Perception of quality of life in people experiencing or having experienced a Clostridioides difficile infection: a US population survey

Abstract

Background: Although the incidence, severity and mortality of Clostridioides (Clostridium) difficile infection (CDI) have been increasing, patients' quality of life changes resulting from CDI have not been studied thoroughly. This study aimed at exploring the consequences of CDI on quality of life through patients' perspective. Methods: An observational, cross-sectional study involving 350 participants with a self-reported CDI diagnosis was conducted through an online self-administered survey. Participants were grouped into those who had active disease ("Current CDI") and those who had a history of CDI ("Past CDI"). Results: One hundred fifteen participants (33%) reported Current CDI and 235 (67%) reported Past CDI. A large majority of participants admitted that their daily activities were impacted by the infection (93.9% and 64.7% of Current and Past CDI respondents respectively, p < 0.05). Physical and psychological consequences of CDI were experienced by 63.5% and 66.1% of participants with active CDI. Despite the infection being cleared, these consequences were still frequently experienced in Past CDI cohort with similar rates (reported by 73.2% of respondents for both, physical consequences p = 0.08; psychological consequences p = 0.21). After the infection, 56.6% of respondents noted that post-CDI symptoms remained; 40.9% believed they would never get rid of them. Conclusions: 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 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.

Potential Cost Savings Associated with Targeted Substitution of Current Guideline-Concordant Inpatient Agents with Omadacycline for the Treatment of Adult Hospitalized Patients with Community-Acquired Bacterial Pneumonia at High Risk for Clostridioides difficile Infections: Results of Healthcare-Decision Analytic Model from the United States Hospital Perspective

“…Data indicates that co-pays of Medicare patients, a high-risk group for primary and recurrent CDI, often exceeds USD 10,000 [11]. Data also indicates that HCA-CDI has considerable physical and psychologic consequences on patients and limits their ability to return to work and resume normal daily activities [50]. Finally, the model was limited to the excess costs associated with HCA-CDI and did not include other important consequences associated with reduction of third generation cephalosporins and fluroquinolones use, such as the reduction of extended spectrum beta-lactamase producing Gram-negatives and MRSA rates [51].…”

Health-related quality of life in patients with recurrent Clostridioides difficile infections

“… 9 – 11 The presence of diarrhoea may affect the patients’ ability to perform their usual activities and have adverse social impacts. 10 , 11 In addition, emotional distress can present as a consequence of the disease, 10 , 11 and most patients fear worsening of symptoms and recurrence of CDI. 10 Studies indicate that these impacts may persist even after receiving effective treatment.…”

“… 10 , 11 In addition, emotional distress can present as a consequence of the disease, 10 , 11 and most patients fear worsening of symptoms and recurrence of CDI. 10 Studies indicate that these impacts may persist even after receiving effective treatment. 10 , 11 …”

“… 10 Studies indicate that these impacts may persist even after receiving effective treatment. 10 , 11 …”

My Treatment Approach to Clostridioides difficile Infection

“…6,7 Patients with C difficile infection unfortunately develop several psychosocial complications including anxiety of illness and a decreased quality of life. 8 Although it has been known for more than 4 decades that this bacterium causes human diarrhea, there remain several challenges to make an accurate diagnosis and optimal management of C difficile infection. 2 When this bacterium was first discovered, it was named a "difficult" Clostridium because of the difficulty of culturing this bacterium; this holds true more than 80 years later due to the difficulty in its management.…”