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High Impact of Pediatric Inflammatory Bowel Disease on Caregivers’ Work Productivity and Daily Activities: An International Prospective Study - 22/06/22

Doi : 10.1016/j.jpeds.2022.04.014 
Renz C.W. Klomberg, MSc, MD 1, , Martine A. Aardoom, MSc, MD 1, Polychronis Kemos, MSc 2, Dimitris Rizopoulos, MSc, PhD 3, Frank M. Ruemmele, MD, PhD 4, Nicholas M. Croft, MD, PhD 2, Lissy de Ridder, MD, PhD 1, , Mattias Neyt, MSc, PhD 5,
on behalf of

the PIBD-SET Quality consortium

Dan Turner, Gili Focht, Janneke Samsom, Gigi Veereman, Sibylle Koletzko, Annecarin Brückner, Arie Levine, Richard Russell, Anne Griffiths, Marina Aloi, Thomas Walters, Michael Walker

1 Department of Pediatric Gastroenterology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands 
2 Pediatric Gastroenterology, Center for Immunobiology, Blizard Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK 
3 Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands 
4 Department of Pediatric Gastroenterology, University of Paris Descartes, Sorbonne Paris City, APHP, Necker Hospital for Sick Children, Paris, France 
5 Medical Evaluation and Technology Assessment, Merendree, Belgium 

Reprint requests: Renz C.W. Klomberg, MD, Department of Pediatric Gastroenterology, Erasmus Medical Center - Sophia Children's Hospital, Room SP-2430, P.O. Box 2040, CA Rotterdam 3000, The NetherlandsDepartment of Pediatric GastroenterologyErasmus Medical Center - Sophia Children's HospitalRoom SP-2430P.O. Box 2040CA Rotterdam3000The Netherlands

Abstract

Objectives

To evaluate the longitudinal evolution of work productivity loss and activity impairment in caregivers of children with inflammatory bowel disease (IBD). We also evaluated the associations between these impairments, IBD-related factors, and caregivers’ health-related quality of life (HRQOL) and estimated the indirect costs related to work absenteeism.

Study design

Since January 2017, children with newly diagnosed IBD were enrolled prospectively in the Pediatric Inflammatory Bowel Disease Network for Safety, Efficacy, Treatment and Quality improvement of care study. The impact of pediatric-onset IBD on caregivers' socioeconomic functioning (work and daily activities) and HRQOL was assessed using the Work Productivity and Activity Impairment for caregivers questionnaire and the European Quality of Life Five Dimension Five Level questionnaire, at diagnosis and 3 and 12 months of age. Generalized estimating equation models were applied to evaluate outcomes longitudinally, adjusted for IBD type, disease activity, and child's age at diagnosis.

Results

Up to July 2021, 491 children with IBD were eligible for analysis of caregivers' Work Productivity and Activity Impairment questionnaire. At diagnosis, the mean caregivers' employment rate was 78.4%; the adjusted mean work productivity loss was 44.6% (95% CI, 40.2%-49.0%), and the adjusted mean activity impairment was 34.3% (95% CI, 30.8%-37.7%). Work productivity loss and activity impairment significantly decreased over time and were associated with disease activity, but not with IBD type or child's age. Caregivers' HRQOL was associated with both impairments. Costs related to work absenteeism were at least €6272 ($7276) per patient during the first year after diagnosis.

Conclusions

Caregivers of children with IBD experience significant impairments in work and daily activities, especially at diagnosis. The impact decreases thereafter and is associated with disease activity and caregivers’ HRQOL. Work absenteeism results in high indirect costs.

Le texte complet de cet article est disponible en PDF.

Keywords : employment, health economics, socioeconomic, parents, Crohn's disease, ulcerative colitis, children

Abbreviations : CD, COVID-19, EU, FPA, GEE, HRQOL, IBD, LFS, PGA, UC, VAS, WPAI


Plan


 The PIBD-SETQuality inception cohort study is supported by the European Union's Horizon 2020 Research and Innovation Program grant (grant agreement number 668023 [to N.C. and L. d.R.]). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. L.d.R. reported grants from ZonMW, ECCO, and Pfizer, and collaboration (such as involved in industry sponsored studies, investigator initiated study, consultancy) with Celltrion, Abbvie, Lilly, Takeda, and Pfizer. N.C. reported collaboration with Eli Lilly, Abbvie, Jansen, Takeda, and Pfizer. The other authors declare no conflicts of interest.
 Conference presentations: Portions of this study were presented as a poster during the European Crohn's and Colitis Organisation (ECCO) 2021 congress (virtual), July 8-10, 2021 and will be presented as an oral presentation at the European Society of Pediatric Gastroenterology, Hepatology and Nutrition meeting, June 22-25, 2022, Copenhagen, Denmark.
 List of PIBD-SETQuality consortium members are available at www.jpeds.com (Appendix 2): Dan Turner, Gili Focht, Janneke Samsom, Gigi Veereman, Sibylle Koletzko, Annecarin Brückner, Arie Levine, Richard Russell, Anne Griffiths, Marina Aloi, Thomas Walters, and Michael Walker.


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