Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
PharmacoEconomics
Published in: PharmacoEconomics 6/2002

01-05-2002 | Original Research Article

Estimating the Effect of Changes in Body Mass Index on Health State Preferences

Authors: Dr Zafar Hakim, Anne Wolf, Louis P. Garrison

Published in: PharmacoEconomics | Issue 6/2002

Login to get access

Abstract

Objective: To investigate the effect of changes in body mass index (BMI) on health state preferences (HSP).
Design: Multiple regression analysis on pooled data from a clinical study, predicting final HSP as a function of changes in BMI and initial HSP, controlling for age and gender. Subgroup analyses according to clinically relevant subgroups were performed.
Setting: Primary care practice sites.
Patients: 402 obese patients of varying disease severity.
Main outcome measures: BMI was operationalised as (weight in kilograms)/(height in metres)2. HSP were measured directly as visual analogue scale (VAS) scores, and converted to time trade-off (TTO) scores.
Results: A one unit decrease in BMI over a 1-year period was associated with a 0.017 gain in utility units (utils). This estimate is comparable to utility gains observed for other widely used treatments (e.g. revascularisation for intermittent claudication, renal transplantation). It varies little over the observed range of VAS to TTO conversion values, and is a conservative estimate compared with using the unconverted VAS scores. If attempts to use weight reduction treatment in only the patients who successfully meet strict weight reduction targets are successful, the gain in HSP experienced by such patients may exceed this estimate. Patients with BMI values ≥28 with hyperglycaemia appear to have the greatest gain in HSP for a given change in BMI over 1 year.
Conclusions: The effect of weight reduction on HSP can be significant, at least in the short term. Estimates of HSP changes presented herein may be useful in economic evaluations of weight reduction treatments.
Literature
1.
Beirman EL, Hirsch J. Obesity. In: Williams RH, editor. Textbook of endocrinology. Philadelphia (PA): WB Saunders Company, 1981: 906–921
2.
Davis MA, Walter H, Neuhaus JM. Obesity and osteoarthritis of the knee: evidence from the National Health Examination Survey (NHANES 1). Semin Arthritis Rheum 1990; 20 (3 Suppl. 1): 34–41PubMedCrossRef
3.
4.
5.
National Institutes of Health. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. 1998; NIH Publication #4083 [online]. Available from URL: http://​www.​nhlbi.​nih.​gov [Accessed 2001 Sep 3]
6.
Pi-Sunyer FX. Medical hazards of obesity. Ann Intern Med 1993; 119: 655–60PubMed
7.
Van Itallie TB. Obesity: adverse effects on health and longevity. Am J Clin Nutr 1979; 32: 2723–33PubMed
8.
Barajas GMA, Robledo ME, Tomas GN, et al. Quality of life in relation to health and obesity in a primary care center. Rev Esp Salud Publica 1998; 72 (3): 221–31CrossRef
9.
Fontaine KR, Cheskin LJ, Barofsky I. Health-related quality of life in obese persons seeking treatment. J Fam Pract 1996; 43: 265–70PubMed
10.
Fontaine KR, Bartlett SJ, Barofsky I. Health-related quality of life among obese persons seeking and not currently seeking treatment. Int J Eat Disord 2000; 27 (1): 101–5PubMedCrossRef
11.
Han TS, Tijhuis MA, Lean ME, et al. Quality of life in relation to overweight and body fat distribution. Am J Public Health 1998; 88 (12): 1814–20PubMedCrossRef
12.
Lean ME, Han TS, Seidell JC. Impairment of health and quality of life using new US Federal Guidelines for the Identification of Obesity. Arch Intern Med 1999; 159 (8): 837–43PubMedCrossRef
13.
Wooley JM, Erder MH, Staten MA. Health related quality of life is lower for obese people [abstract]. Obes Res 1997; 5 Suppl. 1: S87
14.
15.
Sullivan M, Karlsson J, Sjöström L, et al. Swedish obese subjects (SOS) — an intervention study of obesity: baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. Int J Obes Relat Metab Disord 1993; 17: 503–12PubMed
16.
Katz DA, McHorney CA, Atkinson RL. Impact of obesity on health-related quality of life in patients with chronic illness. J Gen Intern Med 2000; 15: 789–96PubMedCrossRef
17.
Doll HA, Petersen SE, Stewart-Brown SL. Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 Questionnaire. Obes Res 2000; 8 (2): 160–70PubMedCrossRef
18.
Choban PS, Onyejekwe J, Burge JC, et al. A health status assessment of the impact of weight loss following Roux-en-Y gastric bypass for clinically severe obesity. J Am Coll Surg 1999; 188 (5): 491–7PubMedCrossRef
19.
Fontaine KR, Barofsky I, Andersen RE, et al. Impact of weight loss on health-related quality of life. Qual Life Res 1999; 8 (3): 275–7PubMedCrossRef
20.
Metz JA, Stern JS, Kris-Etherton P, et al. A randomized trial of improved weight loss with a prepared meal plan in overweight and obese patients: impact on cardiovascular risk reduction. Arch Intern Med 2000; 160 (14): 2150–8PubMedCrossRef
21.
Rippe JM, Price JM, Hess SA, et al. Improved psychological well-being, quality of life, and health practices in moderately overweight women participating in a 12-week structured weight loss program. Obes Res 1998; 6 (3): 208–18PubMedCrossRef
22.
Rossner S, Sjostrom L, Noack R, et al. Weight loss, weight maintenance, and improved cardiovascular risk factors after 2 years treatment with orlistat for obesity. Obes Res 2000; 8 (1): 49–61PubMedCrossRef
23.
Stenius-Aarniala B, Poussa T, Kvarnstrom J, et al. Immediate and long term effects ofweight reduction in obese people with asthma: randomised controlled study. BMJ 2000; 320 (7238): 827–32PubMedCrossRef
24.
Van Gemert WG, Severeijns RM, Greve JW, et al. Psychological functioning of morbidly obese patients after surgical treatment. Int J Obes Relat Metab Disord 1998; 22 (5): 393–8PubMedCrossRef
25.
Van Gemert WG, Adang EM, Greve JW, et al. Quality of life assessment of morbidly obese patients: effect of weight-reducing surgery. Am J Clin Nutr 1998; 67 (2): 197–201PubMed
26.
Fine JT, Colditz GA, Coakley EH, et al. A prospective study of weight change and health-related quality of life in women. JAMA 1999; 282 (22): 2136–42PubMedCrossRef
27.
Wadden TA, Steen SN, Wingate BJ, et al. Psychosocial consequences of weight reduction: how much weight loss is enough? Am J Clin Nutr 1996; 63: S461–5
28.
Erickson P, Smiciklas-Wright H, Friedmann JM, et al. Association between body mass index and health-related quality of life in older adults [abstract]. Qual Life Res 2000; 9 (3): 329
29.
Macran S, Kind P, Farina C. Health-related quality of life in obesity: results from a English population study [abstract]. Qual Life Res 2000; 9 (3): 323
30.
Hakim Z, Howard P, Farina C. Estimating health state preferences in obesity [abstract]. Qual Life Res 2000; 9 (3): 323
31.
Foxcroft DR, Milne R. Orlistat for the treatment of obesity: rapid review and cost-effectiveness model. Obes Rev 2000; 1: 121–6PubMedCrossRef
32.
Hauptman J, Lucas C, Boldrin MN, et al. Orlistat in the long-term treatment of obesity in primary care settings. Arch Fam Med 2000; 9: 160–7PubMedCrossRef
33.
Mathias SD, Williamson CL, Colwell HH, et al. Assessing health-related quality-of-life and health state preference in persons with obesity: a validation study. Qual Life Res 1997; 6 (4): 311–22PubMedCrossRef
34.
Torrance GW, Feeny DH, Furlong WJ, et al. Multiattribute utility function for a comprehensive health status classification system: Health Utilities Index Mark 2. Med Care 1996; 34: 702–22PubMedCrossRef
35.
Stiggelbout AM, Eijkemans MJC, Kiebert GM, et al. The ‘Utility’ of the visual analog scale in medical decision making and technology assessment: is it an alternative to the time tradeoff? Int J Technol Assess Health Care 1996; 12 (2): 291–8PubMedCrossRef
36.
Torrance GW. Measurement of health state utilities for economic appraisal: a review. J Health Econ 1986; 5: 1–30PubMedCrossRef
37.
Furlong W, Feeny D, Torrance GW, et al. Guide to design and development of health state utility instrumentation. Working paper 90-9. Ontario: Centre for Health Economics and Policy Analysis, McMaster University, 1990
38.
Drummond MF, O’Brien BJ, Stoddart GL, et al., editors. Methods for the economic evaluation of health care programmes. 2nd ed. Oxford: Oxford University Press, 1997
39.
Green C, Brazier J, Deverill M. Valuing health-related quality of life: a review of health state valuation techniques. Pharmacoeconomics 2000; 17 (2): 151–65PubMedCrossRef
40.
Torrance GW. Social preferences for health states: an empirical evaluation of three measurement techniques. Socioecon Plann Sci 1976; 10: 129–36CrossRef
41.
Boyle MH, Torrance GW, Sinclair JC, et al. Economic evaluation of neonatal intensive care of very low birth weight infants. N Engl J Med 1983; 308: 1330–7PubMedCrossRef
42.
De Haes JCJM, De Koning HJ, Van Oortmarssen GJ, et al. The impact of a breast cancer screening programme on quality-adjusted life-years. Int J Cancer 1991; 49: 538–44PubMedCrossRef
43.
Torrance GW, Boyle MH, Horwood SP. Application of multiattribute utility theory to measure social preferences for health states. Oper Res 1982; 30 (6): 1043–69PubMedCrossRef
44.
Van Hout B, Bonsel G, Habbema JDF, et al. Heart transplantation in The Netherlands: cost effects and scenarios. J Health Econ 1993; 12: 73–93PubMedCrossRef
45.
Torrance GW, Feeny D, Furlong W. Visual analog scales: do they have a role in the measurement of preferences for health states? Med Decis Making 2001; 21 (4): 329–34PubMed
46.
Dolan P. Effect of age on health state valuations. J Health Serv Res Policy 2000; 5 (1): 17–21PubMed
47.
Froberg DG, Kane RL. Methodology for measuring health state preferences III: population and context effects. J Clin Epidemiol 1989; 42: 585–92PubMedCrossRef
48.
O’Leary JF, Fairclough DL, Jankowski MK, et al. Comparison of time tradeoff utilities and rating scale values of cancer patients and their relatives: evidence for a possible plateau relationship. Med Decis Making 1995; 15 (2): 132–7PubMedCrossRef
49.
Krabbe PFM, Essink-Bot M, Bonsel GJ. The comparability and reliability of five health state valuation methods. Soc Sci Med 1997; 45 (11): 1641–52PubMedCrossRef
50.
Gold MR, Siegel JE, Russell LB, et al., editors. Cost-effectiveness in health and medicine. New York (NY): Oxford University Press, 1996
51.
Patrick D, Erickson P, editors. Health status and health policy: quality of life in health care evaluation and resource allocation. Oxford: Oxford University Press, 1993
52.
Bosch JL, Hunink MGM. Comparison of the Health Utilities Index Mark 3 (HUI3) and the EuroQol EQ-5D in patients treated for intermittent claudication. Qual Life Res 2000; 9: 591–601PubMedCrossRef
53.
Laupacis A, Keown P, Pus N, et al. A study of the quality of life and cost-utility of renal transplantation. Kidney Int 1996; 50: 235–42PubMedCrossRef
54.
Dolan P, Gudex C, Kind P, et al. The time tradeoff method: results from a general population study. Health Econ 1996; 5 (2): 141–54PubMedCrossRef
Metadata
Title
Estimating the Effect of Changes in Body Mass Index on Health State Preferences
Authors
Dr Zafar Hakim
Anne Wolf
Louis P. Garrison
Publication date
01-05-2002
Publisher
Springer International Publishing
Published in
PharmacoEconomics / Issue 6/2002
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200220060-00004

Other articles of this Issue 6/2002

PharmacoEconomics 6/2002 Go to the issue

Original Research Article

Reporting Heterogeneity in the Measurement of Health and Health-Related Quality of Life

Commentary

A Fair Innings for NICE?

Review Article

Cost Effectiveness of Treatments for Amyotrophic Lateral Sclerosis

Original Research Article

Use of Healthcare Services by Patients Treated with Risperidone Versus Conventional Antipsychotic Agents

Review Article

Sickle Cell Anaemia