LymeDisease.org , Chico, CA , USA.
Human-Computer Interaction Institute, Carnegie Mellon University , Pittsburgh, PA , USA.
PeerJ. 2014 Mar 27;2:e322. doi: 10.7717/peerj.322. eCollection 2014.
Overview. The Centers for Disease Control and Prevention (CDC) health-related quality of life (HRQoL) indicators are widely used in the general population to determine the burden of disease, identify health needs, and direct public health policy. These indicators also allow the burden of illness to be compared across different diseases. Although Lyme disease has recently been acknowledged as a major health threat in the USA with more than 300,000 new cases per year, no comprehensive assessment of the health burden of this tickborne disease is available. This study assesses the HRQoL of patients with chronic Lyme disease (CLD) and compares the severity of CLD to other chronic conditions. Methods. Of 5,357 subjects who responded to an online survey, 3,090 were selected for the study. Respondents were characterized as having CLD if they were clinically diagnosed with Lyme disease and had persisting symptoms lasting more than 6 months following antibiotic treatment. HRQoL of CLD patients was assessed using the CDC 9-item metric. The HRQoL analysis for CLD was compared to published analyses for the general population and other chronic illnesses using standard statistical methods. Results. Compared to the general population and patients with other chronic diseases reviewed here, patients with CLD reported significantly lower health quality status, more bad mental and physical health days, a significant symptom disease burden, and greater activity limitations. They also reported impairment in their ability to work, increased utilization of healthcare services, and greater out of pocket medical costs. Conclusions. CLD patients have significantly impaired HRQoL and greater healthcare utilization compared to the general population and patients with other chronic diseases. The heavy burden of illness associated with CLD highlights the need for earlier diagnosis and innovative treatment approaches that may reduce the burden of illness and concomitant costs posed by this illness.
概述。疾病控制与预防中心(CDC)的健康相关生活质量(HRQoL)指标在普通人群中被广泛用于确定疾病负担、确定健康需求并指导公共卫生政策。这些指标还允许比较不同疾病的疾病负担。尽管莱姆病最近在美国被认为是一个主要的健康威胁,每年有超过 30 万例新病例,但尚无对这种蜱传疾病的健康负担进行全面评估。本研究评估了慢性莱姆病(CLD)患者的 HRQoL,并将 CLD 的严重程度与其他慢性疾病进行了比较。方法。在对在线调查做出回应的 5357 名受试者中,选择了 3090 名进行研究。如果患者经临床诊断患有莱姆病且在抗生素治疗后持续出现持续超过 6 个月的症状,则认为其患有 CLD。使用 CDC 9 项指标评估 CLD 患者的 HRQoL。使用标准统计方法将 CLD 的 HRQoL 分析与一般人群和其他慢性疾病的已发表分析进行比较。结果。与普通人群和本文中回顾的其他慢性疾病患者相比,CLD 患者报告的健康质量状况明显较低,不良精神和身体健康天数更多,症状疾病负担显著,活动受限更大。他们还报告工作能力受损、增加了对医疗保健服务的利用以及增加了自付医疗费用。结论。CLD 患者的 HRQoL 明显受损,并且与普通人群和其他慢性疾病患者相比,对医疗保健的利用更多。与 CLD 相关的沉重疾病负担突出表明需要更早的诊断和创新的治疗方法,这可能会减轻这种疾病带来的负担和相关成本。