Abstract
BackgroundRecurrent vulvovaginal candidosis (RVVC) is a chronic condition causing discomfort and pain. Health status and health-related quality of life (HRQoL) in RVVC were never previously described using validated questionnaires. The objective of this study is to describe subjective health status and HRQoL and estimate health state utilities among women with RVVC.MethodsA cross-sectional online survey was conducted among women who reported having suffered four or more yeast infections over the past 12 months, in five European countries (France, Germany, Italy, Spain and the UK) and the USA. Index scores were derived from the EQ-5D, a questionnaire providing a single index value for health status. The SF-36 questionnaire was used for HRQoL assessment. Information on disease severity, treatment patterns and productivity was also collected.Results12,834 members of online research panels were contacted. Among them, 620 women with RVVC (5%) were selected to complete the full questionnaire. The mean EQ-5D index score was 0.70 (95% confidence interval: [0.67, 0.72]) and the difference between women with a yeast infection at the time of questionnaire completion and other respondents was 0.05 (p = 0.47). The EQ-5D index score increased significantly with the time since last infection (p < 0.001). 68% of women reported depression/anxiety problems during acute episode, and 54% outside episodes, compared to less than 20% in general population (p < 0.001). All SF-36 domain scores were significantly below general population norms. Mental health domains were the most affected. The impact on productivity was estimated at 33 lost work hours per year on average, corresponding to estimated costs between €266/year and €1,130/year depending on the country.ConclusionsSubjective health status and HRQoL during and in between acute inflammatory episodes in women with RVVC are significantly worse than in the general population, despite the use of antifungal therapy. The average index score in women with RVVC is comparable to other diseases such as asthma or COPD and worse than diseases such as headache/migraine according to US and UK catalogs of index scores. The survey also revealed a significant loss of productivity associated with RVVC.
Highlights
Recurrent vulvovaginal candidosis (RVVC) is a chronic condition causing discomfort and pain
Patients & disease characteristics 12,834 members of online research panels were contacted and entered the self- screening questions. 865 women did not complete it and 4,389 women were not included in the study because the target number of respondents in their age group had been reached, not because they did not fulfil the criteria for RVVC
All translations were carefully reviewed by native speakers and clinicians. This survey showed that subjective health status and health-related quality of life (HRQoL) are substantially diminished during acute episodes, and outside these episodes in women with RVVC, including some women who have received longterm antifungal therapy as recommended by guidelines
Summary
Recurrent vulvovaginal candidosis (RVVC) is a chronic condition causing discomfort and pain. Recurrent vulvovaginal candidosis (RVVC) is a debilitating chronic infectious condition It is defined as four or more acute inflammatory episodes of VulvoVaginal Candidosis (VVC), known as vaginal yeast infection, within a year [1,2]. The main symptoms of yeast infections are inflammation, itching, an abnormal vaginal discharge and painful sexual intercourse and urination. Such symptoms cause variable but often severe discomfort and pain. Acute inflammatory episodes usually are treated with anti-fungal drugs of the azole class. They are efficient in clearing the acute infection, but are unable to prevent recurrences, which occur on average after a few months only. Many RVVC patients turn to alternative remedies like yoghurt and vinegar which only have very short-term palliative effects [15,16]
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