Impact of Chronic Constipation on Health-Related Quality of Life, Work Productivity, and Healthcare Resource Use: An Analysis of the National Health and Wellness Survey
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There has been limited research addressing the effects of constipation on work productivity and healthcare resource use.
To assess the effect of chronic constipation on health outcomes and healthcare resource use.
Using data from the 2007 National Health and Wellness Survey (NHWS), chronic constipation patients (n = 1,430) were propensity score-matched to controls (n = 1,430) on demographic and clinical characteristics. Differences between groups in health-related quality of life (SF-12v2), work productivity and activity impairment, and resource use in the last 6 months were examined. Mediation analyses were conducted in order to determine whether the relationship between constipation and resource use was caused by a reduction in health status.
Chronic constipation patients reported significantly lower levels of health-related quality of life (physical component summary score: 39.57 vs. 43.73; mental component summary score: 43.19 vs. 47.86, all P-values < 0.01) and significantly higher levels of loss of work productivity and activity impairment (absenteeism: 9.08% vs. 5.20%; presenteeism: 29.52% vs. 19.09%; overall work impairment: 33.65% vs. 21.56%; activity impairment: 46.58% vs. 33.90%, all P-values < 0.01) compared to the matched controls. Chronic constipation patients also reported significantly more provider (7.73 vs. 5.63) and emergency room visits (0.52 vs. 0.30) in the past 6 months (all P-values < 0.01). Mediation analyses suggested that increased resource use among chronic constipation patients were partially a result of reduced health status.
Compared to matched controls, chronic constipation patients reported greater economic and humanistic burden. Alleviating the humanistic burden associated with constipation may have economic benefits.
KeywordsChronic constipation Health-related quality of life Work productivity Healthcare resource use
This research was funded by Takeda Pharmaceuticals North America, Deerfield, IL.
- 1.National Digestive Diseases Information Clearinghouse (NDDIC). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Constipation. NIH Publication No. 07-2754. July 2007. Available online at: http://digestive.niddk.nih.gov/ddiseases/pubs/constipation. Retrieved 10 March 2010.
- 3.Johanson JF. Review of the treatment options for chronic constipation. Med Gen Med. 2007;9:25.Google Scholar
- 8.Cofré LP, Germain PF, Medina LL, et al. Constipation in adults: an update. Rev Med Chil. 2008;136:507–516. Epub 2008 Jun 16.Google Scholar
- 15.Lacy BE, Loew B, Crowell MD. Prucalopride for chronic constipation. Drugs Today (Barc). 2009;45:843–853.Google Scholar
- 16.Belsey J, Greenfield S, Candy D, Geraint M. Systematic review: impact of constipation on quality of life in adults and children. Aliment Pharmcol Ther. 2010;31:938–949.Google Scholar
- 19.Ware JE, Kosinski M, Keller SD. SF-36 physical and mental health summary scales: A user’s manual. Boston, MA: The Health Institute; 1994.Google Scholar
- 20.Ware JE, Kosinski M, Turner-Bowker DM, Gandek B. How to score version 2 of the SF-12 health survey. Lincoln, RI: QualityMetric Incorporated; 2002.Google Scholar
- 23.Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. In: Leinhart S, ed. Sociological methodology 1982. San Francisco: Jossey-Bass; 1982:290–312.Google Scholar
- 27.Paré P, Gray J, Lam S, et al. Health-related quality of life, work productivity, and health care resource utilization of subjects with irritable bowel syndrome: baseline results from LOGIC (Longitudinal Outcomes Study of GastroIntestinal Symptoms in Canada), a naturalistic study. Clin Ther. 2006;28:1726–1735.PubMedCrossRefGoogle Scholar