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Relationship between disease severity, quality of life and health‐care resource use in a cross‐section of Australian patients with Crohn's disease
Author(s) -
Gibson Peter R,
Weston Adèle R,
Shann Amelia,
Florin Timothy H J,
Lawrance Ian C,
Macrae Finlay A,
RadfordSmith Graham
Publication year - 2007
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2007.04930.x
Subject(s) - medicine , crohn's disease , disease , quality of life (healthcare) , referral , inflammatory bowel disease , severity of illness , health care , physical therapy , cross sectional study , family medicine , nursing , pathology , economics , economic growth
Background and Aim: New treatments for Crohn's disease are expensive and place economic strain upon health‐care systems, and ‘value‐for‐money’ needs to be confirmed. This study aimed to correlate disease severity with health‐related quality of life and with health‐care resource use, to allow evaluation of the cost effectiveness of these treatments. Methods: A cross‐sectional, non‐interventional, pharmacoeconomics study was performed with patients completing questionnaires comprising demographic, disease and health‐care utilization questions, together with the disease‐specific Inflammatory Bowel Disease Questionnaire (IBDQ) and the Assessment of Quality of Life (AQoL) multi‐attribute utility instrument. The Crohn's Disease Activity Index (CDAI) was used to assess disease severity. Results: 143 patients with a broad range of disease severity (CDAI 36–446, fistulae 23%) were recruited from referral centers. Stepwise regression analyses demonstrated a negative correlation between disease severity and both IBDQ and AQoL (both P < 0.0001). Age, gender and years since diagnosis did not impact upon either of the quality‐of‐life outcomes. Mean utility score for non‐fistulizing patients with moderate–severe active disease (CDAI ≥ 220) was 0.45, mild disease (CDAI 150–219) was 0.68 and for remission (CDAI < 150) was 0.77. Health‐care resource utilization increased with increasing CDAI ( P < 0.001), with hospital admissions being the largest component cost. Twenty‐seven percent of patients (mean age 38 year) received a government benefit, 51% primarily due to their Crohn's disease. Conclusion: Crohn's disease severity correlates with poor quality of life. Utility scores determined will permit cost–utility analyses to be made in order to best allocate limited health resources.