Perception of Quality of Life Among People Experiencing or Having Experienced a Clostridium difficile Infection in the United States: Qualitative Review of Respondents Verbatim

• Published in: The American journal of gastroenterology Vol. 113; p. S107
• Main Authors: Lurienne, Lise, Bandinelli, Pierre-Alain, Galvain, Thibaut, Coursel, Charles-Alexis, Boutier, Philippe, Oneto, Caterina, Feuerstadt, Paul
• Format: Journal Article
• Language: English
• Published: New York Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins 01.10.2018
• Subjects: Gastroenterology; Infections; Quality of life
• ISSN: 0002-9270; 1572-0241

Introduction: Although the incidence, severity and mortality of Clostridium difficileinfections (CDI) have been increasing, patients' quality of life changes resulting from CDI have not been studied thoroughly. This study aimed at exploring the physical, psychological, social and financial consequences of CDI for patients during and after the disease. Methods: An observational, cross-sectional study involving 350 subjects with a self-reported diagnosis of CDI was conducted through an online self-administered survey. Most questions comprised non-compulsory comment fields which were studied qualitatively to identify 32 consequences of CDI categorized in 5 groups (symptomatic, psychological, relational, adaptation, productivity). Patients were grouped into those who had active disease at the time of the survey, "Current CDI" and those who had a history of CDI, "Past CDI". Results: 115 subjects (33%) reported Current CDI and 235 (67%) reported Past CDI. A majority of Current CDI subjects (86%) spontaneously reported at least one of the symptomatic factors, primarily physical pain (55%) and fatigue (51%). These symptoms remained present frequently after the infection (72%), with physical pain and fatigue being mentioned by approximately one third of respondents in the Past CDI cohort (33% and 31%). The percent of subjects reporting without prompting at least one psychological item remained high during and after CDI (58% and 70%, respectively, p=0.053). Two consequences were seen more frequently in the Past CDI cohort: Post-Traumatic Stress Disorder (11% vs. 0%, p<0.001) and fear of recurrence (46% vs.15%, p<0.001) including the fear of taking antimicrobials again (25% vs. 5%, p<0.001). Life-style adaptation measures seemed to decrease after clearance of the infection but were high in both cohorts (77% vs. 60%, p<0.001); many patients reported changes in their eating habits during and after CDI (29% and 41%, respectively). Finally, 16% of Current CDI and 11% of Past CDI respondents mentioned a major impact of CDI on their professional life (e.g. lost job, forced retirement or inability to work) (p=0.296). Conclusion: While the societal burden of CDI is well described in the literature, our study is one of the first aimed at understanding the major burden of CDI on patients' quality of life. Our results highlight the long-lasting nature of CDI and further reinforce the need for enhanced therapeutics in the prevention and treatment of this devastating infection.