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Published in: Health and Quality of Life Outcomes 1/2008

Open Access 01-12-2008 | Research

Impact of schizophrenia and schizophrenia treatment-related adverse events on quality of life: direct utility elicitation

Authors: Andrew Briggs, Diane Wild, Michael Lees, Matthew Reaney, Serdar Dursun, David Parry, Jayanti Mukherjee

Published in: Health and Quality of Life Outcomes | Issue 1/2008

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Abstract

Objective

To examine the impact of schizophrenia, its treatment and treatment-related adverse events related to antipsychotics, on quality of life from the perspective of schizophrenia patients and laypersons.

Methods

Health state descriptions for stable schizophrenia, extra pyramidal symptoms (EPS), hyperprolactinemia, diabetes, weight gain and relapse were developed based on a review of the literature and expert opinion. The quality of life impact of each health state was elicited using a time trade-off instrument administered by interview to 49 stable schizophrenia patients and 75 laypersons. Regression techniques were employed to examine the importance of subject characteristics on health-related utility scores.

Results

Patients and laypersons completed the interview in similar times. Stable schizophrenia had the highest mean utility (0.87 and 0.92 for laypersons and patients respectively), while relapse (0.48 and 0.60) had the lowest mean utility. Of the treatment-related adverse events, EPS had the lowest mean utility (0.57 and 0.72, respectively). Age, gender and PANSS score did not influence the utility results independently of health state. On average, patient utilities are 0.077 points higher than utilities derived from laypersons, although the ranking was similar between the two groups.

Conclusion

Events associated with schizophrenia and treatment of schizophrenia can bring about a significant detriment in patient quality of life, with relapse having the largest negative impact. Results indicate that patients with stable schizophrenia are less willing to trade years of life to avoid schizophrenia-related symptoms compared to laypersons. Both sets of respondents showed equal ability to complete the questionnaire.
Literature
1.
go back to reference The World Health Report, Mental Health: New understanding, new hope Geneva: World Health Organisation (WHO); 2001. The World Health Report, Mental Health: New understanding, new hope Geneva: World Health Organisation (WHO); 2001.
2.
go back to reference Lee TT, Ziegler JK, Sommi R, Sugar C, Mahmoud R, Lenert LA: Comparison of preferences for health outcomes in schizophrenia among stakeholder groups. Journal of Psychiatric Research 2000, 34: 201–210. 10.1016/S0022-3956(00)00009-1CrossRefPubMed Lee TT, Ziegler JK, Sommi R, Sugar C, Mahmoud R, Lenert LA: Comparison of preferences for health outcomes in schizophrenia among stakeholder groups. Journal of Psychiatric Research 2000, 34: 201–210. 10.1016/S0022-3956(00)00009-1CrossRefPubMed
3.
go back to reference Sevy S, Nathanson K, Schlecter C, Fulop G: Contingency Valuation and Preferences of Health States Associated With Side Effects of Antipsychotic Medications in Schizophrenia. Schizophrenia Bulletin 2001, 27(4):643–651.CrossRefPubMed Sevy S, Nathanson K, Schlecter C, Fulop G: Contingency Valuation and Preferences of Health States Associated With Side Effects of Antipsychotic Medications in Schizophrenia. Schizophrenia Bulletin 2001, 27(4):643–651.CrossRefPubMed
4.
go back to reference Brixner DI, Said Q, Corey-Lisle PK, Tuomari AV, L'Italien GJ, Stockdale W, Oderda GM: Naturalistic Impact of Second-Generation Antipsychotics on Weight Gain. Annals of Pharmacotherapy 2006, 40: 626–632. 10.1345/aph.1G564CrossRefPubMed Brixner DI, Said Q, Corey-Lisle PK, Tuomari AV, L'Italien GJ, Stockdale W, Oderda GM: Naturalistic Impact of Second-Generation Antipsychotics on Weight Gain. Annals of Pharmacotherapy 2006, 40: 626–632. 10.1345/aph.1G564CrossRefPubMed
5.
go back to reference Koro CE, Fedder DO, L'Italien GJ, Weiss SS, Magder LS, Kreyenbuhl J, et al.: Assessment of independent effect of olanzapine and risperidone on risk of diabetes among patients with schizophrenia: population based nested case-control study. BMJ 2002, 325: 243. 10.1136/bmj.325.7358.243PubMedCentralCrossRefPubMed Koro CE, Fedder DO, L'Italien GJ, Weiss SS, Magder LS, Kreyenbuhl J, et al.: Assessment of independent effect of olanzapine and risperidone on risk of diabetes among patients with schizophrenia: population based nested case-control study. BMJ 2002, 325: 243. 10.1136/bmj.325.7358.243PubMedCentralCrossRefPubMed
6.
go back to reference Räsänen P, Roine E, Sintonen H, Semberg-Konttinen V, Ryynänen O-P, Roine R: Use of quality-adjusted life years for the estimation of effectiveness of health care: A systematic literature review. International Journal of Technology Assessment in Health Care 2006, 22(2):235–241. 10.1017/S0266462306051051CrossRefPubMed Räsänen P, Roine E, Sintonen H, Semberg-Konttinen V, Ryynänen O-P, Roine R: Use of quality-adjusted life years for the estimation of effectiveness of health care: A systematic literature review. International Journal of Technology Assessment in Health Care 2006, 22(2):235–241. 10.1017/S0266462306051051CrossRefPubMed
7.
go back to reference Voruganti LN, Awad AG, Oyewumi LK, Cortese L, Zirul S, Dhawan R: Assessing health utilities in schizophrenia. A feasibility study. Pharmacoeconomics 2000, 17(3):273–286. 10.2165/00019053-200017030-00005CrossRefPubMed Voruganti LN, Awad AG, Oyewumi LK, Cortese L, Zirul S, Dhawan R: Assessing health utilities in schizophrenia. A feasibility study. Pharmacoeconomics 2000, 17(3):273–286. 10.2165/00019053-200017030-00005CrossRefPubMed
8.
go back to reference Brazier J, Akehurst R, Brennan A, Dolan P, Claxton K, McCabe C, O'Hagan A, Sculpher MJ: Tsuchyia A. Should patients have a greater role in valuing health states: whose well-being is it anyway? In Sheffield Health Economics Group Discussion Paper Series (Ref: 04/3). University of Sheffield; 2004. Brazier J, Akehurst R, Brennan A, Dolan P, Claxton K, McCabe C, O'Hagan A, Sculpher MJ: Tsuchyia A. Should patients have a greater role in valuing health states: whose well-being is it anyway? In Sheffield Health Economics Group Discussion Paper Series (Ref: 04/3). University of Sheffield; 2004.
9.
go back to reference National Institute for Clinical Excellence (NICE): Guide to the methods of technology assessment. London: NICE; 2004. National Institute for Clinical Excellence (NICE): Guide to the methods of technology assessment. London: NICE; 2004.
10.
go back to reference EuroQoL Group: EuroQoL: A new facility for the measurement of health related quality of life. Health Policy 1990, 16: 199–208. 10.1016/0168-8510(90)90421-9CrossRef EuroQoL Group: EuroQoL: A new facility for the measurement of health related quality of life. Health Policy 1990, 16: 199–208. 10.1016/0168-8510(90)90421-9CrossRef
11.
go back to reference Dolan P: Modeling valuations for EuroQol health states. Medical Care 1997, 35(11):1095–1108. 10.1097/00005650-199711000-00002CrossRefPubMed Dolan P: Modeling valuations for EuroQol health states. Medical Care 1997, 35(11):1095–1108. 10.1097/00005650-199711000-00002CrossRefPubMed
12.
go back to reference Willis GB: Cognitive Interviewing: A "How To" Guide. From the short course "Reducing Survey Error through Research on the Cognitive and Decision Processes in Surveys," presented at the Meeting of the American Statistical Association. 1999. Willis GB: Cognitive Interviewing: A "How To" Guide. From the short course "Reducing Survey Error through Research on the Cognitive and Decision Processes in Surveys," presented at the Meeting of the American Statistical Association. 1999.
13.
go back to reference Cummins C, Stevens A, Kisely S: The use of olanzapine as a first and second choice treatment in schizophrenia, West Midlands Development and Evaluation Committee Report, Wessex Institute for Health Research and Development. 1998. Cummins C, Stevens A, Kisely S: The use of olanzapine as a first and second choice treatment in schizophrenia, West Midlands Development and Evaluation Committee Report, Wessex Institute for Health Research and Development. 1998.
14.
go back to reference Glennie JL: Pharmacoeconomic evaluations of clozapine in treatment resistant schizophrenia and risperidone in chronic schizophrenia. Ottawa (ON): Canadian Coordinating Office for Health Technology Assessment (CCOHTA); 1997. Glennie JL: Pharmacoeconomic evaluations of clozapine in treatment resistant schizophrenia and risperidone in chronic schizophrenia. Ottawa (ON): Canadian Coordinating Office for Health Technology Assessment (CCOHTA); 1997.
15.
go back to reference Risebrogh NA, Lanctot KL: Can patients with schizophrenia judge health related quality of life? Health state utility measurement in a sample of patients with stable schizophrenia. Clinical Investment Medicine 1998, (supplement):S17. Risebrogh NA, Lanctot KL: Can patients with schizophrenia judge health related quality of life? Health state utility measurement in a sample of patients with stable schizophrenia. Clinical Investment Medicine 1998, (supplement):S17.
16.
go back to reference Lee TT, Ziegler JK, Sommi R, Sugar C, Mahmoud R, Lenert LA: Comparison of preferences for health outcomes in schizophrenia among stakeholder groups. Journal of Psychiatric Research 2000, 34: 201–210. 10.1016/S0022-3956(00)00009-1CrossRefPubMed Lee TT, Ziegler JK, Sommi R, Sugar C, Mahmoud R, Lenert LA: Comparison of preferences for health outcomes in schizophrenia among stakeholder groups. Journal of Psychiatric Research 2000, 34: 201–210. 10.1016/S0022-3956(00)00009-1CrossRefPubMed
17.
go back to reference Revicki DA, Shakespeare A, Kind P: Preferences for schizophrenia-related health states: a comparison of patients, caregivers and psychiatrists. International Clinical Psychopharmacology 1996, 11: 101–108. 10.1097/00004850-199611020-00004PubMed Revicki DA, Shakespeare A, Kind P: Preferences for schizophrenia-related health states: a comparison of patients, caregivers and psychiatrists. International Clinical Psychopharmacology 1996, 11: 101–108. 10.1097/00004850-199611020-00004PubMed
18.
go back to reference Sevy S, Nathanson K, Schlecter C, Fulop G: Contingency Valuation and Preferences of Health States Associated With Side Effects of Antipsychotic Medications in Schizophrenia. Schizophrenia Bulletin 2001, 27(4):643–651.CrossRefPubMed Sevy S, Nathanson K, Schlecter C, Fulop G: Contingency Valuation and Preferences of Health States Associated With Side Effects of Antipsychotic Medications in Schizophrenia. Schizophrenia Bulletin 2001, 27(4):643–651.CrossRefPubMed
19.
go back to reference Awad AG, Voruganti LN: Cost-utility Analysis in Schizophrenia. Journal of Clinical Psychiatry 1999, 60(suppl 3):22–26.PubMed Awad AG, Voruganti LN: Cost-utility Analysis in Schizophrenia. Journal of Clinical Psychiatry 1999, 60(suppl 3):22–26.PubMed
20.
go back to reference Kay SR, Fiszbein A, Opler LA: The Positive and Negative Syndrome Scale for schizophrenia. Schizophrenia Bulletin 1987, 13: 261–276.CrossRefPubMed Kay SR, Fiszbein A, Opler LA: The Positive and Negative Syndrome Scale for schizophrenia. Schizophrenia Bulletin 1987, 13: 261–276.CrossRefPubMed
22.
go back to reference Torrance GW, Feeny D, Furlong W: Visual Analog Scales: Do they have a role in the measurement of preferences for health states? Medical Decision Making 2001, 21: 329–344. 10.1177/02729890122062622CrossRefPubMed Torrance GW, Feeny D, Furlong W: Visual Analog Scales: Do they have a role in the measurement of preferences for health states? Medical Decision Making 2001, 21: 329–344. 10.1177/02729890122062622CrossRefPubMed
23.
go back to reference Drummond MF, O'Brien B, Stoddart GL, Torrance GW, ed: Cost-utility analysis. In Methods for the Economic Evaluation of Health Care Programmes. 2nd edition. Oxford: Oxford University Press; 1997. Drummond MF, O'Brien B, Stoddart GL, Torrance GW, ed: Cost-utility analysis. In Methods for the Economic Evaluation of Health Care Programmes. 2nd edition. Oxford: Oxford University Press; 1997.
24.
go back to reference Loewenstein G, O'Donoghue T, Rabin M: Projection Bias In Predicting Future Utility. The Quarterly Journal of Economics 2003, 118(4):1209–1248. 10.1162/003355303322552784CrossRef Loewenstein G, O'Donoghue T, Rabin M: Projection Bias In Predicting Future Utility. The Quarterly Journal of Economics 2003, 118(4):1209–1248. 10.1162/003355303322552784CrossRef
25.
go back to reference Ubel PA, Loewenstein G, Jepson C: Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public. Quality of Life Research 2003, 12: 599–607. 10.1023/A:1025119931010CrossRefPubMed Ubel PA, Loewenstein G, Jepson C: Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public. Quality of Life Research 2003, 12: 599–607. 10.1023/A:1025119931010CrossRefPubMed
26.
go back to reference Lysaker PH, Buck KD, Taylor AC, Roe D: Associations of metacognition and internalized stigma with quantitative assessments of self-experience in narratives of schizophrenia. Psychiatry Res 157(1–3):31–8. 2008 Jan 15 Lysaker PH, Buck KD, Taylor AC, Roe D: Associations of metacognition and internalized stigma with quantitative assessments of self-experience in narratives of schizophrenia. Psychiatry Res 157(1–3):31–8. 2008 Jan 15
27.
go back to reference Bellack AS: Scientific and consumer models of recovery in schizophrenia: concordance, contrasts, and implications. Schizophr Bull 2006, 32(3):432–42. 10.1093/schbul/sbj044PubMedCentralCrossRefPubMed Bellack AS: Scientific and consumer models of recovery in schizophrenia: concordance, contrasts, and implications. Schizophr Bull 2006, 32(3):432–42. 10.1093/schbul/sbj044PubMedCentralCrossRefPubMed
28.
go back to reference Adams J, Davey P, Jackson D, Croker V, Aristides M, Mullen K, Montgomery W: Using a community sample to derive utility values of schizophrenia treatment outcomes from a time trade-off methodology. ISPOR 7th Annual International Meeting, 19–22 May, Arlington. Poster presentation 2002. Adams J, Davey P, Jackson D, Croker V, Aristides M, Mullen K, Montgomery W: Using a community sample to derive utility values of schizophrenia treatment outcomes from a time trade-off methodology. ISPOR 7th Annual International Meeting, 19–22 May, Arlington. Poster presentation 2002.
Metadata
Title
Impact of schizophrenia and schizophrenia treatment-related adverse events on quality of life: direct utility elicitation
Authors
Andrew Briggs
Diane Wild
Michael Lees
Matthew Reaney
Serdar Dursun
David Parry
Jayanti Mukherjee
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2008
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-6-105

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