J Neurogastroenterol Motil.
2017 Oct;23(4):541-549. 10.5056/jnm16179.
Early Assessment of Cost-effectiveness of Gastric Electrical Stimulation for Diabetic Nausea and Vomiting
- Affiliations
-
- 1Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark. meteader@rm.dk
- 2Department of Abdominal Surgery, Aarhus University Hospital, Aarhus, Denmark.
- 3Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
- 4Danish Center for Healthcare Improvements, Aalborg University, Aalborg, Denmark.
- KMID: 2395422
- DOI: http://doi.org/10.5056/jnm16179
Abstract
- BACKGROUND/AIMS
Recurrent nausea and/or vomiting are common complications of diabetes mellitus. The conditions severely impact the quality of life of patients and often cause repeated admissions to hospital incurring significant healthcare costs. If standard treatment fails, gastric electrical stimulation (GES) may be offered in selected cases, as a minimally invasive, but expensive, therapeutic option. Our aims are to evaluate the clinical effect and the cost-utility of GES as a treatment for severe diabetic recurrent nausea and/or vomiting.
METHODS
Among 33 diabetes patients implanted with GES because of recurrent nausea and/or vomiting, 30 were available for evaluation. The effect of treatment was assessed prospectively using symptom-diaries and the SF-36 questionnaires at baseline, after 6 and 12 months, and thereafter yearly. The number of days in hospital due to symptoms related to gastrointestinal dysfunction was calculated using hospital records 12 months prior to and 12 months after implantation.
RESULTS
The surgical procedures were performed without mortality or major complications. Six months after surgery 78% of the respondents had at least 50% reduction in time with nausea and 48% had at least 50% reduction in days with vomiting. Symptom relief persisted at follow-up after at least 4 years. Quality adjusted life years improved after GES, which was cost-effective after 24 months.
CONCLUSIONS
GES reduces symptoms and improves quality of life in diabetes patients with recurrent nausea and/or vomiting. The procedure is supposed as cost-effective over a 2-year time horizon.
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