Health-Related Quality of Life in Patients With Barrett's Esophagus: A Systematic Review
published online 12 March 2009.
Background & Aims
Barrett's esophagus (BE) affects approximately 10% of patients with chronic gastroesophageal reflux disease (GERD). Patients with BE are at risk for reduced health-related quality of life (HRQoL) associated with GERD, in addition to the potential psychosocial stress of carrying a diagnosis of a premalignant condition with a risk of esophageal adenocarcinoma. We sought to systematically review the published literature on HRQoL of patients with BE.
Methods
We searched PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature for relevant clinical trials using a defined search strategy. We also manually searched relevant scientific meeting abstracts and related article bibliographies. Eligible articles were case series, cohort studies, or clinical trials that included one or more measures of HRQoL and/or quantitatively assessed burden of disease in patients with BE. Effect sizes were calculated when possible.
Results
Our initial search identified 95 articles. After 2 physician reviews, 25 articles met inclusion criteria. Data show that BE is associated with a significant decrement in HRQoL as measured by both generic and disease-targeted instruments. In addition, patients with BE are at risk for psychological consequences such as depression, anxiety, and stress, which may be related to their increased risk of esophageal adenocarcinoma. Compared with subjects with GERD alone or the general population, a diagnosis of BE also leads to increased health care use and spending.
Conclusions
BE compromises multiple facets of patients' quality of life. Physicians and researchers should incorporate patient-reported outcomes data including HRQoL measures when treating or studying patients with BE.
⁎Center for Esophageal Diseases and Swallowing, Department of Medicine, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
‡Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
Reprint requests Address requests for reprints to: Seth D. Crockett, MD, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, CB#7080, Chapel Hill, North Carolina 27599-7080. fax: (919) 843-2508
Conflicts of interest The authors disclose no conflicts.
Funding This research was supported, in part, by a grant from the National Institutes of Health (T32 DK 07634).
ABSTRACT
Health-Related Quality of Life in Patients With Barrett's Esophagus: A Systematic Review