PR4 The Effect of Neuropathic Pain on Health Status, Work Productivity Loss, and Health Care Resource Use in Japan

Abstract

OBJECTIVES: Irritable bowel syndrome (IBS) is a relapsing, chronic functional gastrointestinal disorder leading to long-term disturbances on health-related quality of life (HRQoL). Various functional and QoL measures have been developed to evaluate IBS outcomes, but none of the preference-based QoL measure has been applied and validated on Taiwanese people. This study aimed to explore the feasibility of applying preference-based HRQoL measures to IBS patients in Taiwan. METHODS: This prospective study was conducted from July to December 2010 at gastroenterology clinics in a regional hospital in southern Taiwan. IBS outpatients diagnosed by Rome III criteria were invited into participate semi-structure interview survey by using EuroQol (EQ-5D) questionnaire, 100-mm visual analogue scale (EQ-5D VAS) and standard gamble (SG) method. The EQ-5D assessment was transformed into EQ-5D index using Japanese preference weight. Multiple regression was used to assess factors associated with utilities, e.g. demographic, socioeconomic status and disease severity. RESULTS: Of all, 29 participants (mean age 45.8Ϯ16.5 years; 62.1% female) completed QoL survey, except for one rejected SG survey for disagreeing with SG hypothesis. Participants' IBS subtypes include constipation (nϭ11; 37.9%), diarrhea (nϭ16; 55.2%) and unsubtyped IBS (nϭ2; 6.9%); and 12 (41.4%) participants were newly diagnosed IBS and 12 had over two-year disease history. Participants had no problem in EQ-5D survey, some expressed difficulties in dimensions of pain/discomfort and anxiety/depression. Mean utility derived from SG (0.85Ϯ0.16), EQ-5D index (0.79Ϯ0.15) and EQ-5D VAS (0.59Ϯ0.17) were significantly different (pϽ0.05). SG utility was significantly associated with unsubtyped IBS and whether the IBS was newly diagnosed (pϽ0.05). CONCLUSIONS: IBS is well-tolerated but causing problem in anxiety/depression and pain/discomfort in QoL survey. Mean utility of SG is higher than results derived from EQ-5D and EQ VAS, and this finding matches previous literature. Further validate the utility measures in more IBS patients with various subtypes and severity is needed.

The societal burden of chronic pain in Japan: an internet survey

“…By using the WPAI-GH questionnaire, one of the few ways to understand from the patient perspective how their health is affecting their job duties, this study also provides an estimate of the economic burden of chronic pain. Compared with those without chronic pain, respondents with chronic pain were characterized by significantly greater work and activity impairment relative to those without chronic pain, which is consistent with past research in Japan that focused on work effects and impairment in activities of daily living [7][8][9]. Respondents with chronic pain reported between 73-99 % more work and activity impairment compared to those without chronic pain; this equated to approximately one-third more of work time that was missed or rendered ineffective due to health problems.…”

“…Very few studies have assessed the burden of chronic pain in Japan; the ones that have done so were limited by only including a specific type of pain [7][8][9]. Comparisons between those with and without chronic pain suggested, even after adjusting for demographic and health history differences, that patients with chronic pain report worse health status.…”

“…Another study using a home visit survey of the elderly in Takasaki City, found that the presence of chronic knee pain was associated with significantly increased impairments in activities of daily living [8]. Recently, DiBonaventura et al [9] compared respondents with neuropathic pain with controls, adjusting for comorbidities and other variables using the Japan National Health and Wellness Survey, and found that chronic neuropathic pain was associated with lower health status and greater workrelated impairment and healthcare resource use. Aside from physical limitations, other studies have documented the relationship between pain and psychological illness [10].…”

<p>Bibliometric Analysis of Exercise and Neuropathic Pain Research</p>

“…6 Neuropathic pain, a type of chronic pain, can affect physical and psychological functions, reduce work efficiency and lead to disability in severe cases. 7,8 In a French population, the prevalence of chronic pain is 31.7%. Among the patients with chronic pain, 21.7% have neuropathic characteristics.…”