title: Burden of gastro-oesophageal reflux disease in patients with persistent and intense symptoms despite proton pump inhibitor therapy: A post hoc analysis of the 2007 national health and wellness survey.
abstract: OBJECTIVE
  Research on the negative impact of gastro-oesophageal reflux disease (GORD) on the health-related quality of life (HR-QOL) and resource utilization of patients with persistent and intense GORD symptoms despite proton pump inhibitor (PPI) therapy is lacking. The aim of this study was to describe the population of patients with GORD with persistent moderate-to-severe symptoms despite ongoing PPI therapy, and to compare their HR-QOL and healthcare resource use with patients with low GORD symptom load during ongoing PPI therapy.
  
  
  METHODS
  In this post hoc analysis of the 2007 National Health and Wellness Survey (NHWS), PPI-compliant (≥22 days with PPI use in the past month) European (France, Germany and the UK) and US respondents with physician-diagnosed GORD were stratified into those with persistent and intense GORD symptoms, those with low symptom load, or an intermediate group.
  
  
  RESULTS
  5672 PPI-compliant respondents were identified (persistent and intense symptoms, n = 1741; low symptom load, n = 1805; intermediate group, n = 2126). Respondents with persistent and intense symptoms had poorer HR-QOL than patients with a low symptom load, but none of the differences were statistically significant. Respondents with persistent and intense symptoms also reported lower work productivity (all countries; significant difference [p < 0.01] only in the US), greater activity impairment (all countries; significant difference [p < 0.01] only in the US) and more hours missed from work due to health problems (US, UK and Germany; significant difference [p < 0.01] only in the US). In the UK and US, respondents with persistent and intense symptoms reported significantly more visits to both primary-care physicians and specialists than respondents with a low symptom load (all p < 0.01). Additionally, US respondents with persistent and intense symptoms reported significantly more emergency room visits (p < 0.01).
  
  
  CONCLUSIONS
  The 2007 NHWS gives support to the hypothesis that persistent and intense GORD symptoms despite PPI therapy have a significant and negative impact on both HR-QOL and healthcare resource utilization. These findings outline the need for new treatment options for symptomatic GORD patients taking PPI therapy.
authors.affiliation: AstraZeneca RD, Mlndal, Sweden.
authors.forename: Samira
authors.initials: S
authors.lastname: Toghanian
authors.forename: David A
authors.initials: DA
authors.lastname: Johnson
authors.forename: Nils-Olov
authors.initials: NO
authors.lastname: Stålhammar
authors.forename: Frank
authors.initials: F
authors.lastname: Zerbib
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D004351:Drug Resistance; D005260:Female; D005602:France; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000523:psychology*; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D011788:Quality of Life / Q000523:psychology; D057566:Self Report; D006113:United Kingdom; D014481:United States
chemical_list: D054328:Proton Pump Inhibitors