title: A systematic literature review of the economic implications of chemotherapy-induced diarrhea and its impact on quality of life.
abstract: BACKGROUND
  Chemotherapy-induced diarrhea (CID) diminishes physical performance, raises anxiety and depression levels, and increases healthcare resource utilization.
  
  
  OBJECTIVE
  To understand the impact that CID has on health-related quality of life (HRQoL) and on healthcare resource utilization.
  
  
  METHODS
  Systematic searches were conducted in MEDLINE, EMBASE, DARE, and the NHS EED databases.
  
  
  RESULTS
  A total of 22 articles were retrieved for full review (n=17, HRQoL; n=5 healthcare resource utilization). Only 2 studies had assessed HRQoL in patients experiencing CID, while cost studies demonstrated that CID episodes are unnecessarily expensive and can be avoided if diagnosed and treated early.
  
  
  CONCLUSIONS
  Better management of CID has the potential to reduce overall economic burden and improve patients' HRQoL. Available evidence also relays the need to conduct larger studies that assess HRQoL and consider cost beyond direct medical costs in order to understand the full impact of CID on HRQoL and healthcare resource utilization.
authors.affiliation: Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy; Department of Policy Analysis and Public Management, Bocconi University, Milan, Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Tarricone
authors.affiliation: Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy.
authors.forename: Dana
authors.initials: D
authors.lastname: Abu Koush
authors.affiliation: Independent Consultant, Kampala, Uganda.
authors.forename: Barbara
authors.initials: B
authors.lastname: Nyanzi-Wakholi
authors.affiliation: Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy; Health Economics Group, University of Exeter Medical School, Exeter, UK. Electronic address: A.Medina-Lara@exeter.ac.uk.
authors.forename: Antonieta
authors.initials: A
authors.lastname: Medina-Lara
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000191:economics; D003967:Diarrhea / Q000139:chemically induced* / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D017048:Health Care Costs / Q000706:statistics & numerical data; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D011788:Quality of Life
chemical_list: D000970:Antineoplastic Agents
keywords: Chemotherapy-induced diarrhea; Health-related quality of life; Healthcare resource utilization; Incidence