Research article

The impact of illness in patients with moderate to severe gastro-esophageal reflux disease

Samer El-Dika¹ , Gordon H Guyatt^2,3 , David Armstrong³ , Alessio Degl'innocenti⁴ , Ingela Wiklund⁴ , Carlo A Fallone⁵ , Lisa Tanser⁶ , Sander Veldhuyzen van Zanten⁷ , Diane Heels-Ansdell² , Peter Wahlqvist⁴ , Naoki Chiba^3,8 , Alan N Barkun⁵ , Peggy Austin² and Holger J Schünemann^2,9,10

¹  Division of Gastroenterology, Veterans affairs medical center, Salem, Virginia, USA

²  Department of Clinical Epidemiology and Biostatistics' McMaster University, Hamilton, Ontario, Canada

³  Department of Medicine, McMaster University, Hamilton, Ontario, Canada

⁴  AstraZeneca R&D, Clinical Science, Mölndal, Sweden

⁵  Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada

⁶  AstraZeneca R&D, Canada, Mississauga, Ontario, Canada

⁷  Division of Gastroenterology, Dalhousie University, Halifax, Nova Scotia, Canada

⁸  Surrey GI Clinic/Research, Guelph, Ontario, Canada

⁹  Department of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA

¹⁰  Division of Clinical Research Development and Information Translation/INFORMA, Italian National Cancer Institute, Rome/Istituto Regina Elena, Rome, Italy

author email corresponding author email

BMC Gastroenterology 2005, 5:23doi:10.1186/1471-230X-5-23

Published:	10 July 2005

Abstract

Background

Gastro-esophageal reflux disease (GERD) is a common disease. It impairs health related quality of life (HRQL). However, the impact on utility scores and work productivity in patients with moderate to severe GERD is not well known.

Methods

We analyzed data from 217 patients with moderate to severe GERD (mean age 50, SD 13.7) across 17 Canadian centers. Patients completed three utility instruments – the standard gamble (SG), the feeling thermometer (FT), and the Health Utilities Index 3 (HUI 3) – and several HRQL instruments, including Quality of Life in Reflux and Dyspepsia (QOLRAD) and the Medical Outcomes Short Form-36 (SF-36). All patients received a proton pump inhibitor, esomeprazole 40 mg daily, for four to six weeks.

Results

The mean scores on a scale from 0 (dead) to 1 (full health) obtained for the FT, SG, and HUI 3 were 0.67 (95% CI, 0.64 to 0.70), 0.76 (95% CI, 0.75 to 0.80), and 0.80 (95% CI, 0.77 to 0.82) respectively. The mean scores on the SF-36 were lower than the previously reported Canadian and US general population mean scores and work productivity was impaired.

Conclusion

GERD has significant impact on utility scores, HRQL, and work productivity in patients with moderate to severe disease. Furthermore, the FT and HUI 3 provide more valid measurements of HRQL in GERD than the SG. After treatment with esomeprazole, patients showed improved HRQL.