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. 2022 May 14;6(1):49.
doi: 10.1186/s41687-022-00456-9.

Recurrent Clostridioides difficile infection worsens anxiety-related patient-reported quality of life

Richard L Hengel  1 , Claudia P Schroeder  2 , Jinhee Jo  3 , Timothy E Ritter  4 , Ramesh V Nathan  5 , Anne J Gonzales-Luna  3 , Engels N Obi  6 , Ryan J Dillon  6 , Lucinda J Van Anglen  2 , Kevin W Garey  3
Affiliations

Recurrent Clostridioides difficile infection worsens anxiety-related patient-reported quality of life

Richard L Hengel et al. J Patient Rep Outcomes. .

Abstract

Background: Clostridioides difficile infection (CDI) is associated with high recurrence rates impacting health-related quality of life (HrQOL). However, patient-reported data are lacking particularly in the outpatient setting. We assessed changes in HrQOL over time in patients treated with bezlotoxumab at US infusion centers and determined clinical factors associated with HrQOL changes.

Methods: The HrQOL survey was conducted in adult patients with CDI, who received bezlotoxumab in 25 US outpatient infusion centers. The survey was adapted from the Cdiff32 instrument to assess anxiety-related changes to HrQOL and completed on the day of infusion (baseline) and at 90 days post bezlotoxumab (follow-up). Demographics, disease history, CDI risk factors, and recurrence of CDI (rCDI) at 90-day follow-up were collected. Changes in HrQOL scores were calculated and outcomes assessed using a multivariable linear regression model with P < 0.05 defined as statistically significant.

Results: A total of 144 patients (mean age: 68 ± 15 years, 63% female, median Charlson index: 4, 15.9% rCDI) were included. The overall mean baseline and follow-up HrQOL scores were 26.4 ± 11.5 and 56.4 ± 25.0, respectively. At follow-up, this score was significantly higher for patients who had primary CDI (34.5 ± 21.7) compared to those with multiple rCDI (24.7 ± 21.0; P = 0.039). The mean HrQOL change at follow-up was significantly higher for patients without rCDI (34.1 ± 28.8 increase) compared to patients with rCDI (6.7 ± 19.5 increase; P < 0.001), indicating improvement in anxiety.

Conclusions: Using the Cdiff32 instrument, we demonstrated that HrQOL worsened significantly in patients with further rCDI. These findings support the use of Cdiff32 in assessing CDI-related humanistic outcomes.

Keywords: Clostridioides difficile infection; Quality of life; Recurrence.

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Conflict of interest statement

TER is on the advisory boards for Ferring Pharmaceuticals and Rebiotix, Inc. ENO and RJD are current employees of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. and may own stock and/or stock options in Merck & Co., Inc., Kenilworth, NJ, USA. LVA has received research support from Merck Sharp & Dohme Corp. and is on the advisory board for Ferring Pharmaceuticals. KWG has received research support from Acrux, Summit Pharmaceuticals and is a consultant to Seres Health and Ferring Pharmaceuticals. RLH, CPS, JJ, RVN and AJGL have no potential conflicts of interest.

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