Relationship between disease severity and quality of life and assessment of health care utilization and cost for ulcerative colitis in Australia: A cross-sectional, observational study

Gibson, Peter R.; Vaizey, C. J.; Black, Chris; Nicholls, Rebecca; Weston, Adèle R.; Bampton, Peter A.; Sparrow, Miles P.; Lawrance, Ian C.; Selby, Warwick; Andrews, Jane M.; Walsh, Alissa J.; Hetzel, David J.; Macrae, Finlay; Moore, Gregory Thomas Charles; Weltman, Martin; Leong, Rupert W.; Fan, Tao

doi:10.1016/j.crohns.2013.11.017

Cited by 107 publications

(83 citation statements)

References 19 publications

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“…Disease severity also had a direct influence on an individual’s quality of life. The severity of the flare and the frequency of the relapse intensely affected IBD patient’s life well-being 50,51…”

Section: Discussionmentioning

confidence: 99%

Illness perceptions and stress: mediators between disease severity and psychological well-being and quality of life among patients with Crohn’s disease

Zhang¹,

Hong²,

Zhang³

et al. 2016

PPA

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BackgroundDisease severity, illness perceptions, coping strategies, stress, psychological well-being, and quality of life were reported to have close relationships. According to the Common Sense Model, illness perceptions and coping strategies could mediate the relationship between illness stimuli and illness outcomes such as psychological health and quality of life. Stress was also associated with the individual’s disease severity, anxiety, depression, and quality of life.ObjectivesThe study aimed to explore the influencing factors of illness outcomes, and to what extent illness perceptions, coping strategies, and stress mediate the relationship between disease severity and anxiety, and depression and quality of life.MethodsOur study included 159 patients with Crohn’s disease who were attending a tertiary hospital outpatient clinic or who were hospitalized. Disease severity was measured with the Crohn’s Disease Activity Index. Illness perceptions were measured with the Brief Illness Perceptions Questionnaire. Coping strategies were measured with the Carver Brief Coping Questionnaire. Stress was measured with the Perceived Stress Questionnaire. Anxiety and depression were measured with the Hospital Anxiety and Depression Scale. Quality of life was measured with the Inflammatory Bowel Disease Questionnaire.ResultsDisease severity, illness perceptions, maladaptive coping, stress, anxiety, depression and quality of life were significantly correlated with each other among patients with Crohn’s disease. Using structural equation modeling to describe the inner relationship of the aforementioned variables, an excellent-fitted model was drawn. (χ2[10]=13.83, P=0.18, χ2/N=1.38, standardized root mean square residual [SRMR] <0.05, root mean square error of approximation [RMSEA] <0.05, goodness of fit index [GFI] >0.97, comparative fit index [CFI] >0.99). Disease severity had a direct influence on illness perceptions. Illness perceptions had a direct influence on stress. Both illness perceptions and stress had direct influences on anxiety, depression, and quality of life, while maladaptive coping did not directly influence anxiety, depression, or quality of life. Stress had a direct influence on maladaptive coping. Quality of life was also directly influenced by disease severity and anxiety.ConclusionInterrelationships between disease stimuli, disease perceptions and management and disease outcomes could be found in patients with Crohn’s disease. Illness perceptions and stress mediated an individual’s disease severity and anxiety, depression and quality of life, while coping strategy was not an applicable mediator.

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Section: Discussionmentioning

confidence: 99%

Illness perceptions and stress: mediators between disease severity and psychological well-being and quality of life among patients with Crohn’s disease

Zhang¹,

Hong²,

Zhang³

et al. 2016

PPA

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“…The impact of the severity of CD on the cost of productivity loss at unpaid work and the cost of informal care has not been investigated in detail, and only general information on impairment in usual activities, loss of leisure time, sick leave from paid work among caregivers, or time loss among relatives is available [6,9–13]. The inclusion of informal care can have a strong impact on cost-effectiveness outcomes.…”

Section: Introductionmentioning

confidence: 99%

Health-Related Quality of Life Impairment and Indirect Cost of Crohn’s Disease: A Self-Report Study in Poland

et al. 2016

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Background and AimsEvidence on indirect cost of Crohn’s disease (CD) is available but typically provides information on the loss of productivity at paid work of patients. In the present study, the quality of life and indirect costs of CD patients were assessed (overall and by disease severity).MethodsA self-report questionnaire-based study among adult Polish patients with CD was performed. We collected data on patients’ characteristics, quality of life, loss of productivity, consumption of medical resources, and out-of-pocket expenses. The disease severity was determined using the patient’s version of the Harvey-Bradshaw index. Productivity costs were assessed from the social perspective, using a human capital approach. The cost of absenteeism, presenteeism and permanent work disability was valuated using the gross domestic product per worker. The patients’ productivity loss at unpaid work was measured by time inputs of others to assist patients. The productivity loss among informal caregivers and patients’ productivity loss at unpaid work were valuated with the average wage in Poland. The results were adjusted for confounders.ResultsThe responses from 200 patients (47% in remission) were analysed. The mean utility index was 0.839 (SD 0.171). The total indirect cost was estimated at €462.47 per patient per month (24.0%, absenteeism; 35.0%, work disability; 30.4%, presenteeism; 0.4%, productivity loss at unpaid work; and 10.4%, informal care). A significant correlation of the quality of life and productivity losses with disease severity was observed. Compared with active disease, the remission subgroup had a higher utility index by 16% (p<0.001) and lower indirect costs by 71% (p = 0.003) for absenteeism, 41% (p = 0.030) for presenteeism, 76% (p<0.001) for productivity loss at unpaid work, and 75% (p<0.001) for informal care.ConclusionsOur study revealed the social burden of CD and high dependency of indirect costs and quality of life on the severity of CD in Poland.

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“…Sensitivity analyses 5-22: other deterministic sensitivity analyses (medical and surgical options) Table 83 presents the results of the remaining deterministic sensitivity analysis (analyses [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

Section: Assessment Group Model Resultsmentioning

confidence: 99%

“…2,8 Pharmacological treatments for UC do not offer the possibility of cure and the disease course follows a relapsing-remitting pattern. The aim of clinical management is to induce and maintain disease remission and to avoid potential complications and the necessity for surgical intervention.…”

Section: Summary Of Cost-effectiveness Evidencementioning

confidence: 99%

Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy (including a review of TA140 and TA262): clinical effectiveness systematic review and economic model

Archer

Tappenden

Ren

et al. 2016

Health Technol Assess

143

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BackgroundUlcerative colitis (UC) is the most common form of inflammatory bowel disease in the UK. UC can have a considerable impact on patients’ quality of life. The burden for the NHS is substantial.ObjectivesTo evaluate the clinical effectiveness and safety of interventions, to evaluate the incremental cost-effectiveness of all interventions and comparators (including medical and surgical options), to estimate the expected net budget impact of each intervention, and to identify key research priorities.Data sourcesPeer-reviewed publications, European Public Assessment Reports and manufacturers’ submissions. The following databases were searched from inception to December 2013 for clinical effectiveness searches and from inception to January 2014 for cost-effectiveness searches for published and unpublished research evidence: MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library including the Cochrane Systematic Reviews Database, Cochrane Controlled Trials Register, Database of Abstracts of Reviews of Effects, the Health Technology Assessment database and NHS Economic Evaluation Database; ISI Web of Science, including Science Citation Index, and the Conference Proceedings Citation Index-Science and Bioscience Information Service Previews. The US Food and Drug Administration website and the European Medicines Agency website were also searched, as were research registers, conference proceedings and key journals.Review methodsA systematic review [including network meta-analysis (NMA)] was conducted to evaluate the clinical effectiveness and safety of named interventions. The health economic analysis included a review of published economic evaluations and the development of a de novo model.ResultsTen randomised controlled trials were included in the systematic review. The trials suggest that adult patients receiving infliximab (IFX) [Remicade®, Merck Sharp & Dohme Ltd (MSD)], adalimumab (ADA) (Humira®, AbbVie) or golimumab (GOL) (Simponi®, MSD) were more likely to achieve clinical response and remission than those receiving placebo (PBO). Hospitalisation data were limited, but suggested more favourable outcomes for ADA- and IFX-treated patients. Data on the use of surgical intervention were sparse, with a potential benefit for intervention-treated patients. Data were available from one trial to support the use of IFX in paediatric patients. Safety issues identified included serious infections, malignancies and administration site reactions. Based on the NMA, in the induction phase, all biological treatments were associated with statistically significant beneficial effects relative to PBO, with the greatest effect associated with IFX. For patients in response following induction, all treatments except ADA and GOL 100 mg at 32–52 weeks were associated with beneficial effects when compared with PBO, although these were not significant. The greatest effects at 8–32 and 32–52 weeks were associated with 100 mg of GOL and 5 mg/kg of IFX, respectively. For patients in remission following induction, all treatments except ADA at 8–32 weeks and GOL 50 mg at 32–52 weeks were associated with beneficial effects when compared with PBO, although only the effect of ADA at 32–52 weeks was significant. The greatest effects were associated with GOL (at 8–32 weeks) and ADA (at 32–52 weeks). The economic analysis suggests that colectomy is expected to dominate drug therapies, but for some patients, colectomy may not be considered acceptable. In circumstances in which only drug options are considered, IFX and GOL are expected to be ruled out because of dominance, while the incremental cost-effectiveness ratio for ADA versus conventional treatment is approximately £50,300 per QALY gained.LimitationsThe health economic model is subject to several limitations: uncertainty associated with extrapolating trial data over a lifetime horizon, the model does not consider explicit sequential pathways of non-biological treatments, and evidence relating to complications of colectomy was identified through consideration of approaches used within previous models rather than a full systematic review.ConclusionsAdult patients receiving IFX, ADA or GOL were more likely to achieve clinical response and remission than those receiving PBO. Further data are required to conclusively demonstrate the effect of interventions on hospitalisation and surgical outcomes. The economic analysis indicates that colectomy is expected to dominate medical treatments for moderate to severe UC.Study registrationThis study is registered as PROSPERO CRD42013006883.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Relationship between disease severity and quality of life and assessment of health care utilization and cost for ulcerative colitis in Australia: A cross-sectional, observational study

Cited by 107 publications

References 19 publications

Illness perceptions and stress: mediators between disease severity and psychological well-being and quality of life among patients with Crohn’s disease

Illness perceptions and stress: mediators between disease severity and psychological well-being and quality of life among patients with Crohn’s disease

Health-Related Quality of Life Impairment and Indirect Cost of Crohn’s Disease: A Self-Report Study in Poland

Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy (including a review of TA140 and TA262): clinical effectiveness systematic review and economic model

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Relationship between disease severity and quality of life and assessment of health care utilization and cost for ulcerative colitis in Australia: A cross-sectional, observational study

Cited by 107 publications

References 19 publications

Illness perceptions and stress: mediators between disease severity and psychological well-being and quality of life among patients with Crohn&rsquo;s disease

Illness perceptions and stress: mediators between disease severity and psychological well-being and quality of life among patients with Crohn&rsquo;s disease

Health-Related Quality of Life Impairment and Indirect Cost of Crohn’s Disease: A Self-Report Study in Poland

Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy (including a review of TA140 and TA262): clinical effectiveness systematic review and economic model

Contact Info

Product

Resources

About

Illness perceptions and stress: mediators between disease severity and psychological well-being and quality of life among patients with Crohn’s disease

Illness perceptions and stress: mediators between disease severity and psychological well-being and quality of life among patients with Crohn’s disease