Quality of life related to oral versus subcutaneous iron chelation: a time trade-off study
| Autor: | Phoebe Joy Ho, Jennifer Houltram, Richard H. Osborne, Robert Lindeman, Douglas E. Joshua, David Dowton, Andrew Dalton, Richard De Abreu Lourenco |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Iron Overload Time Factors Thalassemia Administration Oral Siderophores Deferoxamine Time-trade-off Patient satisfaction Quality of life Interquartile range Oral administration time trade-off Internal medicine Medicine Humans Infusions Parenteral Infusion Pumps iron chelation administration route business.industry Health Policy Deferasirox Public Health Environmental and Occupational Health Middle Aged medicine.disease Chelation Therapy Surgery Patient Satisfaction Quality of Life Female New South Wales business medicine.drug |
| Zdroj: | Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research. 10(6) |
| ISSN: | 1524-4733 |
| Popis: | ObjectiveTo investigate the utility associated with subcutaneous infusion (deferoxamine) compared with once-daily oral administration (deferasirox) of iron chelation therapy.MethodsInterviews using the time trade-off technique were used to estimate preferences (utility) for health states by finding the point at which respondents were indifferent between a longer but lower quality of life (QoL) and a shorter time in full health. Participants (n = 110) were community-based, 51% women, median age 35 years, from four regions in Sydney, Australia. Respondents rated three health states involving equal outcomes for people with thalassemia but with different treatment modalities for iron chelation; an “anchor state” describing a patient receiving iron chelation without administration mode specified, anchor state plus iron chelation via subcutaneous infusion, and anchor state plus iron chelation through once-daily oral medication.ResultsOn an interval scale between 0 (death) and 1 (full health), median (interquartile range) utility of 0.80 (0.65–0.95) for the anchor state, 0.66 (0.45–0.87) for subcutaneous infusion, and 0.93 (0.80–0.97) for once-daily oral administration was obtained. The mean (median) difference of 0.23 (0.27) between the two treatments was statistically significant (Wilcoxon-signed rank test, P < 0.001). Subcutaneous infusion was associated with a mean (median) utility 0.13 (0.14) lower than the anchor state (P < 0.001), and once-daily oral treatment had a utility 0.10 (0.13) higher (P < 0.001).ConclusionCommunity respondents associate oral administration of an iron chelator such as deferasirox with enhanced QoL compared with subcutaneous treatment. Assuming equal safety and efficacy, QoL gains from once-daily oral treatment compared with subcutaneous infusion are significant. |
| Databáze: | OpenAIRE |
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