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The Burden of Disrupting Gastro-Oesophageal Reflux Disease

A Database Study in US and European Cohorts

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Abstract

Background: Recent data indicate that among patients with gastro-oesophageal reflux disease (GORD) there is a subgroup with a higher disrupting burden of illness in terms of symptom frequency and overall impact.

Objective: The aim of this study was to evaluate the burden of disrupting versus non-disrupting GORD on individuals, healthcare providers and society.

Methods: Data were obtained from European (France, Germany, Italy, Spain and the UK) and US respondents in the 2007 National Health and Wellness Survey (NHWS). Respondents with GORD were classified as having disrupting or non-disrupting GORD based on self-reported symptom frequency, presence of night-time symptoms and medication usage. Disrupting GORD was defined as the presence of GORD symptoms on at least 2 days/week in addition to either night-time symptoms or use of prescribed/ over-the-counter medication at least twice a week during the past month.

Results: Of 116 536 respondents included in the 2007 NHWS, 23% reported GORD symptoms; 39% of these were acknowledged as having disrupting GORD. These patients had higher healthcare resource utilization than those with non-disrupting disease. Respondents with disrupting GORD also had poorer health-related quality of life, greater impairments in health-related work productivity and absenteeism (all p<0.05 vs non-disrupting GORD), and higher associated total medical costs. Overall, patients with physician-diagnosed GORD also had significantly lower health-related quality of life than self-diagnosed respondents (p<0.05).

Conclusions: GORD is a common disease that places a substantial burden on affected individuals and society. A high proportion of patients have disrupting GORD, which has significant adverse potential from both a clinical and an economic perspective.

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References

  1. Vakil N, van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006 Aug; 101(8): 1900–20

    Article  PubMed  Google Scholar 

  2. Wiklund I, Carlsson J, Vakil N. Gastroesophageal reflux symptoms and well-being in a random sample of the general population of a Swedish community. Am J Gastroenterol 2006 Jan; 101(1): 18–28

    Article  PubMed  Google Scholar 

  3. Dean BB, Crawley JA, Schmitt CM, et al. The burden of illness of gastro-oesophageal reflux disease: impact on work productivity. Aliment Pharmacol Ther 2003 May 15; 17(10): 1309–17

    Article  PubMed  CAS  Google Scholar 

  4. Wahlqvist P, Brook RA, Campbell SM, et al. Objective measurement of work absence and on-the-job productivity: a case-control study of US employees with and without gastroesophageal reflux disease. J Occup Environ Med 2008 Jan; 50(1): 25–31

    Article  PubMed  Google Scholar 

  5. Wahlqvist P, Guyatt GH, Armstrong D, et al. The Work Productivity and Activity Impairment Questionnaire for Patients with Gastroesophageal Reflux Disease (WPAI-GERD): responsiveness to change and English language validation. Pharmacoeconomics 2007; 25(5): 385–96

    Article  PubMed  Google Scholar 

  6. Brook RA, Wahlqvist P, Kleinman NL, et al. Cost of gastrooesophageal reflux disease to the employer: a perspective from the United States. Aliment Pharmacol Ther 2007 Sep 15; 26(6): 889–98

    Article  PubMed  CAS  Google Scholar 

  7. Consumer Health Sciences. National Health and Wellness Survey [online]. Available from URL: http://www.nhwsurvey.com [Accessed 2009 Dec 1]

  8. Wahlqvist P, Karlsson M, Johnson D, et al. Relationship between symptom load of gastro-oesophageal reflux disease and health-related quality of life, work productivity, resource utilization and concomitant diseases: survey of a US cohort. Aliment Pharmacol Ther 2008 May; 27(10): 960–70

    Article  PubMed  CAS  Google Scholar 

  9. King A, MacDonald C, Örn C. Understanding gastrooesophageal reflux disease: a patient-cluster analysis. Int J Clin Pract 2008; 62(12): 1838–43

    Article  PubMed  CAS  Google Scholar 

  10. Jones R, Junghard O, Dent J, et al. Development of the GerdQ, a tool for the diagnosis and management of gastrooesophageal reflux disease in primary care. Aliment Pharmacol Ther. Epub 2009 Sep 8

  11. Ware Jr J, Kosinski M, Turner-Bowker DM, et al. How to score version 2 of the SF-12® health survey (with a supplement documenting version 1). Lincoln (RI): QualityMetric Incorporated, 2002

    Google Scholar 

  12. Samsa G, Edelman D, Rothman ML, et al. Determining clinically important differences in health status measures: a general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics 1999 Feb; 15(2): 141–55

    Article  PubMed  CAS  Google Scholar 

  13. Prasad M, Wahlqvist P, Shikiar R, et al. A review of self-report instruments measuring health-related work productivity: a patient-reported outcomes perspective. Pharmacoeconomics 2004; 22(4): 225–44

    Article  PubMed  Google Scholar 

  14. Department of Health. Payment by results in 2007-08 national tariff. UK National Health Service, 2006 [online]. Available from URL: http://www.dh.gov.uk/en/Publicationsand statistics/Publications/PublicationsPolicyAndGuidance/DH_4140197 [Accessed 2010 Feb 1]

  15. World Health Organization. Estimates of unit costs for patient services for United States of America. Geneva: WHO, 2005

    Google Scholar 

  16. Curtis L. Unit costs of health and social care 2007. Canterbury: UK Personal Social Services Research Unit, University of Kent, 2007

    Google Scholar 

  17. Healthcare Consultants Inc. 2005 Physicians’ fee and coding guide (a comprehensive fee and coding reference). Aygusta (GA): MAG Mutual, 2004

    Google Scholar 

  18. Office for National Statistics. Productivity measures. UK National Statistics, 2009 [online]. Available from URL: http://www.statistics.gov.uk/default.asp [Accessed 2010 Feb 1]

  19. Bureau of Labor Statistics. Employer costs for employee compensation-December 2007. Washington, DC: United States Department of Labor, 2008

    Google Scholar 

  20. Dent J, El-Serag HB, Wallander M-A, et al. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 2005 May; 54(5): 710–7

    Article  PubMed  CAS  Google Scholar 

  21. Jones R, Armstrong D, Malfertheiner P, et al. Does the treatment of gastroesophageal reflux disease (GERD) meet patients’ needs? A survey-based study. Curr Med Res Opin 2006 Apr; 22(4): 657–62

    Article  PubMed  Google Scholar 

  22. Jones R, Liker HR, Ducrotté P. Relationship between symptoms, subjective well-being and medication use in gastro-oesophageal reflux disease. Int J Clin Pract 2007 Aug; 61(8): 1301–7

    Article  PubMed  CAS  Google Scholar 

  23. El-Serag HB, Graham DY, Satia JA, et al. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol 2005 Jun; 100(6): 1243–50

    Article  PubMed  Google Scholar 

  24. Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med 2005 Aug 2; 143(3): 199–211

    PubMed  Google Scholar 

  25. Ramsey S, Willke R, Briggs A, et al. Good research practices for cost-effectiveness analysis alongside clinical trials: the ISPOR RCT-CEA Task Force report. Value Health 2005 Sep-Oct; 8(5): 521–33

    Article  PubMed  Google Scholar 

  26. Lerner D, Amick 3rd BC, Lee JC, et al. Relationship of employee-reported work limitations to work productivity. Med Care 2003 May; 41(5): 649–59

    PubMed  Google Scholar 

  27. Glick HA, Doshi JA, Sonnad SS, et al. Economic evaluation in clinical trials. 1st ed. Oxford: Oxford University Press, 2007

    Google Scholar 

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Acknowledgements

This study was supported by AstraZeneca R&D, Mölndal, Sweden. The authors thank Claire Byrne and Anna Mett, from Wolters Kluwer Pharma Solutions, who provided medical writing support funded by AstraZeneca.

Samira Toghanian, Peter Wahlqvist and Bengt Liljas are employees of AstraZeneca. David A. Johnson is a consultant to AstraZeneca, Esai, Novartis and Takeda, and has received research/grant support from AstraZeneca and Takeda; he is also a clinical investigator for AstraZeneca, Novartis and Takeda, and has received speaker fees from AstraZeneca. Susan C. Bolge is a former employee of Consumer Health Sciences.

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Toghanian, S., Wahlqvist, P., Johnson, D.A. et al. The Burden of Disrupting Gastro-Oesophageal Reflux Disease. Clin. Drug Investig. 30, 167–178 (2010). https://doi.org/10.2165/11531670-000000000-00000

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  • DOI: https://doi.org/10.2165/11531670-000000000-00000

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