Costo sociale annuo della dispepsia funzionale dopo l'eradicazione dell'Helicobacter pylori : risultati di un'indagine in centri di endoscopia digestiva

Objective: The aim of this study was to evaluate socio-demographic and clinical characteristics of dyspeptic patients in Italy after the eradication of Helicobacter pylori infection and to evaluate the impact of this syndrome on daily activities, on loss of production, and, finally, to estimate its cost for both National Health Service and society. Design: An observational, prospective, one-year, multicenter study was conducted from April 1999 to April 2002 under the aegis of the Italian study group of digestive tract motility (GISMAD). The study was based on 577 consecutive functional dyspeptic patients after eradication of H. pylori. Data were collected by a Case Report Form (CRF). Setting: 91 Centres of Digestive Endoscopy (CED), all located in Italy. Results: The mean age of the 577 dyspeptic patients enrolled in the study was 52 yrs.±14 (13.3% was younger than 40 yrs old; mostly females: 56.7%). Sixty point seven percent of patients met expenses related with the treatment of dyspepsia. Patients were stratified into four groups according to their prevalent symptoms: ulcer-like (UL), dismotility-like (DL), reflux-like (RL) and 'other'. Annual mean cost estimated for each patient was € 145.54, with differences between females and males ( € 168.95 vs € 114.91 respectively). "RL" patients resulted at the highest cost (€ 204.32). Total costs were divided into health related costs (€ 60.87) and loss of productivity (€ 84.67), the latter being mostly related absences (21%). Conclusions: During a follow-up period of 12 months, in each group there was a clear evidence of both a reduction of negative influence of dyspeptic symptoms on the patients' activities and a decrease of the mean cost for the treatment of dyspepsia. "RL" group presents cost 30% higher when compared with "UL" and "DL" groups, and 90% higher when compared with "other".