The Humanistic and Economic Burden of Chronic Idiopathic Constipation in the USA: A Systematic Literature Review
Received 19 November 2019
Accepted for publication 25 June 2020
Published 16 July 2020 Volume 2020:13 Pages 255—265
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Andreas M. Kaiser
Arpita Nag,1 Susan A Martin,2 Deirdre Mladsi,3 Oyebimpe Olayinka-Amao,4 Molly Purser,5 Renu M Vekaria6
1Global Health Economics, Outcomes Research and Epidemiology, Shire, a Takeda Company, Lexington, MA, USA; 2Patient-Centered Outcomes Assessment Group, RTI Health Solutions, Ann Arbor, MI, USA; 3Health Economics – Strategy and Early Modeling Group, RTI Health Solutions, Durham, NC, USA; 4Patient-Centered Outcomes Assessment Group, RTI Health Solutions, Durham, NC, USA; 5Health Economics – Regenerative Medicine and Advanced Therapies Group, RTI Health Solutions, Durham, NC, USA; 6Value Insight and Access Strategy Group, RTI Health Solutions, Manchester, Lancashire, UK
Correspondence: Molly Purser
RTI Health Solutions, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA
Tel +1 919 541 6439
Fax +1 919 541 7222
Background: Chronic idiopathic constipation (CIC) is a functional gastrointestinal disorder with an estimated prevalence of 16% in the USA; however, the humanistic and economic burden of CIC is poorly characterized.
Aim: This systematic literature review aimed to assess the humanistic and economic burden of CIC in adults in the USA.
Methods: Two systematic literature searches of English-language publications on the humanistic and economic burden of CIC in adults in the USA were conducted using electronic databases and other resources. Both searches included the terms “chronic idiopathic constipation” and “functional constipation”. Specific terms used in the search on humanistic burden included “quality of life”, “SF-36”, “SF-12”, and “PAC-QOL”; search terms for economic burden included “cost”, “resource use”, “absenteeism”, and “productivity”.
Results: Overall, 16 relevant articles were identified. Health-related quality of life (HRQoL) appeared to be reduced in patients with CIC compared with controls and the general US population. Abdominal (r=0.33– 0.49), stool (r=0.23– 0.33), and rectal symptoms (r=0.53) appeared to be associated with reduced HRQoL. Younger age and female sex were associated with reduced overall HRQoL and greater symptom severity. Direct outpatient costs were higher in patients with CIC than those without CIC (US$6284 vs US$5254). Patients with CIC and abdominal symptoms reported more days of disrupted productivity per month than those without abdominal symptoms (3.2 days vs 1.2 days). The overall prevalence of complementary and alternative medicine use by patients with CIC was similar to that in the general US population.
Conclusion: The reduced HRQoL and increased costs associated with CIC indicate unmet therapeutic need in this disorder. Further research is required to better understand the humanistic and economic burden of CIC in the USA.
Keywords: chronic idiopathic constipation, functional constipation, economic burden, health-related quality of life
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