypotheses: To assess healthcare resource use in patients in England with CAH.

Method: The English Clinical Practice Research Datalink (CPRD) database is an observational and interventional research service overseen by the UK Department of Health. Approximately 50% of CPRD patients link to more detailed records than the standard dataset and we selected patients eligible for linkage to Hospital Episode Statistics (HES) data. We analysed data from 351 CAH patients of all ages as defined by Read and ICD-10 coding, alongside 3510 age- and sex-matched controls. Patients’ resource use and costs were analysed by age group: 51 patients/510 controls 0–6 years, 33 patients/330 controls 7–17 years, and compared by Mann-Whitney test. Neonatal utilisations were only captured after a patient was registered with primary care.

Results: Primary care usage was approximately double for paediatric patients compared with controls, with a median 9.0 vs 4.0 consultations/year (P<0.001) in 0–6 years and 4.0 vs 2.0 consultations/year (P<0.001) in 7–17 years. Secondary care usage was higher in CAH with higher median outpatient appointments: 8.0 vs 0.0 (P<0.001) (0–6 years) and 5.0 vs 0.0 (P<0.001) (7–17 years). Median inpatient admissions were also more common in CAH 2.0 vs 0.0 (P<0.001) (0–6 years) and 1.0 vs 0.0 (P<0.001) in 7–17 years.

Conclusion: This study shows a significantly increased healthcare utilisation from CAH throughout childhood. Refining and improving treatment for patients with CAH should help to reduce this burden on the healthcare system.

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