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Open Access 01-12-2015 | Research article

Longitudinal and cross sectional assessments of health utility in adults with HIV/AIDS: a systematic review and meta-analysis

Authors: Bach Xuan Tran, Long Hoang Nguyen, Arto Ohinmaa, Rachel Marie Maher, Vuong Minh Nong, Carl A Latkin

Published in: BMC Health Services Research | Issue 1/2015

Abstract

Background

Utility estimates are important health outcomes for economic evaluation of care and treatment interventions for patients with HIV/AIDS. We conducted a systematic review and meta-analysis of utility measurements to examine the performance of preference-based instruments, estimate health utility of patients with HIV/AIDS by disease stages, and investigate changes in their health utility over the course of antiretroviral treatment.

Methods

We searched PubMed/Medline, Cochrane Database of Systematic Review, NHS Economic Evaluation Database and Web of Science for English-language peer-reviewed papers published during 2000–2013. We selected 49 studies that used 3 direct and 6 indirect preference based instruments to make a total of 218 utility measurements. Random effect models with robust estimation of standard errors and multivariate fractional polynomial regression were used to obtain the pooled estimates of utility and model their trends.

Results

Reliability of direct-preference measures tended to be lower than other types of measures. Utility elicited by two of the indirect preference measures - SF-6D (0.171) and EQ-5D (0.114), and that of Time-Trade off (TTO) (0.151) was significantly different than utility elicited by Standard Gamble (SG). Compared to asymptomatic HIV patients, symptomatic and AIDS patients reported a decrement of 0.025 (p = 0.40) and 0.176 (p = 0.001) in utility scores, adjusting for method of assessment. In longitudinal studies, the pooled health utility of HIV/AIDS patients significantly decreased in the first 3 months of treatment, and rapidly increased afterwards. Magnitude of change varied depending on the method of assessment and length of antiretroviral treatment.

Conclusion

The study provides an accumulation of evidence on measurement properties of health utility estimates that can help inform the selection of instruments for future studies. The pooled estimates of health utilities and their trends are useful in economic evaluation and policy modelling of HIV/AIDS treatment strategies.

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Title: Longitudinal and cross sectional assessments of health utility in adults with HIV/AIDS: a systematic review and meta-analysis
Authors: Bach Xuan Tran
Long Hoang Nguyen
Arto Ohinmaa
Rachel Marie Maher
Vuong Minh Nong
Carl A Latkin
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-014-0640-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Longitudinal and cross sectional assessments of health utility in adults with HIV/AIDS: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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