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

Lorraine Johnson,Raphael B Stricker,Jennifer Mankoff,Spencer Wilcox

doi:10.7717/peerj.322

Lorraine Johnson, Raphael B Stricker + Show 2 more

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https://doi.org/10.7717/peerj.322

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Abstract

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.

Highlights

Lyme disease is the most common vector-borne disease in the United States
Centers for Disease Control and Prevention (CDC) health-related quality of life (HRQoL) health module Table 3 shows the scoring of chronic Lyme disease (CLD) patients on the HRQoL metric
There were no significant differences between the two groups with the exception that patients who reported erythema migrans (EM) rash/CDC serology were diagnosed more quickly, had a greater number of inpatient stays in the last year, and incurred less out-of-pocket medical expenses

Summary

Introduction

Lyme disease is the most common vector-borne disease in the United States. It is caused by the spirochete Borrelia burgdorferi and transmitted via tick bite. The CDC estimates that roughly 300,000 people (approximately 1% of the U.S population) are diagnosed with Lyme disease each year (Centers for Disease Control and Prevention, 2013b). A proportion of patients with Lyme disease develop debilitating symptoms that persist in the absence of initial treatment or following short-course antibiotic therapy. This condition is commonly referred to as post-treatment Lyme disease (PTLD) or chronic Lyme disease (CLD). It is estimated that as many as 36% of those diagnosed and treated early for Lyme disease remain ill after treatment (Aucott et al, 2013)

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