title: Subjective health status and health-related quality of life among women with Recurrent Vulvovaginal Candidosis (RVVC) in Europe and the USA.
abstract: BACKGROUND
  Recurrent vulvovaginal candidosis (RVVC) is a chronic condition causing discomfort and pain. Health status and health-related quality of life (HRQoL) in RVVC were never previously described using validated questionnaires. The objective of this study is to describe subjective health status and HRQoL and estimate health state utilities among women with RVVC.
  
  
  METHODS
  A cross-sectional online survey was conducted among women who reported having suffered four or more yeast infections over the past 12 months, in five European countries (France, Germany, Italy, Spain and the UK) and the USA. Index scores were derived from the EQ-5D, a questionnaire providing a single index value for health status. The SF-36 questionnaire was used for HRQoL assessment. Information on disease severity, treatment patterns and productivity was also collected.
  
  
  RESULTS
  12,834 members of online research panels were contacted. Among them, 620 women with RVVC (5%) were selected to complete the full questionnaire. The mean EQ-5D index score was 0.70 (95% confidence interval: [0.67, 0.72]) and the difference between women with a yeast infection at the time of questionnaire completion and other respondents was 0.05 (p = 0.47). The EQ-5D index score increased significantly with the time since last infection (p < 0.001). 68% of women reported depression/anxiety problems during acute episode, and 54% outside episodes, compared to less than 20% in general population (p < 0.001). All SF-36 domain scores were significantly below general population norms. Mental health domains were the most affected. The impact on productivity was estimated at 33 lost work hours per year on average, corresponding to estimated costs between €266/year and €1,130/year depending on the country.
  
  
  CONCLUSIONS
  Subjective health status and HRQoL during and in between acute inflammatory episodes in women with RVVC are significantly worse than in the general population, despite the use of antifungal therapy. The average index score in women with RVVC is comparable to other diseases such as asthma or COPD and worse than diseases such as headache/migraine according to US and UK catalogs of index scores. The survey also revealed a significant loss of productivity associated with RVVC.
authors.affiliation: Université Lyon I, decision sciences and health policies, Lyon, France. saballea@gmail.com.
authors.forename: Samuel
authors.initials: S
authors.lastname: Aballéa
authors.forename: Florent
authors.initials: F
authors.lastname: Guelfucci
authors.forename: Julian
authors.initials: J
authors.lastname: Wagner
authors.forename: Amine
authors.initials: A
authors.lastname: Khemiri
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Dietz
authors.forename: Jack
authors.initials: J
authors.lastname: Sobel
authors.forename: Mondher
authors.initials: M
authors.lastname: Toumi
mesh_terms: D000328:Adult; D002181:Candidiasis, Vulvovaginal / Q000523:psychology*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006304:Health Status; D006801:Humans; D011788:Quality of Life; D012008:Recurrence; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult