Burden of illness in patients with reflux disease--evidence from a recent comparative methodological study in Hungary

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.

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

Patients with symptoms of heartburn completed the Hungarian 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.

136 patients completed the assessments (mean age of 47 years, SD = 13; 58% female). 53% of patients had moderate symptoms and two thirds (69%) had symptoms on 3 or more days in the previous week. Patients were most bothered by symptoms of reflux (mean GSRS score of 3.4, on a scale of 1 [not bothered] to 7 [very bothered]), abdominal pain (2.8) and indigestion (2.6). As a result of their symptoms, patients experienced problems with food and drink (mean QOLRAD score of 4.6, on a scale of 1 to 7, where 1 represents the most severe impact on daily functioning), emotional distress (4.6), impaired vitality (4.7), and sleep disturbance (4.8). This led to impaired overall HRQL across all domains (mean SF-36 score of this heartburn population compared to a general population in Hungary). Using HAD, 29% of patients were anxious and 17% were depressed.

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