P618. The relationship between disease severity, quality of life and health care resource utilization among United Kingdom patients with ulcerative colitis
C. Vaizey1, P.R. Gibson2, C.M. Black3, R.J. Nicholls4, A.R. Weston4, D.R. Gaya5, S. Sebastian6, I. Shaw7, S. Lewis8, S. Bloom9, J.N. Gordon10, A. Beale11, I. Arnott12, S. Cambell13, T. Fan3, 1St Mark's Hospital, Department of Surgery, London, United Kingdom, 2Monash University, Victoria, Australia, 3Merck & Co. Inc., Global Health Outcomes, Whitehouse Station, United States, 4OptumInsight, Sydney, Australia, 5Glasgow Royal Infirmary, Gastroenterology Unit, Glasgow, United Kingdom, 6Hull Royal Infirmary, Department of Gastroenterology, Hull, United Kingdom, 7Gloucester Royal Hospital, Department of Gastroenterology, Gloucester, United Kingdom, 8Derriford Hospital, Department of Gastroenterology, Plymouth, United Kingdom, 9University College London Hospital, Department of Gastroenterology, London, United Kingdom, 10Royal Hampshire Hospital, Department of Gastroenterology, Winchester, United Kingdom, 11Bristol Royal Infirmary, Bristol, United Kingdom, 12Western General Hospital, Edinburgh, United Kingdom, 13Manchester Royal Infirmary, Manchester, United Kingdom
Ulcerative colitis (UC) is a chronic disease that has a reported prevalence in the United Kingdom ranging from 125–250 per 100,000 people. This study was conducted to determine the relationship between disease severity and patient quality of life (QoL), and to describe healthcare resource utilization in UC patients.
This cross-sectional, observational study that used a patient questionnaire including demographic, disease characteristics and two standardized QoL instruments (EQ-5D-5L & IBDQ). Clinical assessment of the patient's disease severity was measured using the partial Mayo score (pMayo) and was grouped into remission, mild and moderate/severe for analysis (0–2, 3–4, 5+). UC-related health care resource utilization was collected using the patient questionnaire and a chart review for UC-related hospitalizations (over 1 year) and all other UC health care resource use (over 3 months). Unit costs were derived from government sources. The Kruskal–Wallis test was used to compare QoL scores between disease severities.
173 were included in the study. The median pMayo score was 2.00, with 58% of patients' diseases severity in remission, 18% with mild and 24% with moderate/severe activity. Remission patients had significantly higher EQ-5D-5L (0.86 vs. 0.77 vs. 0.66, p < 0.0001) scores when compared to mild and moderate/severe UC patients. The disease-specific IBDQ was found to be positively correlated with the EQ-5D-5L (0.56, p < 0.0001). Patients reported that general practitioners were the most utilized health care provider, where 69% of patients made at least one visit and more than 15% had 5+ visits in the previous year. 88% of patients saw a gastroenterologist in the previous 3 months. 62% of patients had UC-related investigations, with a mean of 1.75±2.4 investigations per patient. Over the past year, 43% of patients were hospitalized and 8% visited the emergency department without being admitted. The total 3 month cost per patient for UC-related health care was £1,211.06. Prescription medication use accounted for the greatest proportion of the total costs (∼28%) with other outpatient UC-related investigations and hospitalizations for more than one day accounting for approximately 20% each.
Overall, UC disease severity has a significant impact on a patient's QoL, work productivity and daily activities. UC-related prescription medication, investigations, and hospitalizations account for the greatest proportion of the total UC-related health care costs.