The Burden of Peristomal Skin Complications on Health Utility and Quality of Life in an Ostomy Population

Thomas Nichols, M.S., MBA, Health Economics, Hollister Incorporated, Libertyville, IL and Gary Inglese, RN, MBA, Hollister Incorporated, Libertyville, IL
Introduction: Peristomal skin complications (PSC’s) have a profound impact on health related quality of life for those individuals with stomas. PSC’s are health stressors influencing the burden of health of the ostomate.  It is estimated that PSC’s affect upwards of 2/3’s of ostomates at some point in time1.  A difficulty encountered by researchers assessing PSC’s is the inability to separate this burden from the general health of the ostomate. 

Objective: It was the aim of this study to quantify the relationship between PSC’s, health utility, and quality of life in an ostomy sample (n= 2,329).

Methods: Utilizing the SF36v22, the SF6D3, and a visual analog scale assessing quality of life (scale=0-100) we present the burden of health as represented by health utility and quality of life associated with three levels of PSC controlling for general health.  The study is a cross-sectional survey. Analysis includes descriptive statistics and analysis of covariance.  Covariates are age and time from surgery. IRB approval was obtained for the conduct of the study.

Results: The data provides empirical evidence that as general health of the ostomate increases there is a corresponding health utility and quality of life increase that can be influenced by PSC’s.  As PSC severity changes, there are corresponding directional changes in health utility and quality of life.  The average adjusted health utility for those reporting no PSC’s is found to be 0.76 (QoL= 81.2).  The average adjusted health utility for those reporting mild to moderate PSC’s is 0.70 (QoL= 76.7), while for those reporting severe PSC’s this is 0.63 (QoL=65.6).

Conclusions: PSCs affect more than the obvious skin health of those with a stoma.  The role of the stoma care nurse in intervening and managing skin health is an integral part of enhancing the health related quality for those living with a stoma.