Health-related quality of life, work productivity, and indirect costs among patients with irritable bowel syndrome with diarrhea.
Health-related quality of life, work productivity, and indirect costs among patients with irritable bowel syndrome with diarrhea.
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DOI：
10.1186/s12955-017-0611-2
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发表时间：
2017-02-14
影响因子：
3.6
通讯作者：
Flores NM
中科院分区：
文献类型：
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作者：
Buono JL;Carson RT;Flores NM
肠易激综合征（IBS）影响美国10-15%的成年人，并与健康相关生活质量（HRQoL）的显著损害相关;然而，缺乏腹泻亚型（IBS-D）的特定信息。我们评估了IBS-D对HRQoL，工作效率和日常活动的影响，以及相关的间接成本，在美国人群中的样本。2012年美国国家健康与健康调查中报告医生诊断为IBS-D或症状符合IBS-D罗马II标准的受访者（≥18岁）被确定为患有IBS-D。对照组包括没有IBS-D或炎症性肠病的受访者。HRQoL通过简表36健康调查第2版问卷进行评估，并总结为精神和身体健康总评量表（MCS; PCS）评分和简表6维度（SF-6D）效用评分。通过工作效率和活动损害问卷：一般健康版本（WPAI：GH）评估工作和活动损害，该问卷测量缺勤、出勤、整体工作效率损失和日常活动损害。间接成本是使用美国劳工统计局的单位成本数据和WPAI：GH的变量计算的。广义线性模型用于检查IBS-D和对照组之间的健康结果差异，控制人口统计学和健康特征。总共分析了66，491名受访者（1102名IBS-D; 65，389名对照）。平均年龄为48.7岁; 50%为女性。与对照组相比，IBS-D队列报告的HRQoL显著降低（平均MCS：45.16 vs. 49.48; p < 0.001;平均PCS：47.29 vs. 50.67; p < 0.001;平均SF-6D：0.677 vs. 0.741; p < 0.001）和缺勤率较高（5.1% vs. 2.9%; p = 0.004）、出勤率（17.9% vs. 11.3%; p < 0.001）、总体工作效率下降（20.7% vs. 13.2%; p < 0.001）和活动障碍（29.6% vs. 18.9%; p < 0.001）。IBS-D患者的间接费用估计也增加了2486美元（7008美元对4522美元; p < 0.001）。与对照组相比，IBS-D与HRQoL显著降低、工作和日常活动受损更大以及间接成本更高相关，给患者和雇主带来了巨大负担。这些发现表明，对有效的IBS-D治疗存在显著未满足的需求。
Irritable bowel syndrome (IBS) affects 10–15% of adults in the US, and is associated with significant impairment in health-related quality of life (HRQoL); however, information specific to the diarrhea subtype (IBS-D) is lacking. We assessed the impact of IBS-D on HRQoL, work productivity, and daily activities, and the associated indirect costs, among a sample of the US population. Respondents (≥18 years) from the 2012 US National Health and Wellness Survey who reported an IBS-D diagnosis by a physician or symptoms consistent with Rome II criteria for IBS-D were identified as having IBS-D. Controls included respondents without IBS-D or inflammatory bowel disease. HRQoL was assessed via the Short Form 36 Health Survey version 2 questionnaire and summarized into Mental and Physical Component Summary (MCS; PCS) scores and a Short Form-6 dimension (SF-6D) utility score. Work and activity impairment were assessed via the Work Productivity and Activity Impairment Questionnaire: General Health version (WPAI:GH), which measures absenteeism, presenteeism, overall work productivity loss, and daily activity impairment. Indirect costs were calculated using unit cost data from the Bureau of Labor Statistics and variables from the WPAI:GH. Generalized linear models were used to examine differences in health outcomes between respondents with IBS-D and controls, controlling for demographic and health characteristics. In total, 66,491 respondents (1102 IBS-D; 65,389 controls) were analyzed. Mean age was 48.7 years; 50% were female. Compared with controls, the IBS-D cohort reported significantly lower HRQoL (mean MCS: 45.16 vs. 49.48; p < 0.001; mean PCS: 47.29 vs. 50.67; p < 0.001; mean SF-6D: 0.677 vs. 0.741; p < 0.001) and greater absenteeism (5.1% vs. 2.9%; p = 0.004), presenteeism (17.9% vs. 11.3%; p < 0.001), overall work productivity loss (20.7% vs. 13.2%; p < 0.001), and activity impairment (29.6% vs. 18.9%; p < 0.001). Respondents with IBS-D also incurred an estimated $2486 more in indirect costs ($7008 vs. $4522; p < 0.001). Compared with controls, IBS-D is associated with significantly lower HRQoL, greater impairments in work and daily activities, and higher indirect costs, imposing a substantial burden on patients and employers. These findings suggest a significant unmet need exists for effective IBS-D treatments.