Gibson Peter R, Vaizey Carolynne, Black Christopher M, Nicholls Rebecca, Weston Adèle R, Bampton Peter, Sparrow Miles, Lawrance Ian C, Selby Warwick S, Andrews Jane M, Walsh Alissa J, Hetzel David J, Macrae Finlay A, Moore Gregory T, Weltman Martin D, Leong Rupert W, Fan Tao
Alfred Hospital, Australia; Monash University, Clayton, Victoria, Australia.
St. Mark's Hospital, London, United Kingdom.
J Crohns Colitis. 2014 Jul;8(7):598-606. doi: 10.1016/j.crohns.2013.11.017. Epub 2013 Dec 15.
BACKGROUND & AIMS: The burden of ulcerative colitis (UC) in relation to disease severity is not well documented. This study quantitatively evaluated the relationship between disease activity and quality of life (QoL), as well as health care utilization, cost, and work-related impairment associated with UC in an Australian population.
A cross-sectional, noninterventional, observational study was performed in patients with a wide range of disease severity recruited during routine specialist consultations. Evaluations included the Assessment of Quality of Life-8-dimension (AQoL-8D), EuroQol 5-dimension, 5-level (EQ-5D-5L), the disease-specific Inflammatory Bowel Disease Questionnaire (IBDQ), and the Work Productivity and Activity Impairment (WPAI) instrument. The 3-item Partial Mayo Score was used to assess disease severity. Health care resource utilization was assessed by chart review and patient questionnaires.
In 175 patients, mean (SD) AQoL-8D and EQ-5D-5L scores were greater for patients in remission (0.80 [0.19] and 0.81 [0.18], respectively) than for patients with active disease (0.70 [0.20] and 0.72 [0.19], respectively, both Ps<0.001). IBDQ correlated with both AQoL-8D (r=0.73; P<0.0001) and EQ-5D-5L (0.69; P<0.0001). Mean 3-month UC-related health care cost per patient was AUD $2914 (SD=$3447 [mean for patients in remission=$1970; mild disease=$3736; moderate/severe disease=$4162]). Patients in remission had the least work and activity impairment.
More severe UC disease was associated with poorer QoL. Substantial health care utilization, costs, and work productivity impairments were found in this sample of patients with UC. Moreover, greater disease activity was associated with greater health care costs and impairment in work productivity and daily activities.
溃疡性结肠炎（UC）的疾病负担与疾病严重程度之间的关系尚无充分记录。本研究定量评估了澳大利亚人群中UC的疾病活动与生活质量（QoL）之间的关系，以及医疗保健利用、成本和与工作相关的损伤情况。
在常规专科会诊期间招募了一系列疾病严重程度不同的患者，进行了一项横断面、非干预性观察性研究。评估包括生活质量8维度评估（AQoL-8D）、欧洲五维度健康量表5级（EQ-5D-5L）、特定疾病的炎症性肠病问卷（IBDQ）以及工作效率和活动障碍（WPAI）工具。采用3项部分梅奥评分评估疾病严重程度。通过病历审查和患者问卷评估医疗保健资源利用情况。
175例患者中，缓解期患者的平均（标准差）AQoL-8D和EQ-5D-5L评分（分别为0.80[0.19]和0.81[0.18]）高于活动期疾病患者（分别为0.70[0.20]和0.72[0.19]，P均<0.001）。IBDQ与AQoL-8D（r=0.73；P<0.0001）和EQ-5D-5L（0.69；P<0.0001）均相关。每位患者3个月的UC相关医疗保健成本平均为2914澳元（标准差=3447澳元[缓解期患者平均为1970澳元；轻度疾病为3736澳元；中度/重度疾病为4162澳元]）。缓解期患者的工作和活动损伤最少。
更严重的UC疾病与较差的生活质量相关。在该UC患者样本中发现了大量的医疗保健利用、成本和工作效率损伤。此外，更高的疾病活动度与更高的医疗保健成本以及工作效率和日常活动损伤相关。
