Smoking is Associated with Higher Disease-related Costs and Lower Health-related Quality of Life in Inflammatory Bowel Disease.
J Crohns Colitis
; 11(3): 342-352, 2017 Mar 01.
Article
em En
| MEDLINE
| ID: mdl-27647859
ABSTRACT
BACKGROUND AND AIMS:
Smoking affects the course of inflammatory bowel disease [IBD]. We aimed to study the impact of smoking on IBD-specific costs and health-related quality-of-life [HrQoL] among adults with Crohn's disease [CD] and ulcerative colitis [UC].METHODS:
A large cohort of IBD patients was prospectively followed during 1 year using 3-monthly questionnaires on smoking status, health resources, disease activity and HrQoL. Costs were calculated by multiplying used resources with corresponding unit prices. Healthcare costs, patient costs, productivity losses, disease course items and HrQoL were compared between smokers, never-smokers and ex-smokers, adjusted for potential confounders.RESULTS:
In total, 3030 patients [1558 CD, 1054 UC, 418 IBD-unknown] were enrolled; 16% smoked at baseline. In CD, disease course was more severe among smokers. Smoking was associated with > 30% higher annual societal costs in IBD (7,905 [95% confidence interval 6,234 - 9,864] vs 6,017 [5,186 - 6,946] in never-smokers and 5,710 [4,687 - 6,878] in ex-smokers, p = 0.06 and p = 0.04, respectively). In CD, smoking patients generated the highest societal costs, primarily driven by the use of anti-tumour necrosis factor compounds. In UC, societal costs of smoking patients were comparable to those of non-smokers. Societal costs of IBD patients who quitted smoking > 5 years before inclusion were lower than in patients who quitted within the past 5 years ( 5,135 [95% CI 4,122 - 6,303] vs 9,342 [6,010 - 12,788], p = 0.01). In both CD and UC, smoking was associated with a lower HrQoL.CONCLUSIONS:
Smoking is associated with higher societal costs and lower HrQoL in IBD patients. Smoking cessation may result in considerably lower societal costs.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Fumar
/
Colite Ulcerativa
/
Doença de Crohn
/
Custos de Cuidados de Saúde
/
Efeitos Psicossociais da Doença
Tipo de estudo:
Health_economic_evaluation
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Crohns Colitis
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Holanda