COMPARISON OF HEALTH RELATED QUALITY OF LIFE BETWEEN HEPATITIS, CIRRHOSIS, LIVER TRANSPLANTATION AND HEPATIC CARCINOMA: RESULTS OF THE COME STUDY
Ciampichini R(1) , Scalone L(1), Gardini I(2), Gaeta L(3), Del Prete A(3), Fusco F(1), Fagiuoli S(3), Mantovani LG(4)
(1)CHARTA Foundation, Milano, (2)EpaC ONLUS, (3)Ospedali Riuniti, Bergamo, (4)Policlinico Hospital - University of Naples Federico II, Naples
OBJECTIVES: As a result of successful treatments for chronic hepatic diseases (CHDs), patients generally live longer but often with a compromised wellbeing. We assessed Health-Related Quality-of-Life (HRQoL) of CHDs adult patients.
METHODS: A naturalistic multicentre Cost-of-Illness study was conducted. Adult patients (age 18 years) diagnosed with CHDs, consequently accessing at gastroenterology unit of 2 hospitals, were enrolled. Direct, indirect and intangible costs were estimated from the societal perspective. The patients were sub-grouped according to their main condition at the enrollment: hepatitis B and/or C, cirrhosis, liver transplantation, hepatic carcinoma. HRQoL was assessed with the EQ-5D 3L and 5L versions (the psychometric properties of the 5L new version was previously discussed: podium by Scalone et al, 13th ISPOR Congress 2011, Prague). The following results pertain the EQ-5D-5L results.
RESULTS:We enrolled 1,088 valid patients, 62% male, aged 19-90 (median60) years. Patients with hepatitis were 60.4%, 20.2% had cirrhosis, 11.9% had liver transplantation, 7.5% hepatic carcinoma. Among all the patients, the mean+SD VAS was 69.1+20.8. Mobility was an extreme/severe problem for 3.3% and a moderate/slight problem for 22.6% of the patients. Self-care was an extreme/severe problem for 1.2% and a moderate/slight problem for 11.5% of the patients. Usual activities was an extreme/severe problem for 4.0% and a moderate/slight problem for 25.5% of the patients. Pain/discomfort was extreme/severe for 3.2% and a moderate/slight problem for 36.1% of the patients. Anxiety/Depression was extreme/severe for 4.5% and a moderate/slight for 43.5% of the patients. Patients with cirrhosis reported the worst levels of HRQoL, those with carcinoma had a worse HRQoL than patients with transplantation, those with hepatitis reported better levels of HRQoL.
CONCLUSIONS: Our study shows how HRQoL is negatively related with the severity and chronicity of CHDs. Health technology aimed to improve wellbeing in patients with disabling long term hepatic disease is required.