title: Health-related quality of life, work productivity and health care resource use associated with constipation predominant irritable bowel syndrome.
abstract: OBJECTIVE
  Irritable bowel syndrome (IBS) is a common gastrointestinal disorder. Prevalence estimates of IBS vary widely, from 10 to 15%, in the U.S. However, few studies have examined constipation predominant IBS (IBS-C), a subtype of IBS. The aim of this study was to assess the effect of IBS-C on health-related quality of life (HRQOL), work productivity and activity impairment, and health care resource use.
  
  
  METHODS
  Using data from the 2007 U.S. National Health and Wellness Survey, IBS-C patients (n = 789) were compared to a propensity-score matched comparison group (n = 789). Differences between the groups were examined on HRQOL (SF-12v2), work productivity and activity impairment (WPAI questionnaire), and self-reported resource use in the last 6 months.
  
  
  RESULTS
  Patients with IBS-C reported significantly lower levels of HRQOL (physical component summary score: 41.55 [95% CI: 40.72-42.37] versus 44.49 [95% CI: 43.67-45.31]; mental component summary score: 40.58 [95% CI: 39.75-41.40] vs. 45.87 [95% CI: 45.04-46.70]) and significantly higher mean levels of presenteeism (31.72% [95% CI: 28.25%-35.61%] vs. 21.43% [95% CI: 19.03%-24.15%]), overall work impairment (35.54% [95% CI: 31.76%-39.76%] vs. 25.29% [95% CI: 22.59%-28.30%]), and activity impairment (45.78% [95% CI: 43.08%-48.66%] vs. 33.03% [95% CI: 31.08%-35.11%]) than matched comparators (all P values < 0.01). Patients with IBS-C reported significantly more provider visits (8.07 [95% CI: 7.38-8.82] vs. 5.55 [95% CI: 5.07-6.08]) and emergency room visits (0.57 [95% CI: 0.46-0.70] vs. 0.36 [95% CI: 0.29-0.45]) in the past 6 months (all Ps < 0.01). No statistically significant differences between the groups were observed in absenteeism or the number of the days hospitalized.
  
  
  CONCLUSIONS
  IBS-C was associated with poorer HRQOL, greater work productivity loss and activity impairment, and greater healthcare resource use. Limitations include the study's cross-sectional design and its self-reported nature. Nevertheless, improved management of IBS-C may reduce the humanistic and economic burden of the condition and benefit patients, employers, and the healthcare system.
authors.affiliation: Kantar Health, New York, NY 10010, USA. Marco.DiBonaventura@kantarhealth.com
authors.forename: Marco
authors.initials: M
authors.lastname: DiBonaventura
authors.forename: Shawn X
authors.initials: SX
authors.lastname: Sun
authors.forename: Susan C
authors.initials: SC
authors.lastname: Bolge
authors.forename: Jan-Samuel
authors.initials: JS
authors.lastname: Wagner
authors.forename: Reema
authors.initials: R
authors.lastname: Mody
mesh_terms: D000328:Adult; D003248:Constipation / Q000209:etiology*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D004526:Efficiency; D004651:Employment; D005260:Female; D006306:Health Surveys; D006801:Humans; D007182:Income; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000191:economics; D008875:Middle Aged; D011788:Quality of Life; D014481:United States