title: The burden of illness of gastro-oesophageal reflux disease: impact on work productivity.
abstract: BACKGROUND
  The impact of gastro-oesophageal reflux disease on work productivity has become increasingly important, as the symptoms of gastro-oesophageal reflux disease affect individuals in their productive years of life.
  
  
  OBJECTIVE
  To assess the impact of gastro-oesophageal reflux disease on reduced work productivity and to identify the predictors of reduced productivity.
  
  
  METHODS
  A sample of employed individuals reporting chronic heartburn was selected from US household mail survey respondents. Heartburn severity and frequency were recorded using a diary, and work productivity was assessed using the Work Productivity and Activity Impairment Questionnaire for Patients with Symptoms of Gastro-oesophageal Reflux Disease. Predictors of reduced productivity were evaluated.
  
  
  RESULTS
  Over 30% of heartburn sufferers reported reduced productivity. Individuals with symptoms of gastro-oesophageal reflux disease (n = 1003) reported 6.0% reduced productivity attributable to symptoms. Over 48% of respondents with severe symptoms reported reduced productivity, compared with 40% and 12% of respondents with moderate and mild symptoms, respectively. Using logistic regression, severity, a younger age and nocturnal symptoms were associated with increased odds of reduced productivity. In those reporting nocturnal heartburn, medication use and sleep interference increased the odds of reduced productivity.
  
  
  CONCLUSIONS
  Reduced work productivity is seen in a large proportion of subjects on prescription medication for gastro-oesophageal reflux disease. Symptom severity and nocturnal heartburn are significantly associated with reduced work productivity, particularly when nocturnal heartburn interferes with sleep.
authors.affiliation: Zynx Health, Inc., a subsidiary of Cerner Corporation, Los Angeles, CA 90212, USA. bdean@cerner.com
authors.forename: B B
authors.initials: BB
authors.lastname: Dean
authors.forename: J A
authors.initials: JA
authors.lastname: Crawley
authors.forename: C M
authors.initials: CM
authors.lastname: Schmitt
authors.forename: J
authors.initials: J
authors.lastname: Wong
authors.forename: J J
authors.initials: JJ
authors.lastname: Ofman
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000503:physiopathology; D006356:Heartburn / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000150:complications* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014938:Work Capacity Evaluation