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
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, longitu...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2020-12-01
|
| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/7/1/e000456.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850111065961005056 |
|---|---|
| author | Joseph C Cappelleri Matthew J Brookes Natalie Bohm John Waller Irene Modesto Marco D DiBonaventura Ruth Mokgokong Danielle Bargo |
| author_facet | Joseph C Cappelleri Matthew J Brookes Natalie Bohm John Waller Irene Modesto Marco D DiBonaventura Ruth Mokgokong Danielle Bargo |
| author_sort | Joseph C Cappelleri |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-c5d9c17e64254fdcb9025b0823da3aa2 |
| institution | OA Journals |
| issn | 2054-4774 |
| language | English |
| publishDate | 2020-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-c5d9c17e64254fdcb9025b0823da3aa22025-08-20T02:37:42ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742020-12-017110.1136/bmjgast-2020-000456Living with Ulcerative Colitis Study (LUCY) in England: a retrospective study evaluating healthcare resource utilisation and direct healthcare costs of postoperative care in ulcerative colitisJoseph C Cappelleri0Matthew J Brookes1Natalie Bohm2John Waller3Irene Modesto4Marco D DiBonaventura5Ruth Mokgokong6Danielle Bargo7Pfizer Inc, Groton, Connecticut, USA14 Gastroenterology, Royal Wolverhampton NHS Trust, Wolverhampton, UKPfizer Ltd, Tadworth, UKAdelphi Real World, Bollington, UK6 Pfizer SLU, Madrid, SpainPatient Health Impact, Pfizer Inc, New York, New York, USAPfizer Inc, Tadworth, UKFlatiron Health Inc, New York, New York, USAObjective 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.https://bmjopengastro.bmj.com/content/7/1/e000456.full |
| spellingShingle | Joseph C Cappelleri Matthew J Brookes Natalie Bohm John Waller Irene Modesto Marco D DiBonaventura Ruth Mokgokong Danielle Bargo 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 |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | https://bmjopengastro.bmj.com/content/7/1/e000456.full |
| work_keys_str_mv | AT josephccappelleri livingwithulcerativecolitisstudylucyinenglandaretrospectivestudyevaluatinghealthcareresourceutilisationanddirecthealthcarecostsofpostoperativecareinulcerativecolitis AT matthewjbrookes livingwithulcerativecolitisstudylucyinenglandaretrospectivestudyevaluatinghealthcareresourceutilisationanddirecthealthcarecostsofpostoperativecareinulcerativecolitis AT nataliebohm livingwithulcerativecolitisstudylucyinenglandaretrospectivestudyevaluatinghealthcareresourceutilisationanddirecthealthcarecostsofpostoperativecareinulcerativecolitis AT johnwaller livingwithulcerativecolitisstudylucyinenglandaretrospectivestudyevaluatinghealthcareresourceutilisationanddirecthealthcarecostsofpostoperativecareinulcerativecolitis AT irenemodesto livingwithulcerativecolitisstudylucyinenglandaretrospectivestudyevaluatinghealthcareresourceutilisationanddirecthealthcarecostsofpostoperativecareinulcerativecolitis AT marcoddibonaventura livingwithulcerativecolitisstudylucyinenglandaretrospectivestudyevaluatinghealthcareresourceutilisationanddirecthealthcarecostsofpostoperativecareinulcerativecolitis AT ruthmokgokong livingwithulcerativecolitisstudylucyinenglandaretrospectivestudyevaluatinghealthcareresourceutilisationanddirecthealthcarecostsofpostoperativecareinulcerativecolitis AT daniellebargo livingwithulcerativecolitisstudylucyinenglandaretrospectivestudyevaluatinghealthcareresourceutilisationanddirecthealthcarecostsofpostoperativecareinulcerativecolitis |