Impact of Pediatric Acute Otitis Media on Child and Parental Quality of Life and Associated Productivity Loss in Malaysia: A Prospective Observational Study

Bruce Crawford, Siti Sabzah Mohd Hashim, Narayanan Prepageran, Goh Bee See, Genevieve Meier, Keiko Wada, Cheryl Coon, Emmanuelle Delgleize, Michael DeRosa, Bruce Crawford, Siti Sabzah Mohd Hashim, Narayanan Prepageran, Goh Bee See, Genevieve Meier, Keiko Wada, Cheryl Coon, Emmanuelle Delgleize, Michael DeRosa

Abstract

Background: Acute otitis media (AOM) affects both child and parental quality of life (QoL). Data on QoL associated with AOM in Malaysia is sparse, and the burden of indirect costs have not been previously reported.

Objective: To determine the effect of pediatric AOM on child and parental QoL in Malaysia and its economic impact (indirect costs).

Methods: We utilized a set of QoL questionnaires (PAR-AOM-QOL, OM-6, and EQ-5D) combined with questions addressing work/productivity loss and financial costs associated with caring for a child during his or her illness in an observational, multicenter, prospective study.

Results: One hundred and ten AOM patients aged ≤5 years were included in the analysis. The majority of respondents were the patient's mother. Parental QoL was negatively affected for both emotional and daily disturbance scales, but the level of disturbance was low. Using OM-6, the greatest negative impact was on the child's QoL, followed by caregiver concerns, physical suffering, and emotional distress. Using EQ-5D, a moderately positive relationship between parents' emotional disturbance and daily disturbance, and a weak, negative correlation between parental emotional disturbance and parental health status was found. Parents with paid employment took an average of 21 h from work to care for their child, at an average cost of 321.8 Malaysian ringgit (US$97) in addition to their contribution to direct medical costs. Productivity losses whilst at work, uncompensated wage losses, and leisure time losses are also reported.

Conclusions: This study found that AOM is associated with some negative impact on parental QoL and significant economic impact at both patient and societal levels. The findings provide useful data on healthcare resource utilization and disease burden of AOM in Malaysia.

Conflict of interest statement

Funding

This study and all costs associated with the development and publication of this manuscript were funded by GlaxoSmithKline Biologicals SA.

Competing interests

Bruce Crawford, Keiko Wada, Cheryl Coon, and Michael DeRosa are or were employees of the Adelphi Values who were paid consultants to GSK in connection with the development of this study and manuscript. Adelphi Values received consulting fees from the GSK group of companies for the design and implementation of the study, conduct of the data analysis and writing of the summary report. Genevieve Meier and Emmanuelle Delgleize are or were employees of the GSK group of companies and report ownership of restricted shares from the GSK group of companies. Siti Sabzah Mohd Hashim, Narayanan Prepageran, and Goh Bee See report no conflicts of interest.

Ethical approval

The study protocol was reviewed and approved by the ethics board of each participating center (the University of Malaya and the National University of Malaysia) and Sultanah Bahiyah Hospital. The study was conducted in accordance with the Declaration of Helsinki and guidelines on good clinical practice.

Figures

Fig. 1
Fig. 1
Study flowchart showing patient disposition. Data were evaluated for the 110 subjects whose parents were interviewed at visit 2 (within 14–30 days of initial clinical assessment)
Fig. 2
Fig. 2
Proportion of responses for the Parental Acute Otitis Media Quality of Life questionnaire (PAR-AOM-QOL) questionnaire. The PAR-AOM-QOL scores range from 0 to 100, with higher scores associated with worse quality of life
Fig. 3
Fig. 3
Proportion of responses for the Otitis Media-6 (OM-6) questionnaire. The OM-6 scores range from 0 to 100 with higher scores associated with greater negative effect of the ear infection on the child/caregiver

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Source: PubMed

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