Institut des Maladies de l'Appareil Digestif (IMAD), CHU Hôtel Dieu, 1 place Alexis Ricordeau, 44 093 Nantes, France.
Dig Liver Dis. 2013 Mar;45(3):200-6. doi: 10.1016/j.dld.2012.11.005. Epub 2012 Dec 10.
BACKGROUND: Few studies have evaluated the impact of gastroesophageal reflux disease symptoms on work productivity and no French data are available. AIM: To compare the impact of typical symptoms of nocturnal vs diurnal gastroesophageal reflux disease on work productivity and daily activities. METHODS: A French prospective, multicenter, observational study was performed in primary care setting. Patient characteristics, symptomatology and treatment were reported. Work productivity loss was assessed using the work productivity and activity impairment questionnaire, predictors were identified using multivariate regression models, and estimated cost was calculated. RESULTS: 716 eligible patients (mean age: 46.3 years) were included by 407 physicians. Nocturnal symptoms were reported in 50.8% of patients and exclusively diurnal symptoms in 49.2%. Mean work productivity and daily activities decreased by 31.4% and 32.6%, respectively (both p<0.001). Work productivity was influenced by symptom intensity, diurnal symptoms occurrence, regurgitation and diurnal sleepiness. The mean associated cost per patient/week (€313) was higher in patients with diurnal symptoms (without (€346) or with nocturnal (€312) symptoms) than in patients with exclusive nocturnal symptoms (€253) (p<0.001). CONCLUSION: Gastroesophageal reflux disease incurs high work productivity loss especially in patients with diurnal symptoms. Further medico-economic analyses are needed to estimate the cost effectiveness ratio according to therapeutic strategies.
背景:很少有研究评估胃食管反流病症状对工作效率的影响,并且没有法国的数据。
目的:比较夜间与日间胃食管反流病典型症状对工作效率和日常活动的影响。
方法:在初级保健环境中进行了一项法国前瞻性、多中心、观察性研究。报告了患者特征、症状和治疗情况。使用工作生产力和活动障碍问卷评估工作生产力损失,使用多变量回归模型确定预测因素,并计算估计成本。
结果:407 名医生纳入了 716 名符合条件的患者(平均年龄:46.3 岁)。50.8%的患者报告有夜间症状,49.2%的患者仅报告日间症状。工作生产力和日常活动分别下降了 31.4%和 32.6%(均<0.001)。工作生产力受症状强度、日间症状发生、反流和日间嗜睡的影响。每周每位患者的平均相关费用(€313)在有日间症状的患者(无(€346)或有夜间(€312)症状)高于仅夜间症状的患者(€253)(<0.001)。
结论:胃食管反流病导致工作效率严重下降,特别是在有日间症状的患者中。需要进一步进行医学经济学分析,根据治疗策略评估成本效益比。
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