PT - JOURNAL ARTICLE AU - Mark Hudson AU - Amr Radwan AU - Paola Di Maggio AU - Riccardo Cipelli AU - Stephen D Ryder AU - John F Dillon AU - William Jonathan Cash AU - Robert T Przemioslo AU - Mark Wright AU - Debbie L Shawcross AU - Rajiv Jalan AU - Sushma Saksena AU - Michael Allison AU - Paul Richardson AU - Elizabeth Farrington AU - Richard J Aspinall TI - The impact of rifaximin-α on the hospital resource use associated with the management of patients with hepatic encephalopathy: a retrospective observational study (IMPRESS) AID - 10.1136/flgastro-2016-100792 DP - 2017 Oct 01 TA - Frontline Gastroenterology PG - 243--251 VI - 8 IP - 4 4099 - http://fg.bmj.com/content/8/4/243.short 4100 - http://fg.bmj.com/content/8/4/243.full SO - Frontline Gastroenterol2017 Oct 01; 8 AB - 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.