title: Social and medical impact, sleep quality and the pharmaceutical costs of heartburn in Taiwan.
abstract: BACKGROUND
  Little is known about the social and medical burdens of heartburn in Asia.
  
  
  OBJECTIVE
  To assess the impact of heartburn in Taiwan.
  
  
  METHODS
  We applied a questionnaire to 2018 apparently healthy adult Chinese receiving a routine health maintenance programme. Costs of heartburn-related prescriptions were obtained from the Bureau of National Health Insurance of Taiwan.
  
  
  RESULTS
  Heartburn prevalence (>1 episode/week) was 7%. Smoking and increased body mass index were associated with heartburn occurrence. Heartburn sufferers reported more atypical gastro-oesophageal reflux disease symptoms, e.g. chest pain, dysphagia and globus. They were more likely to consult physicians, and have an increased frequency and number of days of absenteeism, irrespective of upper gastrointestinal or nongastrointestinal-related illnesses. They experienced sleep disturbances more frequently. The 62 heartburn consulters (48%) were more likely to have co-existing globus, visited physicians more, had more absenteeism, suffered from more sleep disturbances and had higher costs for antacids, proton pump inhibitors, hypnotic/sedatives, tranquilizers and antidepressants than nonconsulters.
  
  
  CONCLUSIONS
  Heartburn prevalence in Taiwan is lower than in Western countries. Nevertheless, heartburn in Taiwanese creates a significant burden in terms of social impact, health resource utilization, sleep quality and pharmaceutical costs. The increased costs of psychoactive drugs in consulters suggest that anxiety/depression affects their health-seeking behaviour.
authors.affiliation: Division of Gastroenterology, Taipei Veterans General Hospital, and School of Medicine, National Yang-Ming University, Taipei, Taiwan. cllu@vghtpe.gov.tw
authors.forename: C-L
authors.initials: CL
authors.lastname: Lu
authors.forename: H-C
authors.initials: HC
authors.lastname: Lang
authors.forename: F-Y
authors.initials: FY
authors.lastname: Chang
authors.forename: T-J
authors.initials: TJ
authors.lastname: Chen
authors.forename: C-Y
authors.initials: CY
authors.lastname: Chen
authors.forename: J-C
authors.initials: JC
authors.lastname: Luo
authors.forename: S-D
authors.initials: SD
authors.lastname: Lee
mesh_terms: D000041:Absenteeism; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015992:Body Mass Index; D017281:Cost of Illness; D016527:Drug Costs / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006356:Heartburn / Q000150:complications / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011788:Quality of Life; D017678:Sex Distribution; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology*; D012907:Smoking / Q000009:adverse effects; D013624:Taiwan / Q000453:epidemiology