The burden of non-alcoholic steatohepatitis (NASH) among patients from Europe: A real-world patient-reported outcomes study
| Autor: | Nancy Krieger, Maria-Magdalena Balp, Elliot B. Tapper, Nico Janssens, Garth Wall, S.J. Mckenna, Raymond Przybysz, J. Cai, Nate Way, Dion H. Zappe |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Activities of daily living Population Type 2 diabetes Quality of life (healthcare) Health care Internal Medicine Immunology and Allergy Medicine lcsh:RC799-869 education Depression (differential diagnoses) education.field_of_study Hepatology business.industry Gastroenterology non-alcoholic fatty liver disease medicine.disease Family medicine burden of illness Cohort Anxiety lcsh:Diseases of the digestive system. Gastroenterology non-alcoholic steatohepatitis type 2 diabetes medicine.symptom business Research Article |
| Zdroj: | JHEP Reports JHEP Reports, Vol 1, Iss 3, Pp 154-161 (2019) |
| ISSN: | 2589-5559 |
| Popis: | Background & Aims Data on the economic and humanistic burden of non-alcoholic steatohepatitis (NASH) are scarce. This study assessed the comparative burden of NASH, relative to a representative sample from the general population and a type 2 diabetes mellitus (T2DM) cohort, in terms of health-related quality of life, work productivity and activity impairment (WPAI), and healthcare resource use. Methods Data across 5 European countries came from the 2016 National Health and Wellness Survey, a nationally representative patient-reported outcomes survey. Outcomes included mental (MCS) and physical (PCS) component scores from the Short-Form (SF)-36v2, WPAI scores, self-reported physician diagnosis of sleep difficulties, anxiety, and depression, and healthcare resource use: healthcare professional visits, hospital visits, and emergency room visits in the previous 6 months. Bivariate and multivariable analyses were conducted for each outcome and comparative group. Results After adjusting for matching criteria and covariates, patients with NASH (n = 184) reported significantly worse health-related quality of life, worse WPAI scores, and more healthcare resource use than the general population (n = 736) (MCS 39.22 vs. 45.16, PCS 42.84 vs. 47.76; overall work impairment 49.15% vs. 30.77%, healthcare professional visits 10.73 vs. 6.01, emergency room visits 0.57 vs. 0.22, hospitalizations 0.47 vs. 0.17, p ≪0.05 for all). Patients with NASH did not differ from patients with T2DM (n = 368) on PCS and WPAI scores, suggesting a similar impairment on work and daily activities, but did report significantly worse mental status (MCS 39.64 vs. 43.64, p ≪0.05) and more healthcare resource use than those with T2DM (healthcare professional visits 10.85 vs. 7.86, emergency room visits 0.65 vs. 0.23, hospitalizations 0.39 vs. 0.19, p ≪0.05 for all). Conclusions These findings suggest that the burden of NASH may be underestimated, highlighting the unmet needs of patients with NASH. Lay summary These findings show that patients with non-alcoholic steatohepatitis (NASH) experience a significant burden of illness, in terms of health-related quality of life, work productivity and activity impairment, and healthcare resource use. As there is currently no approved treatment for NASH, these findings highlight the unmet medical need of patients with NASH. Graphical abstract Unlabelled Image Highlights • Non-alcoholic steatohepatitis (NASH) is a progressive form of non-alcoholic fatty liver disease. • NASH imposes a significant humanistic and economic burden on individuals and society. • NASH impairs health-related quality of life, work productivity and activity, while increasing healthcare resource use. • This study highlights the unmet need of patients with NASH in the absence of any approved treatment. |
| Databáze: | OpenAIRE |
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