Assessment of health-related quality of life and health utilities in Australian patients with cirrhosis.

Autor: McPhail SM; Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work Queensland University of Technology Brisbane Queensland Australia.; Clinical Informatics Directorate Metro South Health Brisbane Queensland Australia., Amarasena S; Department of Gastroenterology and Hepatology Royal Brisbane and Women's Hospital Brisbane Queensland Australia., Stuart KA; Department of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane Queensland Australia., Hayward K; Centre for Liver Disease Research, Translational Research Institute, Faculty of Medicine The University of Queensland Brisbane Queensland Australia., Gupta R; Gastroenterology and Hepatology Department The Prince Charles Hospital Brisbane Queensland Australia., Brain D; Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work Queensland University of Technology Brisbane Queensland Australia.; Clinical Informatics Directorate Metro South Health Brisbane Queensland Australia., Hartel G; QIMR Berghofer Medical Research Institute Brisbane Queensland Australia., Rahman T; Gastroenterology and Hepatology Department The Prince Charles Hospital Brisbane Queensland Australia., Clark PJ; Department of Gastroenterology and Hepatology Mater Hospitals Brisbane Queensland Australia., Bernardes CM; Gastroenterology and Hepatology Department The Prince Charles Hospital Brisbane Queensland Australia., Skoien R; Department of Gastroenterology and Hepatology Royal Brisbane and Women's Hospital Brisbane Queensland Australia., Mckillen B; Department of Gastroenterology and Hepatology Royal Brisbane and Women's Hospital Brisbane Queensland Australia., Lee A; Department of Gastroenterology and Hepatology Mater Hospitals Brisbane Queensland Australia., Pillay L; Department of Gastroenterology and Hepatology Logan Hospital Brisbane Queensland Australia., Lin L; Gastroenterology and Hepatology Department The Prince Charles Hospital Brisbane Queensland Australia., Khaing MM; Gastroenterology and Hepatology Department The Prince Charles Hospital Brisbane Queensland Australia., Horsfall L; Department of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane Queensland Australia.; Centre for Liver Disease Research, Translational Research Institute, Faculty of Medicine The University of Queensland Brisbane Queensland Australia., Powell EE; Department of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane Queensland Australia.; Centre for Liver Disease Research, Translational Research Institute, Faculty of Medicine The University of Queensland Brisbane Queensland Australia., Valery PC; QIMR Berghofer Medical Research Institute Brisbane Queensland Australia.
Jazyk: angličtina
Zdroj: JGH open : an open access journal of gastroenterology and hepatology [JGH Open] 2020 Dec 10; Vol. 5 (1), pp. 133-142. Date of Electronic Publication: 2020 Dec 10 (Print Publication: 2021).
DOI: 10.1002/jgh3.12462
Abstrakt: Background and Aim: Health-related quality-of-life measurements are important to understand lived experiences of patients who have cirrhosis. These measures also inform economic evaluations by modelling quality-adjusted life years (QALYs). We aimed to describe health-related quality of life, specifically multiattribute utility (scale anchors of death = 0.00 and full health = 1.00), across various stages and etiologies of cirrhosis.
Methods: Face-to-face interviews were used to collect Short Form 36 (SF-36) questionnaire responses from CirCare study participants with cirrhosis (June 2017 to December 2018). The severity of cirrhosis was assessed using the Child-Pugh score classified as class A (5-6 points), B (7-9), or C (10-15) and by the absence ("compensated") versus presence ("decompensated") of cirrhosis-related complications.
Results: Patients ( n = 562, average 59.8 years [SD = 11.0], male 69.9%) had a range of primary etiologies (alcohol-related 35.2%, chronic hepatitis C 25.4%, non-alcoholic fatty liver disease (NAFLD) 25.1%, chronic hepatitis B 5.9%, "other" 8.4%). Significantly lower (all P < 0.001) mean multiattribute utility was observed in the health states of patients with decompensated (mean = 0.62, SD = 0.15) versus compensated cirrhosis (mean = 0.68, SD = 0.12), Child-Pugh class C (mean = 0.59, SD = 0.15) or B (mean = 0.63, SD = 0.15) versus A (mean = 0.68, SD = 0.16), and between those of working age (18-64 years; mean = 0.64, SD = 0.16) versus those aged 65+ years (mean = 0.70, SD = 0.16). The greatest decrements in health-related quality of life relative to Australian population norms were observed across physical SF-36 domains.
Conclusions: Persons with more advanced cirrhosis report greater life impacts. Estimates from this study are suitable for informing economic evaluations, particularly cost-utility modelling, which captures the benefits of effective prevention, surveillance, and treatments on both the quality and quantity of patients' lives.
(© 2020 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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