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PharmacoEconomics
Published in: PharmacoEconomics 4/2019

Open Access 01-04-2019 | Dementia | Systematic Review

Spillover Effects on Caregivers’ and Family Members’ Utility: A Systematic Review of the Literature

Authors: Eve Wittenberg, Lyndon P. James, Lisa A. Prosser

Published in: PharmacoEconomics | Issue 4/2019

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Abstract

Background

A growing body of research has identified health-related quality-of-life effects for caregivers and family members of ill patients (i.e. ‘spillover effects’), yet these are rarely considered in cost-effectiveness analyses (CEAs).

Objective

The objective of this study was to catalog spillover-related health utilities to facilitate their consideration in CEAs.

Methods

We systematically reviewed the medical and economic literatures (MEDLINE, EMBASE, and EconLit, from inception through 3 April 2018) to identify articles that reported preference-based measures of spillover effects. We used keywords for utility measures combined with caregivers, family members, and burden.

Results

Of 3695 articles identified, 80 remained after screening: 8 (10%) reported spillover utility per se, as utility or disutility (i.e. utility loss); 25 (30%) reported a comparison group, either population values (n = 9) or matched, non-caregiver/family member or unaffected individuals’ utilities (n = 16; 3 reported both spillover and a comparison group); and 50 (63%) reported caregiver/family member utilities only. Alzheimer’s disease/dementia was the most commonly studied disease/condition, and the EQ-5D was the most commonly used measurement instrument.

Conclusions

This comprehensive catalog of utilities showcases the spectrum of diseases and conditions for which caregiver and family members’ spillover effects have been measured, and the variation in measurement methods used. In general, utilities indicated a loss in quality of life associated with being a caregiver or family member of an ill relative. Most studies reported caregiver/family member utility without any comparator, limiting the ability to infer spillover effects. Nevertheless, these values provide a starting point for considering spillover effects in the context of CEA, opening the door for more comprehensive analyses.
Appendix
Available only for authorised users
Footnotes
1
We use ‘CEA’ to include cost-utility analysis for ease of reading.
 
2
Disutility is the utility loss associated with a particular state of health, as opposed to the utility of that state of health.
 
3
Multiple studies reported utilities for more than one disease/condition, each of which is represented in the tables as a separate entry.
 
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Metadata
Title
Spillover Effects on Caregivers’ and Family Members’ Utility: A Systematic Review of the Literature
Authors
Eve Wittenberg
Lyndon P. James
Lisa A. Prosser
Publication date
01-04-2019
Publisher
Springer International Publishing
Keywords
Dementia
Dementia
Published in
PharmacoEconomics / Issue 4/2019
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI
https://doi.org/10.1007/s40273-019-00768-7

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