title: Gastroesophageal reflux disease: impact on work productivity and daily-life activities of daytime workers. A French cross-sectional study.
abstract: BACKGROUND
  Few studies have evaluated the impact of gastroesophageal reflux disease symptoms on work productivity and no French data are available.
  
  
  OBJECTIVE
  To compare the impact of typical symptoms of nocturnal vs diurnal gastroesophageal reflux disease on work productivity and daily activities.
  
  
  METHODS
  A French prospective, multicenter, observational study was performed in primary care setting. Patient characteristics, symptomatology and treatment were reported. Work productivity loss was assessed using the work productivity and activity impairment questionnaire, predictors were identified using multivariate regression models, and estimated cost was calculated.
  
  
  RESULTS
  716 eligible patients (mean age: 46.3 years) were included by 407 physicians. Nocturnal symptoms were reported in 50.8% of patients and exclusively diurnal symptoms in 49.2%. Mean work productivity and daily activities decreased by 31.4% and 32.6%, respectively (both p<0.001). Work productivity was influenced by symptom intensity, diurnal symptoms occurrence, regurgitation and diurnal sleepiness. The mean associated cost per patient/week (€313) was higher in patients with diurnal symptoms (without (€346) or with nocturnal (€312) symptoms) than in patients with exclusive nocturnal symptoms (€253) (p<0.001).
  
  
  CONCLUSIONS
  Gastroesophageal reflux disease incurs high work productivity loss especially in patients with diurnal symptoms. Further medico-economic analyses are needed to estimate the cost effectiveness ratio according to therapeutic strategies.
authors.affiliation: Institut des Maladies de l'Appareil Digestif (IMAD), CHU Hôtel Dieu, 1 place Alexis Ricordeau, 44 093 Nantes, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Bruley des Varannes
authors.forename: Philippe
authors.initials: P
authors.lastname: Ducrotté
authors.forename: Thierry
authors.initials: T
authors.lastname: Vallot
authors.forename: Anna
authors.initials: A
authors.lastname: Garofano
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bardoulat
authors.forename: Frédéric
authors.initials: F
authors.lastname: Carrois
authors.forename: Léa
authors.initials: L
authors.lastname: Ricci
mesh_terms: D000041:Absenteeism; D000328:Adult; D002940:Circadian Rhythm; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004526:Efficiency; D004651:Employment / Q000191:economics*; D005260:Female; D005602:France; D005764:Gastroesophageal Reflux / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014937:Work / Q000191:economics*