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. Aim: To describe the impact of heartburn on patients' Health-Related Quality of Life (HRQL) in Hungary.

Method: 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.

Results: 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.

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