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PeerJ — Severity of chronic Lyme disease symptoms compared to other chronic conditions

PeerJ — Severity of chronic Lyme disease compared to other chronic conditions: a quality of life survey.

Johnson L, Wilcox S, Mankoff J, Stricker RB. — PeerJ. 2014; 2:e322.
PubMed [journal] — PMID: 24749006 PMCID: PMC3976119

Overview. The Centers for Disease Control and Prevention (CDC) health-related quality of life (HRQoL) indicators are widely used in the general population to determine the burden of disease, identify health needs, and direct public health policy. These indicators also allow the burden of illness to be compared across different diseases. Although Lyme disease has recently been acknowledged as a major health threat in the USA with more than 300,000 new cases per year, no comprehensive assessment of the health burden of this tickborne disease is available. This study assesses the HRQoL of patients with chronic Lyme disease (CLD) and compares the severity of CLD to other chronic conditions.

Methods. Of 5,357 subjects who responded to an online survey, 3,090 were selected for the study. Respondents were characterized as having CLD if they were clinically diagnosed with Lyme disease and had persisting symptoms lasting more than 6 months following antibiotic treatment. HRQoL of CLD patients was assessed using the CDC 9-item metric. The HRQoL analysis for CLD was compared to published analyses for the general population and other chronic illnesses using standard statistical methods.

Results. Compared to the general population and patients with other chronic diseases reviewed here, patients with CLD reported significantly lower health quality status, more bad mental and physical health days, a significant symptom disease burden, and greater activity limitations. They also reported impairment in their ability to work, increased utilization of healthcare services, and greater out of pocket medical costs.

Conclusions. CLD patients have significantly impaired HRQoL and greater healthcare utilization compared to the general population and patients with other chronic diseases. The heavy burden of illness associated with CLD highlights the need for earlier diagnosis and innovative treatment approaches that may reduce the burden of illness and concomitant costs posed by this illness.

Introduction

Patient Selection and Characteristics

Study Methods

Statistical Analysis

Results

CDC HRQoL health module

Overall health status

Symptom severity

Healthy days and activity limitations

Increased utilization of services

Productivity losses

Discussion

Strengths and Limitations

Conclusions

Supplemental Information

Additional Information and Declarations

Competing Interests

Lorraine Johnson and Spencer Wilcox are affiliated with LymeDisease.org. Raphael B. Stricker is affiliated with LymeDisease.org and the International Lyme & Associated Diseases Society. The other authors have no competing interests to declare.

Author Contributions

Lorraine Johnson and Spencer Wilcox conceived and designed the experiments, performed the experiments, analyzed the data, contributed reagents/materials/analysis tools, wrote the paper, prepared figures and/or tables, reviewed drafts of the paper.

Jennifer Mankoff conceived and designed the experiments, analyzed the data, wrote the paper, prepared figures and/or tables, reviewed drafts of the paper.

Raphael B. Stricker conceived and designed the experiments, analyzed the data, wrote the paper, prepared figures and/or tables, reviewed drafts of the paper, submitted manuscript online.

Human Ethics

The following information was supplied relating to ethical approvals (i.e., approving body and any reference numbers):

Analysis of the survey data was exempted from review by the Carnegie Mellon University Institutional Review Board (IRB) because none of the data contained identifiable personal information.

Funding

There was no funding for this work.

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