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英国溃疡性结肠炎的疾病状况、患者生活质量及医疗资源利用:一项观察性研究。

Disease status, patient quality of life and healthcare resource use for ulcerative colitis in the UK: an observational study.

作者信息

Vaizey Carolynne J, Gibson Peter R, Black Christopher M, Nicholls Rebecca J, Weston Adèle R, Gaya Daniel R, Sebastian Shaji, Shaw Ian, Lewis Stephen, Bloom Stuart, Gordon John N, Beale Amanda, Arnott Ian, Campbell Simon, Fan Tao

机构信息

Department of Surgery, St. Mark's Hospital, London, UK.

Alfred Hospital, Melbourne, and Monash University, Victoria, Australia.

出版信息

Frontline Gastroenterol. 2014 Jul;5(3):183-189. doi: 10.1136/flgastro-2013-100409. Epub 2014 Jan 24.

Abstract

BACKGROUND

Ulcerative colitis is a lifelong, chronic, relapsing-remitting disease.

OBJECTIVE

To assess the relationship between ulcerative colitis disease status and patient quality of life, and to determine the impact of ulcerative colitis on healthcare costs and work productivity, in the UK.

METHODS

Clinicians assessed 173 adult patients' current disease status at a single study visit using the partial Mayo (pMayo) instrument. Patients completed the Euro Quality of Life 5-dimension, 5-level (EQ-5D-5L) questionnaire, the Work Productivity and Activity Impairment (WPAI) questionnaire. Healthcare resource use was determined from questionnaires and from patients' medical charts.

RESULTS

Patients in remission had a significantly higher EQ-5D-5L scores (mean (SD) 0.86 (0.15)) than patients with active disease (0.71 (0.20); p<0.001). Patients with mild disease had significantly higher mean (SD) EQ-5D-5L scores than patients with moderate/severe disease: 0.77 (0.11) and 0.66 (0.24), respectively (p<0.001). The mean percent productivity impairment was greater for patients with active disease than for patients in remission on all items of the WPAI questionnaire: 24.6% vs 1.8% for work time missed, 34.1% vs 12.9% for impairment while working, 40.8% vs 14.4% for overall work impairment and 42.7% vs 13.0% for activity impairment (p<0.001 for all comparisons). The mean (SD) total cost of healthcare for ulcerative colitis in the prior 3 months was £1211 (1588).

CONCLUSIONS

When compared with patients in remission, patients with active ulcerative colitis have significantly worse quality of life and significantly more work impairment. The healthcare costs of ulcerative colitis are considerable.

摘要

背景

溃疡性结肠炎是一种终身性、慢性、复发缓解型疾病。

目的

评估在英国溃疡性结肠炎疾病状态与患者生活质量之间的关系,并确定溃疡性结肠炎对医疗费用和工作生产力的影响。

方法

临床医生在单次研究访视时使用部分梅奥(pMayo)工具评估173例成年患者的当前疾病状态。患者完成欧洲五维度五水平健康量表(EQ-5D-5L)问卷、工作生产力和活动障碍(WPAI)问卷。医疗资源使用情况通过问卷和患者病历确定。

结果

缓解期患者的EQ-5D-5L评分(均值(标准差)0.86(0.15))显著高于活动期疾病患者(0.71(0.20);p<0.001)。轻度疾病患者的EQ-5D-5L评分均值(标准差)显著高于中度/重度疾病患者:分别为0.77(0.11)和0.66(0.24)(p<0.001)。在WPAI问卷的所有项目上,活动期疾病患者的平均生产力受损百分比均高于缓解期患者:工作时间缺勤方面为24.6%对1.8%,工作时受损方面为34.1%对12.9%,总体工作受损方面为40.8%对14.4%,活动受损方面为42.7%对13.0%(所有比较p<0.001)。前3个月溃疡性结肠炎的平均(标准差)医疗总费用为1211英镑(1588)。

结论

与缓解期患者相比,活动期溃疡性结肠炎患者的生活质量显著更差,工作受损也显著更多。溃疡性结肠炎的医疗费用相当可观。

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