Health-related quality of life, work productivity and health care resource use associated with constipation predominant irritable bowel syndrome

摘要

Objectives: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder. Prevalence estimates of IBS vary widely, from 10 to 15%, in the U.S. However, few studies have examined constipation predominant IBS (IBS-C), a subtype of IBS. The aim of this study was to assess the effect of IBS-C on health-related quality of life (HRQOL), work productivity and activity impairment, and health care resource use. Methods: Using data from the 2007 U.S. National Health and Wellness Survey, IBS-C patients (n=789) were compared to a propensity-score matched comparison group (n=789). Differences between the groups were examined on HRQOL (SF-12v2), work productivity and activity impairment (WPAI questionnaire), and self-reported resource use in the last 6 months. Results: Patients with IBS-C reported significantly lower levels of HRQOL (physical component summary score: 41.55 [95% CI: 40.7242.37] versus 44.49 [95% CI: 43.6745.31]; mental component summary score: 40.58 [95% CI: 39.7541.40] vs. 45.87 [95% CI: 45.0446.70]) and significantly higher mean levels of presenteeism (31.72% [95% CI: 28.25%35.61%] vs. 21.43% [95% CI: 19.03%24.15%]), overall work impairment (35.54% [95% CI: 31.76%39.76%] vs. 25.29% [95% CI: 22.59%28.30%]), and activity impairment (45.78% [95% CI: 43.08%48.66%] vs. 33.03% [95% CI: 31.08%35.11%]) than matched comparators (all P values<0.01). Patients with IBS-C reported significantly more provider visits (8.07 [95% CI: 7.388.82] vs. 5.55 [95% CI: 5.076.08]) and emergency room visits (0.57 [95% CI: 0.460.70] vs. 0.36 [95% CI: 0.290.45]) in the past 6 months (all Ps<0.01). No statistically significant differences between the groups were observed in absenteeism or the number of the days hospitalized. Conclusions: IBS-C was associated with poorer HRQOL, greater work productivity loss and activity impairment, and greater healthcare resource use. Limitations include the study's cross-sectional design and its self-reported nature. Nevertheless, improved management of IBS-C may reduce the humanistic and economic burden of the condition and benefit patients, employers, and the healthcare system.