The impact of illness in patients with moderate to severe gastro-esophageal reflux disease.
BACKGROUND
Gastro-esophageal reflux disease (GERD) is a common disease. It impairs health related quality of life (HRQL). However, the impact on utility scores and work productivity in patients with moderate to severe GERD is not well known.


METHODS
We analyzed data from 217 patients with moderate to severe GERD (mean age 50, SD 13.7) across 17 Canadian centers. Patients completed three utility instruments--the standard gamble (SG), the feeling thermometer (FT), and the Health Utilities Index 3 (HUI 3)--and several HRQL instruments, including Quality of Life in Reflux and Dyspepsia (QOLRAD) and the Medical Outcomes Short Form-36 (SF-36). All patients received a proton pump inhibitor, esomeprazole 40 mg daily, for four to six weeks.


RESULTS
The mean scores on a scale from 0 (dead) to 1 (full health) obtained for the FT, SG, and HUI 3 were 0.67 (95% CI, 0.64 to 0.70), 0.76 (95% CI, 0.75 to 0.80), and 0.80 (95% CI, 0.77 to 0.82) respectively. The mean scores on the SF-36 were lower than the previously reported Canadian and US general population mean scores and work productivity was impaired.


CONCLUSIONS
GERD has significant impact on utility scores, HRQL, and work productivity in patients with moderate to severe disease. Furthermore, the FT and HUI 3 provide more valid measurements of HRQL in GERD than the SG. After treatment with esomeprazole, patients showed improved HRQL.
El-Dika
Samer
S
Division of Gastroenterology, Veterans Affairs Medical Center, Salem, Virginia, USA. Seldika@gmail.com
Guyatt
Gordon H
GH
Armstrong
David
D
Degl'innocenti
Alessio
A
Wiklund
Ingela
I
Fallone
Carlo A
CA
Tanser
Lisa
L
Veldhuyzen van Zanten
Sander
S
Heels-Ansdell
Diane
D
Wahlqvist
Peter
P
Chiba
Naoki
N
Barkun
Alan N
AN
Austin
Peggy
P
Schünemann
Holger J
HJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D064098:Esomeprazole / Q000627:therapeutic use; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000503:physiopathology*; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D054328:Proton Pump Inhibitors; D011788:Quality of Life; D018434:Sickness Impact Profile; D014938:Work Capacity Evaluation
D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors; D064098:Esomeprazole