What is the burden of illness in patients with reflux disease in South Africa?

Abstract

Objectives: To describe the impact of heartburn on patients’ Health-Related Quality of Life (HRQL) in South Africa.

Design: Survey of patient-reported outcomes and physician-assessed symptoms. Setting: South African, major referral gastroenterology clinic. Subjects: Consecutive patients with predominant symptoms of heartburn.

Outcome measures:Patients completed the Afrikaans versions of the Gastrointestinal Symptom Rating Scale (GSRS), the Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD) and the Short Form Health-36 (SF-36). Physician-assessed frequency and severity of heartburn during the previous 7 days were also recorded.

Results: 125 patients with symptoms of heartburn (age: M=46.0 [±12 years]; females= 74%, 87% mixed race) completed the Afrikaans translation of GSRS, the QOLRAD and the Short-Form-36 (SF-36). Patients were bothered most by symptoms of reflux (mean GSRS score of 4.9, on a scale of 1 [not bothered] to 7 [very bothered]), indigestion (4.0) and abdominal pain (4.0). As a result of their symptoms, important
reflux related aspects of life, such as problems with food and drink (3.5), emotional distress (3.6), impaired vitality (3.7), sleep disturbance (3.8) and impaired physical/social functioning (4.3) were experienced (QOLRAD scores where 1 represents the most severe impact on daily functioning and 7 no impact). Overall HRQL measured by the SF-36 was poor across all domains and was significantly lower compared to the UK general population. Conclusions: There is consistent
evidence that GERD symptoms substantially impair all aspects of HRQL in this mixed race South African population referred to this central clinic.