Burden of constipation-predominant irritable bowel syndrome (IBS-C) in France, Italy, and the United Kingdom

Abstract

BackgroundSeveral studies have examined the effect of irritable bowel syndrome (IBS) on health outcomes in Western Europe, but less research has focused on the constipation subtype (IBS-C). The current study addresses this gap by comparing patients with IBS-C and matched controls for health status, work productivity, and resource utilization.MethodsData were obtained from the 2010 5EU National Health and Wellness Survey (NHWS), which includes respondents from France, Germany, Italy, Spain, and the UK. Only participants from France (n = 15,051), Italy (n = 7580), and the UK (n = 15,065) were included in the analyses. Respondents who reported a physician diagnosis of IBS and reported only constipation symptoms were compared with respondents who did not report being diagnosed with IBS using a propensity score-matching methodology (matching on sociodemographics, health behaviors, and comorbidities). Differences between patients with IBS-C and matched controls were examined on health status (Short Form Survey Instrument version 2), work productivity (Work Productivity and Activity Impairment questionnaire), and health care resource use in the past 6 months.ResultsA total of 83 (0.55%), 109 (1.44%), and 204 (1.35%) respondents reported a diagnosis of IBS with only constipation symptoms in France, Italy, and the UK, respectively. Within each country, patients with IBS-C reported significantly worse health status compared with matched controls (all P < 0.05) and significantly more physician visits (all P < 0.05). More hospitalizations were also observed in the UK (P < 0.05). Among those who were employed, patients with IBS-C in France and the UK also reported significantly more presenteeism than matched controls (all P < 0.05).ConclusionThese findings highlight the pervasive influence of IBS-C on the day-to-day functioning of sufferers, their ability to be productive at work, and their influence on the wider health care system. Significant unmet needs remain, and improved management of this condition could result in significant and clinically meaningful gains in health status as well as alleviating a societal cost burden.

In‐hospital costs associated with chronic constipation in Belgium: a retrospective database study

“…The difference (0.18 visits to hospital per patient‐year) can be used as a proxy to estimate the incremental rate of hospitalizations due to chronic constipation. This estimate is consistent with the rates provided by a European study, showing an incremental rate of hospitalization attributable to chronic constipation equal to 0.44 and 0.32 visits/patient‐year in a population of patients with constipation‐predominant IBS in France and the United Kingdom, respectively . This confirms the fact that most of the constipation patients would seek treatment in an ambulatory setting and be treated for instance with laxatives available as over‐the‐counter drugs.…”

“…This estimate is consistent with the rates provided by a European study, showing an incremental rate of hospitalization attributable to chronic constipation equal to 0.44 and 0.32 visits/patient-year in a population of patients with constipation-predominant IBS in France and the United Kingdom, respectively. 16 This confirms the fact that most of the constipation patients would seek treatment in an ambulatory setting and be treated for instance with laxatives available as over-the-counter drugs. However, the higher proportion of constipation patients treated in ambulatory setting is compensated by the low cost related to these patients as compared with hospitalized patients; Caekelbergh et al (2009) estimated that the cost of an episode of constipation related to opioid use treated in ambulatory setting in Belgium was €130 (95% CI: 108-153), including the cost of laxatives that are not reimbursed by the Belgian public health care payer.…”

Burden of irritable bowel syndrome in an increasingly cost-aware National Health Service

“…A group in the USA and Spain that assessed the burden of IBS-C in three European countries reported prevalences of 0.55%, 1.44% and 1.35% in France, Italy and the UK, respectively 22. There are few comparable data in the literature; however, a recent report from Lin et al 13 (2013) evaluated the population prevalence of differing IBS subtypes within the UK and reported a total population prevalence of 6%, with the highest being IBS-M (2.7%).…”

A four‐country comparison of healthcare systems, implementation of diagnostic criteria, and treatment availability for functional gastrointestinal disorders

“…A recent systematic review on the burden of illness of IBS‐C in Europe found no studies on the cost of illness or use of diagnostic resources in Italy . In contrast, one study showed that compared to controls, IBS‐C patients reported 108% and 71% more consultations to general practice and specialists, respectively . There is almost no information on expenses incurred in treating FGIDs.…”

“…56 In contrast, one study showed that compared to controls, IBS-C patients reported 108% and 71% more consultations to general practice and specialists, respectively. 57 There is almost no information on expenses incurred in treating FGIDs. One survey indicated that the mean annual cost for a diagnostic work-up for IBS was $85.7 USD and the indirect costs incurred by patients with functional constipation was $5100 USD.…”