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BMC Gastroenterol ; 19(1): 69, 2019 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-31064345


BACKGROUND: Irritable bowel syndrome with predominant constipation (IBS-C) is a complex disorder with gastrointestinal and nervous system components. The study aim was to assess the economic burden of moderate to severe IBS-C in six European countries (France, Germany, Italy, Spain, Sweden and the UK). METHODS: An observational, one year retrospective-prospective (6 months each) study of patients diagnosed in the last five years with IBS-C (Rome III criteria) and moderate to severe disease at inclusion (IBS Symptom Severity Scale score ≥ 175). The primary objective was to assess the direct cost to European healthcare systems. RESULTS: Five hundred twenty-five patients were included, 60% (range: 43.1-78.8%) suffered from severe IBS-C. During follow-up 11.1-24.0% of patients had a hospitalisation/emergency room (ER) visit, median stay range: 1.5-12.0 days and 41.1-90.4% took prescription drugs for IBS-C. 21.4-50.8% of employed patients took sick leave (mean: 11.6-64.1 days). The mean annual direct cost to the healthcare systems was €937.1- €2108.0. The total direct cost (combined costs to healthcare systems and patient) for IBS-C was €1421.7-€2487.1. CONCLUSIONS: IBS-C is not a life-threatening condition; however, it has large impact on healthcare systems and society. Direct and indirect costs for moderate to severe IBS-C were high with the largest direct cost driver being hospitalisations/ER visits.

Constipação Intestinal/complicações , Constipação Intestinal/economia , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/economia , Adulto , Idoso , Constipação Intestinal/diagnóstico , Custos de Medicamentos , Europa (Continente) , Utilização de Instalações e Serviços , Feminino , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Humanos , Síndrome do Intestino Irritável/diagnóstico , Masculino , Pessoa de Meia-Idade , Visita a Consultório Médico/economia , Visita a Consultório Médico/estatística & dados numéricos , Estudos Prospectivos , Estudos Retrospectivos , Índice de Gravidade de Doença , Licença Médica/economia
United European Gastroenterol J ; 6(9): 1417-1427, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30386615


Background: Irritable bowel syndrome with diarrhoea (IBS-D) comprises multiple troublesome symptoms and negatively impacts patients' quality of life. Objective: The objective of this article is to assess IBS-D patient burden and patient and healthcare professional (HCP) attitudes towards IBS. Methods: Patients and HCPs from Australia, Canada, France, Germany, Italy, Spain and the United Kingdom completed internet-based surveys via market research panels. Attitudes to IBS-D-related statements were scored using seven-point Likert scales. Results: The patient survey included 513 patients (70% female, mean age 40.9 years). Faecal urgency was reported as the most troublesome symptom (27%) and fatigue occurred on the most days per month (mean: 18); 61% of patients used ≥3 types of treatment daily or intermittently; 19% used antidepressants daily. Thirty-three per cent thought HCPs should listen and provide more support and 46% reported willingness to 'try anything' to help manage their IBS-D. The HCP survey included 366 primary care physicians and 313 gastroenterologists: A total of 70% and 65%, respectively, agreed it was important that IBS-D patients feel listened to and supported; 73% agreed their main aim was to improve quality of life; ∼30% expressed frustration at managing IBS-D. Conclusion: IBS-D imposes a substantial burden on patients and HCPs. These findings point towards a need for improved patient-HCP communication.

Z Gastroenterol ; 56(7): 738-744, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29742779


BACKGROUND: Linaclotide is a minimally absorbed peptide guanylate cyclase-C agonist approved for the treatment of irritable bowel syndrome with constipation (IBS-C). This study assessed the efficacy and tolerability of linaclotide in IBS-C in routine clinical practice in Germany. METHODS: This was a 52-week, noninterventional study of linaclotide in patients aged ≥ 18 years with moderate to severe IBS-C. Severity of abdominal pain and bloating and frequency of bowel movements were assessed over 5 study visits. Treatment-related adverse events were recorded. RESULTS: The study enrolled 375 patients; the mean observation duration was 4.4 months. Linaclotide marketing was halted during the study period for economic reasons, accounting for low patient numbers and short observation duration. Linaclotide significantly reduced mean (standard deviation [SD]) scores between treatment start (visit 1) and study end (visit 5) for abdominal pain intensity (visit 1: 4.87 [2.63] vs. visit 5: 2.40 [2.20], p < 0.0001), mean [SD] bloating intensity (visit 1: 5.30 [2.70] vs. visit 5: 2.86 [2.34], p < 0.0001), and increased mean [SD] bowel movement frequency (visit 1: 2.71 [1.80] vs. 4.38 [1.86], p < 0.0001). Diarrhea, occurring in 5.1 % of patients, was the most common adverse event. CONCLUSION: Linaclotide is effective in improving the major symptoms of IBS-C and demonstrates a favorable safety profile in the real-world environment of routine clinical practice. DRKS ( DRKS00005088.