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Disease status, patient quality of life and healthcare resource use for ulcerative colitis in the UK: an observational study
  1. Carolynne J Vaizey1,
  2. Peter R Gibson2,
  3. Christopher M Black3,4,
  4. Rebecca J Nicholls5,
  5. Adèle R Weston5,
  6. Daniel R Gaya6,
  7. Shaji Sebastian7,
  8. Ian Shaw8,
  9. Stephen Lewis9,
  10. Stuart Bloom10,
  11. John N Gordon11,
  12. Amanda Beale12,
  13. Ian Arnott13,
  14. Simon Campbell14,
  15. Tao Fan4
  1. 1Department of Surgery, St. Mark's Hospital, London, UK
  2. 2Alfred Hospital, Melbourne, and Monash University, Victoria, Australia
  3. 3St. John's University, Queens, New York, USA
  4. 4Merck & Co., Inc., Global Health Outcomes, Whitehouse Station, New Jersey, USA
  5. 5OptumInsight, Sydney, Australia
  6. 6 Gastroenterology Unit, Glasgow Royal Infirmary, Glasgow, UK
  7. 7Department of Gastroenterology, Hull Royal Infirmary, Hull, UK
  8. 8Department of Gastroenterology, Gloucester Royal Hospital, Gloucester, UK
  9. 9Department of Gastroenterology, Derriford Hospital, Plymouth, UK
  10. 10Department of Gastroenterology, University College London Hospital, London, UK
  11. 11Department of Gastroenterology, Royal Hampshire Hospital, Winchester, UK
  12. 12Bristol Royal Infirmary, Bristol, UK
  13. 13Western General Hospital, Edinburgh, UK
  14. 14Manchester Royal Infirmary, Manchester, UK
  1. Correspondence to Carolynne Vaizey, Department of Surgery, St. Mark's Hospital, Watford Rd, Harrow, Middlesex HA1 3UJ, UK; cvaizey{at}nhs.net

Abstract

Background Ulcerative colitis is a lifelong, chronic, relapsing-remitting disease.

Objective To assess the relationship between ulcerative colitis disease status and patient quality of life, and to determine the impact of ulcerative colitis on healthcare costs and work productivity, in the UK.

Methods Clinicians assessed 173 adult patients’ current disease status at a single study visit using the partial Mayo (pMayo) instrument. Patients completed the Euro Quality of Life 5-dimension, 5-level (EQ-5D-5L) questionnaire, the Work Productivity and Activity Impairment (WPAI) questionnaire. Healthcare resource use was determined from questionnaires and from patients’ medical charts.

Results Patients in remission had a significantly higher EQ-5D-5L scores (mean (SD) 0.86 (0.15)) than patients with active disease (0.71 (0.20); p<0.001). Patients with mild disease had significantly higher mean (SD) EQ-5D-5L scores than patients with moderate/severe disease: 0.77 (0.11) and 0.66 (0.24), respectively (p<0.001). The mean percent productivity impairment was greater for patients with active disease than for patients in remission on all items of the WPAI questionnaire: 24.6% vs 1.8% for work time missed, 34.1% vs 12.9% for impairment while working, 40.8% vs 14.4% for overall work impairment and 42.7% vs 13.0% for activity impairment (p<0.001 for all comparisons). The mean (SD) total cost of healthcare for ulcerative colitis in the prior 3 months was £1211 (1588).

Conclusions When compared with patients in remission, patients with active ulcerative colitis have significantly worse quality of life and significantly more work impairment. The healthcare costs of ulcerative colitis are considerable.

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