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Living with ulcerative colitis study (LUCY) in England: A retrospective study evaluating healthcare resource utilisation and direct healthcare costs of postoperative care in ulcerative colitis
Waller, J Cappelleri, JC Modesto, I Dibonaventura, MD Bohm, N Mokgokong, R Massey, O Wood, R Bargo, D
Waller, J
Cappelleri, JC
Modesto, I
Dibonaventura, MD
Bohm, N
Mokgokong, R
Massey, O
Wood, R
Bargo, D
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Other contributors
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Epub Date
Issue Date
2020-09-16
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Abstract
Objective Ulcerative colitis (UC) is a lifelong, relapsing-remitting disease. Patients non-responsive to pharmacological treatment may require a colectomy. We estimated pre-colectomy and post-colectomy healthcare resource utilisation (HCRU) and costs in England. Design/Method A retrospective, longitudinal cohort study indexing adult patients with UC undergoing colectomy (2009-2015), using linked Clinical Practice Research Datalink/Hospital Episode Statistics data, was conducted. HCRU, healthcare costs and pharmacological treatments were evaluated during 12 months prior to and including colectomy (baseline) and 24 months post-colectomy (follow-up; F-U), comparing baseline/F-U, emergency/elective colectomy and subtotal/full colectomy using descriptive statistics and paired/unpaired tests. Results 249 patients from 26 165 identified were analysed including 145 (58%) elective and 184 (74%) full colectomies. Number/cost of general practitioner consultations increased post-colectomy (p<0.001), and then decreased at 13-24 months (p<0.05). From baseline to F-U, the number of outpatient visits, number/cost of hospitalisations and total direct healthcare costs decreased (all p<0.01). Postoperative HCRU was similar between elective and emergency colectomies, except for the costs of colectomy-related hospitalisations and medication, which were lower in the elective group (p<0.05). Postoperative costs were higher for subtotal versus full colectomies (p<0.001). At 1-12 month F-U, 30%, 19% and 5% of patients received aminosalicylates, steroids and immunosuppressants, respectively. Conclusion HCRU/costs increased for primary care in the first year post-colectomy but decreased for secondary care, and varied according to the colectomy type. Ongoing and potentially unnecessary pharmacological therapy was seen in up to 30% of patients. These findings can inform patients and decision-makers of potential benefits and burdens of colectomy in UC.
Citation
Brookes, M.J., Waller, J., Cappelleri, J.C., et al. (2020) Living with Ulcerative Colitis Study (LUCY) in England: a retrospective study evaluating healthcare resource utilisation and direct healthcare costs of postoperative care in ulcerative colitis. BMJ Open Gastroenterology, 7:e000456. doi:10.1136/ bmjgast-2020-000456
Publisher
Journal
Research Unit
PubMed ID
32938582 (pubmed)
PubMed Central ID
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Type
Journal article
Language
en
Description
© 2020 The Authors. Published by BMJ. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: http://dx.doi.org/10.1136/bmjgast-2020-000456
Series/Report no.
ISSN
2054-4774
EISSN
2054-4774
ISBN
ISMN
Gov't Doc #
Sponsors
The study was funded by Pfizer Inc.
Rights
Licence for published version: Creative Commons Attribution-NonCommercial 4.0 International