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Z Gastroenterol 2003; 41(12): 1137-1143
DOI: 10.1055/s-2003-45277
Originalarbeit
© Karl Demeter Verlag im Georg Thieme Verlag Stuttgart · New York

Impact of Reflux Disease on General and Disease-Related Quality of Life - Evidence from a Recent Comparative Methodological Study in Germany

Einfluss der gastroösophagealen Refluxkrankheit auf die allgemeine und krankheitsbezogene Lebensqualität - Ergebnisse einer Validierungsstudie in DeutschlandA. Madisch1 , K. R. Kulich2 , P. Malfertheiner3 , K. Ziegler4 , E. Bayerdörffer5 , S. Miehlke1 , J. Labenz6 , J. Carlsson2 , I. K. Wiklund2
  • 1Medical Department I, Technical University of Dresden, Dresden, Germany
  • 2Clinical Science, AstraZeneca R&D Mölndal, Sweden
  • 3Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany
  • 4Private clinic, Berlin, Germany
  • 5Center for Internal Medicine, University of Marburg, Germany
  • 6Medical Department, Ev. Jung-Stilling-Hospital, Academic Hospital of the University of Bonn, Germany
Further Information

Publication History

Accepted after revision: 20. October 2003

Manuscript received: 29. October 2003

Publication Date:
08 December 2003 (online)

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Abstract

Background: The clinical and socioeconomic burden of gastro-esophageal reflux disease (GERD) is considerable. The primary symptom of GERD is heartburn, but it may also be associated with extraesophageal manifestations, such as asthma, chest pain and otolaryngologic disorders.

Aim: To describe the impact of heartburn on patients’ Health-Related Quality of Life (HRQL) in Germany, using validated generic and disease-specific instruments to measure patient-reported outcomes.

Method: Patients with symptoms of heartburn completed the German versions of the Gastrointestinal Symptom Rating Scale (GSRS), the Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD), the Short Form-36 (SF-36) and the Hospital Anxiety and Depression (HAD) scale. Frequency and severity of heartburn during the previous 7 days were also recorded.

Results: 142 consecutive patients completed the assessments (mean age of 47.5 years, SD = 14.6; 55.6 % female). 70 % of patients had moderate symptoms. Over half (68 %) had symptoms on more than 4 days in the previous week. Patients were most bothered by symptoms of reflux with a mean GSRS score, (ranges from 1 [not bothered] to 7 [very bothered]), of 3.9, indigestion of 3.3 and abdominal pain of 3.0, respectively. As a result of their symptoms, patients experienced problems with food and drink. The mean QOLRAD score (ranges from 1 to 7; the lower the value the more severe the impact on quality of life) of daily functioning was 4.4, impaired vitality 4.6, emotional distress 5.0 and sleep disturbance 5.1, respectively. This led to impaired overall HRQL across all domains (mean SF-36 score of this heartburn population compared to a general population in Germany). Using HAD, 25 % of patients were anxious and 8 % were depressed.

Conclusion: There is consistent evidence that heartburn substantially impairs all aspects of health-related quality of life.

Zusammenfassung

Einleitung: Die klinische und sozioökonomische Bedeutung der gastroösophagealen Refluxkrankheit (GERD) ist erheblich. Das Leitsymptom der GERD ist Sodbrennen, aber auch extraösophageale Manifestationen wie z. B. Asthma, Thoraxschmerzen und Laryngitis sind möglich.

Ziel: Ziel der Untersuchung ist die Messung der krankheitsbezogenen Lebensqualität (Health Related Quality of Life - HRQL) bei Patienten mit GERD mittels generischer und krankheitsspezifischer HRQL-Instrumente.

Methodik: Patienten mit Refluxsymptomen wurden gleichzeitig mit den deutschen Versionen der Gastrointestinal Symptom Rating Scale (GSRS), des Quality of Life in Reflux and Dyspepsia Index (QOLRAD), der kurzen Version des SF-36 und der hospital Angst- und Depressionsskala (HAD) befragt. Häufigkeit und Intensität der GERD-Symptome wurden erfasst.

Ergebnisse: 142 konsekutive Patienten (mittleres Alter 47,5 ± 14,6; 55,6 % Frauen) haben die Fragebogen komplett beantwortet. 70 % der Patienten klagten über mäßige Refluxsymptome, 68 % der Patienten hatten über mehr als 4 Tage in der letzten Woche Refluxsymptome. Die im Vordergrund stehenden gastrointestinalen Symptome waren Sodbrennen mit einem mittleren GSRS-Score von 3,9 (Spanne von 1 [keine Beeinträchtigung] bis 7 [sehr starke Beeinträchtigung]), ein undefinierbares Unwohlsein mit 3,3 und abdominelle Schmerzen mit 3,0. Die Patienten waren in ihren Ernährungs- und Essgewohnheiten eingeschränkt. Der Mittelwert des QOLRAD-Scores (Spanne 1 bis 7, je niedriger, desto stärker die Beeinträchtigung) betrug bei der Dimension tägliche Leistungsfähigkeit 4,4, Vitalität 4,6, emotionale Kontrolle 5,0 und Schlafstörungen 5,1. Die Patienten zeigten in allen Dimensionen des SF-36 geringere Indexwerte im Vergleich zur Normalbevölkerung. 25 % der Patienten waren in der HAD-Skala ängstlich, 8 % depressiv.

Schlussfolgerung: Das Symptom Sodbrennen führt zu einer deutlichen Einschränkung der allgemeinen und krankheitsbezogenen Lebensqualität.

Key words

Burden of illness - heartburn - health-related quality of life - Germany

Schlüsselwörter

Krankheitsbezogene Einschränkung der Lebensqualität - HRQL - GERD - Sodbrennen

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Dr. Ahmed Madisch

Medical Department I, Technical University of Hospital

Fetscherstrasse 74

01307 Dresden, Germany

Email: madisch@mk1.med.tu-dresden.de

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