A retrospective and prospective 12-month observational study of the socioeconomic burden of moderate to severe irritable bowel syndrome with constipation in Spain

Gastroenterol Hepatol. 2019 Mar;42(3):141-149. doi: 10.1016/j.gastrohep.2018.10.008. Epub 2019 Jan 3.
[Article in English, Spanish]

Abstract

Introduction: The socioeconomic burden of irritable bowel syndrome with constipation (IBS-C) has never been formally assessed in Spain.

Patients and methods: This 12-month (6-month retrospective and prospective periods) observational, multicentre study assessed the burden of moderate-to-severe IBS-C in Spain. Patients were included if they had been diagnosed with IBS-C (Rome III criteria) within the last 5 years and had moderate-to-severe IBS-C (IBS Symptom Severity Scale score [IBS-SSS] ≥175) at inclusion. The primary objective was to assess the direct cost to the Spanish healthcare system (HS).

Results: A total of 112 patients were included, 64 (57%) of which had severe IBS-C at inclusion. At baseline, 89 (80%) patients reported abdominal pain and distention. Patient quality of life (QoL), measured by the IBS-C QoL and EQ-5D instruments, was found to be impaired with a mean score of 59 and 57 (0-100, worst-best), respectively. Over the 6-month prospective period the mean IBS-C severity, measured using the IBS-SSS showed some improvement (315-234 [0-500, best-worst]). During the year, 89 (80%) patients used prescription drugs for IBS-C, with laxatives being the most frequently prescribed (n=70; 63%). The direct cost to the HS was €1067, and to the patient was €568 per year. The total direct cost for moderate-to-severe IBS-C was €1635.

Discussion: The majority of patients reported continuous IBS-C symptoms despite that 80% were taking medication to treat their IBS-C. Overall healthcare resource use and direct costs were asymmetric, with a small group of patients consuming the majority of resources.

Keywords: Costes directos; Direct costs; España; Healthcare resource use; Irritable bowel syndrome; Irritable bowel syndrome with constipation; Spain; Síndrome del intestino irritable; Síndrome del intestino irritable con estreñimiento; Utilización de recursos sanitarios.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Abdominal Pain / etiology
  • Constipation / complications
  • Constipation / drug therapy
  • Constipation / economics*
  • Direct Service Costs
  • Female
  • Gastric Dilatation / etiology
  • Gastrointestinal Agents / economics
  • Gastrointestinal Agents / therapeutic use
  • Health Care Costs*
  • Health Services Needs and Demand / economics
  • Health Services Needs and Demand / statistics & numerical data
  • Humans
  • Irritable Bowel Syndrome / complications
  • Irritable Bowel Syndrome / drug therapy
  • Irritable Bowel Syndrome / economics*
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life
  • Retrospective Studies
  • Severity of Illness Index
  • Socioeconomic Factors
  • Spain
  • Time Factors

Substances

  • Gastrointestinal Agents