Open AccessConstipation severity is associated with productivity losses and healthcare utilization in patients with chronic constipation
Author(s) -
Neri Luca,
Basilisco Guido,
Corazziari Enrico,
Stanghellini Vincenzo,
Bassotti Gabrio,
Bellini Massimo,
Perelli Ilaria,
Cuomo Rosario
Publication year - 2014
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640614528175
Subject(s) - medicine , constipation , presenteeism , somatization , functional constipation , health care , checklist , productivity , physical therapy , absenteeism , confounding , anxiety , psychiatry , psychology , management , economics , cognitive psychology , macroeconomics , economic growth
Objective We sought to evaluate the association between constipation severity, productivity losses and healthcare utilization in a national sample of Italian patients with chronic non‐organic constipation (CC) Methods We enrolled 878 outpatients with CC. Clinical and demographic data were collected by physicians during clinical examinations. Patients completed a self‐administered questionnaire (Patient Assessment of Constipation‐Symptoms, PAC‐SYM; Work Productivity and Activity Impairment; healthcare utilization, and Symptoms Checklist 90 Revised – Somatization Scale, SCL‐90 R). Results Mean PAC‐SYM score was 1.62 ± 0.69. Mean weekly sick time due to constipation was 2.7 ± 8.6 h and productivity losses due to presenteeism was 19.7% ± 22.3%. Adjusted productivity losses in patients with severe CC (PAC‐SYM score 2.3–4.0) compared to patients with mild symptoms (PAC‐SYM score 0.0–1.0) was Italian Purchase Power Parity US$ 6160. Constipation severity (PAC‐SYM quintiles) was associated with higher healthcare utilization (RR PAC‐SYM 4/0 1.84; p ‐value for linear trend <0.01). After adjustment for somatization scores, the association of constipation severity with productivity losses and healthcare utilization rates was attenuated yet statistically significant. Conclusions We observed a graded increase in productivity losses and healthcare utilization with increasing constipation severity. Further studies should evaluate whether significant savings might be achieved with regimens aimed at reducing the constipation severity.