Health utility of patients with Crohn’s disease and ulcerative colitis: a systematic review and meta-analysis

ABSTRACT Introduction: The aim of this systematic review was to collect and summarize the current data on the utilities of patients with Crohn’s disease (CD) and ulcerative colitis (UC). Areas covered: A meta-analysis of the obtained utilities was performed using a random-effects model and meta-regression by the disease type and severity. A bootstrap analysis was performed as it does not require assumption on distribution of the data. The highest utility among patients with CD and UC was observed when the diseases were in remission. The meta-regression analysis showed that both disease severity and an instrument/method/questionnaire used to obtain utilities were significant predictors of utility. Utility was the lowest for severe disease and the highest for disease in remission, the association was more notable in patients with CD compared with UC. Expert commentary: The issue of patients’ utility is important for healthcare decision makers but it has not been fully investigated and requires further study.

[1]  I. Russell,et al.  Development of a short questionnaire to assess the quality of life in Crohn's disease and ulcerative colitis. , 2015, Journal of Crohn's & colitis.

[2]  E. Rowland.  Theory of Games and Economic Behavior , 1946, Nature.

[3]  N. Borruel,et al.  Mucosal healing restores normal health and quality of life in patients with inflammatory bowel disease , 2012, European journal of gastroenterology & hepatology.

[4]  C. Núñez,et al.  Inflammatory bowel disease and celiac disease: overlaps and differences. , 2014, World journal of gastroenterology.

[5]  F. Casellas,et al.  Impact of surgery for Crohn's disease on health-related quality of life , 2000, American Journal of Gastroenterology.

[6]  Martin J Buxton,et al.  Mapping from disease-specific measures to utility: an analysis of the relationships between the Inflammatory Bowel Disease Questionnaire and Crohn's Disease Activity Index in Crohn's disease and measures of utility. , 2007, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[7]  C. Schmitt,et al.  Health-related quality of life after ileoanal pull-through evaluation and assessment of new health status measures. , 1997, Gastroenterology.

[8]  Kyeong Ok Kim,et al.  Predictive Factors of Impaired Quality of Life in Korean Patients With Inactive Inflammatory Bowel Disease: Association With Functional Gastrointestinal Disorders and Mood Disorders , 2013, Journal of clinical gastroenterology.

[9]  B. Feagan,et al.  Clinically Meaningful Improvement in Health-Related Quality of Life in a Randomized Controlled Trial of Certolizumab Pegol Maintenance Therapy for Crohn's Disease , 2009, The American Journal of Gastroenterology.

[10]  E. Irvine.  Quality of Life in inflammatory bowel disease: biases and other factors affecting scores. , 1995, Scandinavian journal of gastroenterology. Supplement.

[11]  Z. Cohen,et al.  Quality of life of patients with ulcerative colitis preoperatively and postoperatively. , 1991, Gastroenterology.

[12]  Aditi Saxena,et al.  Perceived and Actual Quality of Life With Ulcerative Colitis: A Comparison of Medically and Surgically Treated Patients , 2011, The American Journal of Gastroenterology.

[13]  A. Morris,et al.  Proximity to Disease and Perception of Utility: Physicians' vs Patients' Assessment of Treatment Options for Ulcerative Colitis , 2011, Diseases of the colon and rectum.

[14]  A. Connors,et al.  Do patient preferences influence decisions on treatment for patients with steroid-refractory ulcerative colitis? , 2006, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[15]  N. Borruel,et al.  Cutoff values of the Inflammatory Bowel Disease Questionnaire to predict a normal health related quality of life. , 2010, Journal of Crohn's & colitis.

[16]  D. Richards,et al.  Patient quality of life after successful restorative proctocolectomy is normal , 2001, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[17]  A. Detsky,et al.  Can the Standard Gamble Be Used to Determine Utilities for Uncertain Health States? , 2000, Medical decision making : an international journal of the Society for Medical Decision Making.

[18]  P. Siersema,et al.  Determinants of health-related quality of life in Crohn's disease: a systematic review and meta-analysis. , 2014, Journal of Crohn's & colitis.

[19]  A. Connors,et al.  Cost-utility of initial medical management for Crohn's disease perianal fistulae. , 2001, Gastroenterology.

[20]  A. Kennedy,et al.  Is self-care a cost-effective use of resources? Evidence from a randomized trial in inflammatory bowel disease , 2006, Journal of health services research & policy.

[21]  W. Selby,et al.  Relationship between disease severity and quality of life and assessment of health care utilization and cost for ulcerative colitis in Australia: a cross-sectional, observational study. , 2014, Journal of Crohn's & colitis.

[22]  C. FordAlexander,et al.  ULCERATIVE colitis. , 1997, Journal of the American Medical Association.

[23]  B. Feagan,et al.  An Evaluation of Utility Measurement in Crohn's Disease , 1997, Inflammatory bowel diseases.

[24]  R. Gearry,et al.  Pharmacoeconomic Analyses of Azathioprine, Methotrexate and Prospective Pharmacogenetic Testing for the Management of Inflammatory Bowel Disease , 2012, PharmacoEconomics.

[25]  G PLACITELLI,et al.  [Ulcerative colitis]. , 1958, La Riforma medica.

[26]  Anthony J. Culyer,et al.  Cost-effectiveness Analysis Registry , 2014 .

[27]  R. Bollinger,et al.  A prospective evaluation of health-related quality of life after ileal pouch anal anastomosis for ulcerative colitis , 2001, American Journal of Gastroenterology.

[28]  T. Mittendorf,et al.  Cost effectiveness of ulcerative colitis treatment in Germany: a comparison of two oral formulations of mesalazine , 2011, BMC health services research.

[29]  K. Bodger,et al.  Development and validation of a rapid, generic measure of disease control from the patient's perspective: the IBD-Control questionnaire , 2013, Gut.

[30]  F. Casellas,et al.  Sustained improvement of health‐related quality of life in Crohn's disease patients treated with infliximab and azathioprine for 4 years , 2007, Inflammatory bowel diseases.

[31]  H. König,et al.  Validity, reliability, and responsiveness of the EQ‐5D in inflammatory bowel disease in Germany , 2010, Inflammatory bowel diseases.

[32]  J. Powell,et al.  Dietary iron does not impact the quality of life of patients with quiescent ulcerative colitis: an observational study , 2013, Nutrition Journal.

[33]  F. Casellas,et al.  Relevance of the Phenotypic Characteristics of Crohn's Disease in Patient Perception of Health-Related Quality of Life , 2005, The American Journal of Gastroenterology.

[34]  R. Farmer,et al.  Quality of life assessment by patients with inflammatory bowel disease. , 1992, Cleveland Clinic journal of medicine.

[35]  N. Hyman,et al.  A Comparison of the Quality of Life of Ulcerative Colitis Patients after IPAA vs Ileostomy , 2012, Diseases of the colon and rectum.

[36]  C. Mittermaier,et al.  Health-Related Quality of Life in Patients with Crohn's Disease (Influence of Surgical Operation-A Prospective Trial) , 1999, Digestive Diseases and Sciences.

[37]  I. Leodolter.  [Crohn's disease]. , 1967, Wiener Zeitschrift fur innere Medizin und ihre Grenzgebiete.

[38]  P. Atanasov,et al.  Cost Utility of Adalimumab versus Infliximab Maintenance Therapies in the United States for Moderately to Severely Active Crohn’s Disease , 2012, PharmacoEconomics.

[39]  G. Corazza,et al.  Burden of Crohn’s disease: economics and quality of life aspects in Italy , 2012, ClinicoEconomics and outcomes research : CEOR.

[40]  M. Wolfson,et al.  The Health Utility Index: measuring health differences in Ontario by socioeconomic status. , 1995, Health reports.

[41]  D. Moher,et al.  Reprint--preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. , 2009, Physical therapy.

[42]  H. Tsai,et al.  A model of the long‐term cost effectiveness of scheduled maintenance treatment with infliximab for moderate‐to‐severe ulcerative colitis , 2008, Alimentary Pharmacology and Therapeutics.

[43]  J. Chao,et al.  Cost-effectiveness of adalimumab for the maintenance of remission in patients with Crohn's disease , 2009, European journal of gastroenterology & hepatology.

[44]  F. Casellas,et al.  Impairment of Health‐Related Quality of Life in Patients With Inflammatory Bowel Disease: a Spanish Multicenter Study , 2005, Inflammatory bowel diseases.

[45]  P. Marteau,et al.  A comparison of physician-rated disease severity and patient reported outcomes in mild to moderately active ulcerative colitis. , 2010, Journal of Crohn's & colitis.