Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2004

Open Access 01-12-2004 | Research

Usefulness of EQ-5D in Assessing Health Status in Primary Care Patients with Major Depressive Disorder

Authors: Christophe Sapin, Bruno Fantino, Marie-Laure Nowicki, Paul Kind

Published in: Health and Quality of Life Outcomes | Issue 1/2004

Login to get access

Abstract

Objectives

Major depressive disorder (MDD) is a prevalent psychiatric disorder associated with impaired patient functioning and reductions in health-related quality of life (HRQL). The present study describes the impact of MDD on patients' HRQL and examines preference-based health state differences by patient features and clinical characteristics.

Methods

95 French primary care practitioners recruited 250 patients with a DSM-IV diagnosis of MDD for inclusion in an eight-week follow-up cohort. Patient assessments included the Montgomery Asberg Depression Rating Scale (MADRS), the Clinical Global Impression of Severity (CGI), the Short Form-36 Item scale (SF-36), the Quality of Life Depression Scale (QLDS) and the EuroQoL (EQ-5D).

Results

The mean EQ-5D utility at baseline was 0.33, and 8% of patients rated their health state as worse than death. There were no statistically significant differences in utilities by demographic features. Significant differences were found in mean utilities by level of disease severity assessed by CGI. The different clinical response profiles, assessed by MADRS, were also revealed by EQ-5D at endpoint: 0.85 for responders remitters, 0.72 for responders non-remitter, and 0.58 for non-responders. Even if HRQL and EQ-5D were moderately correlated, they shared only 40% of variance between baseline and endpoint.

Conclusions

Self-reported patient valuations for depression are important patient-reported outcomes for cost-effectiveness evaluations of new antidepressant compounds and help in further understanding patient compliance with antidepressant treatment.
Literature
1.
go back to reference Williams JW Jr, Kerber CA, Mulrow CD, Medina A, Aguilar C: Depressive disorders in primary care: prevalence, functional disability and identification. J Gen Intern Med 1995, 10: 7–12.PubMedCrossRef Williams JW Jr, Kerber CA, Mulrow CD, Medina A, Aguilar C: Depressive disorders in primary care: prevalence, functional disability and identification. J Gen Intern Med 1995, 10: 7–12.PubMedCrossRef
2.
go back to reference Le Pape A, Lecomte T: Prévalence et prise en charge de la dépression. Paris: Centre de Recherche en Economie de la Santé 1999. Le Pape A, Lecomte T: Prévalence et prise en charge de la dépression. Paris: Centre de Recherche en Economie de la Santé 1999.
3.
go back to reference Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer K: Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry 1995, 52: 11–9.PubMedCrossRef Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer K: Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry 1995, 52: 11–9.PubMedCrossRef
4.
go back to reference Saarijarvi S, Salminen JK, Toikka T, Raitasalo R: Health-related quality of life among patients with major depression. Nord J Psychiatry 2002, 56: 261–4. 10.1080/08039480260242741PubMedCrossRef Saarijarvi S, Salminen JK, Toikka T, Raitasalo R: Health-related quality of life among patients with major depression. Nord J Psychiatry 2002, 56: 261–4. 10.1080/08039480260242741PubMedCrossRef
5.
go back to reference Lecrubier Y: The burden of depression and anxiety in general medicine. J Clin Psychiatry 2001, 62: 4–9.PubMed Lecrubier Y: The burden of depression and anxiety in general medicine. J Clin Psychiatry 2001, 62: 4–9.PubMed
6.
go back to reference Goff VV: Depression: a decade of progress, more to do. NHPF Issure Brief 2002, 786: 1–14. (Nov 22) Goff VV: Depression: a decade of progress, more to do. NHPF Issure Brief 2002, 786: 1–14. (Nov 22)
7.
go back to reference Nierenberg AA: Current perspectives on the diagnosis and treatment of major depressive disorder. Am J Manag Care 2001, 7: S353–66.PubMed Nierenberg AA: Current perspectives on the diagnosis and treatment of major depressive disorder. Am J Manag Care 2001, 7: S353–66.PubMed
8.
go back to reference Brown C, Schulberg HC, Prigerson HG: Factors associated with symptomatic improvement and recovery from major depression in primary care patients. Gen Hosp Psychiatry 2000, 22: 242–50. 10.1016/S0163-8343(00)00086-4PubMedCrossRef Brown C, Schulberg HC, Prigerson HG: Factors associated with symptomatic improvement and recovery from major depression in primary care patients. Gen Hosp Psychiatry 2000, 22: 242–50. 10.1016/S0163-8343(00)00086-4PubMedCrossRef
9.
go back to reference Revicki DA, Simon GE, Chan K, Katon W, Heiligenstein J: Depression, health-related quality of life, and medical cost outcomes of receiving, recommended levels of antidepressant treatment. J Fam Pract 1998, 47: 446–52.PubMed Revicki DA, Simon GE, Chan K, Katon W, Heiligenstein J: Depression, health-related quality of life, and medical cost outcomes of receiving, recommended levels of antidepressant treatment. J Fam Pract 1998, 47: 446–52.PubMed
10.
go back to reference Reynolds CF 3rd: Treatment of major depression in late life: a life cycle perspective. Psychiatr Q 1997, 68: 221–46. 10.1023/A:1025484123244PubMedCrossRef Reynolds CF 3rd: Treatment of major depression in late life: a life cycle perspective. Psychiatr Q 1997, 68: 221–46. 10.1023/A:1025484123244PubMedCrossRef
11.
go back to reference Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB: Recommendations of the Panel on Cost-Effectiveness in Health and Medicine. JAMA 1996, 276: 1253–8. 10.1001/jama.276.15.1253PubMedCrossRef Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB: Recommendations of the Panel on Cost-Effectiveness in Health and Medicine. JAMA 1996, 276: 1253–8. 10.1001/jama.276.15.1253PubMedCrossRef
12.
go back to reference Bennett KJ, Torrance GW: Measuring health state preferences and utilities: rating scale, time trade-off and standard gamble techniques. In: Quality of Life and Pharmacoeconomics in Clinical Trials 2 Edition (Edited by: Spilker B). Philadelphia: Lipincott-Raven 1996. Bennett KJ, Torrance GW: Measuring health state preferences and utilities: rating scale, time trade-off and standard gamble techniques. In: Quality of Life and Pharmacoeconomics in Clinical Trials 2 Edition (Edited by: Spilker B). Philadelphia: Lipincott-Raven 1996.
13.
go back to reference de Boer AG, Stalmeier PF, Sprangers MA, de Haes JC, van Sandick JW, Hulscher JB, van Lanschot JJ: Transhiatal vs extended transthoracic resection in oesophageal carcinoma: patients' utilities and treatment preferences. Br J Cancer 2002, 86: 851–7. 10.1038/sj.bjc.6600203PubMedCentralPubMedCrossRef de Boer AG, Stalmeier PF, Sprangers MA, de Haes JC, van Sandick JW, Hulscher JB, van Lanschot JJ: Transhiatal vs extended transthoracic resection in oesophageal carcinoma: patients' utilities and treatment preferences. Br J Cancer 2002, 86: 851–7. 10.1038/sj.bjc.6600203PubMedCentralPubMedCrossRef
14.
go back to reference Tosteson AN, Hammond CS: Quality-of-life assessment in osteoporosis: health-status and preferenced-based measures. Pharmacoeconomics 2002, 20: 289–303.PubMedCrossRef Tosteson AN, Hammond CS: Quality-of-life assessment in osteoporosis: health-status and preferenced-based measures. Pharmacoeconomics 2002, 20: 289–303.PubMedCrossRef
15.
go back to reference Smith DS, Krygiel J, Nease RF Jr, Sumner W 2nd, Catalona WJ: Patient preferences for outcomes associated with surgical management of prostate cancer. J Urol 2002, 167: 2117–22. 10.1097/00005392-200205000-00042PubMedCrossRef Smith DS, Krygiel J, Nease RF Jr, Sumner W 2nd, Catalona WJ: Patient preferences for outcomes associated with surgical management of prostate cancer. J Urol 2002, 167: 2117–22. 10.1097/00005392-200205000-00042PubMedCrossRef
16.
go back to reference Chouinard G, Albright PS: Economic and health state utility determinations for schizophrenic patients treated with risperidone or haloperidol. J Clin Psychopharmacol 1997, 17: 298–307. 10.1097/00004714-199708000-00010PubMedCrossRef Chouinard G, Albright PS: Economic and health state utility determinations for schizophrenic patients treated with risperidone or haloperidol. J Clin Psychopharmacol 1997, 17: 298–307. 10.1097/00004714-199708000-00010PubMedCrossRef
17.
go back to reference Wells KB, Sherbourne CD: Functioning and utility for current health status of patients with depression or chronic medical conditions in managed, primary care practices. Arch Gen Psychiatry 1999, 56: 897–904. 10.1001/archpsyc.56.10.897PubMedCrossRef Wells KB, Sherbourne CD: Functioning and utility for current health status of patients with depression or chronic medical conditions in managed, primary care practices. Arch Gen Psychiatry 1999, 56: 897–904. 10.1001/archpsyc.56.10.897PubMedCrossRef
18.
go back to reference Bennett KJ, Torrance GW, Boyle MH, Guscott R: Cost-utility analysis in depression: the McSad utility measure for depression health state. Psychiatr Serv 2000, 51: 1171–6. 10.1176/appi.ps.51.9.1171PubMedCrossRef Bennett KJ, Torrance GW, Boyle MH, Guscott R: Cost-utility analysis in depression: the McSad utility measure for depression health state. Psychiatr Serv 2000, 51: 1171–6. 10.1176/appi.ps.51.9.1171PubMedCrossRef
19.
go back to reference Schaffer A, Levitt AJ, Hershkop SK, Oh P, MacDonald C, Lanctot K: Utility scores of symptom profiles in major depression. Psychiatry Res 2002, 110: 189–97. 10.1016/S0165-1781(02)00097-5PubMedCrossRef Schaffer A, Levitt AJ, Hershkop SK, Oh P, MacDonald C, Lanctot K: Utility scores of symptom profiles in major depression. Psychiatry Res 2002, 110: 189–97. 10.1016/S0165-1781(02)00097-5PubMedCrossRef
20.
go back to reference Lenert LA, Morss S, Goldstein MK, Bergen MR, Faustman WO, Garber AM: Measurement of the validity of utility elicitations performed by computerized interview. Med Care 1997, 35: 915–20. 10.1097/00005650-199709000-00004PubMedCrossRef Lenert LA, Morss S, Goldstein MK, Bergen MR, Faustman WO, Garber AM: Measurement of the validity of utility elicitations performed by computerized interview. Med Care 1997, 35: 915–20. 10.1097/00005650-199709000-00004PubMedCrossRef
21.
go back to reference Revicki DA, Wood M: Patient-assigned health state utilities for depression-related outcomes: differences by depression severity and antidepressant medications. J Affect Disord 1998, 48: 25–36. 10.1016/S0165-0327(97)00117-1PubMedCrossRef Revicki DA, Wood M: Patient-assigned health state utilities for depression-related outcomes: differences by depression severity and antidepressant medications. J Affect Disord 1998, 48: 25–36. 10.1016/S0165-0327(97)00117-1PubMedCrossRef
22.
go back to reference Committee for Proprietary Medicinal Products: Note for Guidance on Clinical Assessment of Medicinal Products in the Treatment of Depression. London: EMEA 2002. Committee for Proprietary Medicinal Products: Note for Guidance on Clinical Assessment of Medicinal Products in the Treatment of Depression. London: EMEA 2002.
23.
go back to reference American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. Washington DC: American Psychiatric Association 4 Edition 1994. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. Washington DC: American Psychiatric Association 4 Edition 1994.
24.
go back to reference Montgomery SA, Asberg M: A New Depression Scale Designed to be Sensitive to Change. Br J Psychiatry 1979, 134: 382–9.PubMedCrossRef Montgomery SA, Asberg M: A New Depression Scale Designed to be Sensitive to Change. Br J Psychiatry 1979, 134: 382–9.PubMedCrossRef
25.
go back to reference Leplège A, Ecosse E, Verdier A, Perneger TV: The French SF-36 Health Survey: translation, cultural adaptation and preliminary psychometric evaluation. J Clin Epidemiol 1998, 51: 1013–23. 10.1016/S0895-4356(98)00093-6PubMedCrossRef Leplège A, Ecosse E, Verdier A, Perneger TV: The French SF-36 Health Survey: translation, cultural adaptation and preliminary psychometric evaluation. J Clin Epidemiol 1998, 51: 1013–23. 10.1016/S0895-4356(98)00093-6PubMedCrossRef
26.
go back to reference Ware JE Jr, Gandek B, Kosinski M, Aaronson NK, Apolone G, Brazier J, Bullinger M, Kaasa S, Leplège A, Prieto L, Sullivan M, Thunedborg K: The equivalence of SF-36 summary health scores estimated using standard and country-specific algorithms in 10 countries. J Clin Epidemiol 1998, 51: 1167–70. 10.1016/S0895-4356(98)00108-5PubMedCrossRef Ware JE Jr, Gandek B, Kosinski M, Aaronson NK, Apolone G, Brazier J, Bullinger M, Kaasa S, Leplège A, Prieto L, Sullivan M, Thunedborg K: The equivalence of SF-36 summary health scores estimated using standard and country-specific algorithms in 10 countries. J Clin Epidemiol 1998, 51: 1167–70. 10.1016/S0895-4356(98)00108-5PubMedCrossRef
27.
go back to reference Hunt SM, McKenna SP: The QLDS, a scale for the measurement of quality of life in depression. Health Policy 1992, 22: 307–19. 10.1016/0168-8510(92)90004-UPubMedCrossRef Hunt SM, McKenna SP: The QLDS, a scale for the measurement of quality of life in depression. Health Policy 1992, 22: 307–19. 10.1016/0168-8510(92)90004-UPubMedCrossRef
28.
go back to reference McKenna SP, Doward LC, Kohlmann T, Mercier C, Niero M, Paes M, Patrick D, Ramirez N, Thorsen H, Whalley D: International development of the Quality of Life in Depression Scale (QLDS). J Affect Disord 2001, 63: 189–99. 10.1016/S0165-0327(00)00184-1PubMedCrossRef McKenna SP, Doward LC, Kohlmann T, Mercier C, Niero M, Paes M, Patrick D, Ramirez N, Thorsen H, Whalley D: International development of the Quality of Life in Depression Scale (QLDS). J Affect Disord 2001, 63: 189–99. 10.1016/S0165-0327(00)00184-1PubMedCrossRef
29.
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
30.
go back to reference Dolan P, Gudex C, Kind P, Williams A: A social tariff for EuroQoL: Results from a UK General Population Survey. University of York: Center for Health Economics 1995. Dolan P, Gudex C, Kind P, Williams A: A social tariff for EuroQoL: Results from a UK General Population Survey. University of York: Center for Health Economics 1995.
31.
go back to reference Kohn Y, Zislin J, Agid O, Hanin B, Troudard T, Shapira B, Bloch M, Gur E, Ritsner M, Lerer B: Increased prevalence of negative life events in subtypes of major depressive disorder. Compr Psychiatry 2001, 42: 57–63. 10.1053/comp.2001.19753PubMedCrossRef Kohn Y, Zislin J, Agid O, Hanin B, Troudard T, Shapira B, Bloch M, Gur E, Ritsner M, Lerer B: Increased prevalence of negative life events in subtypes of major depressive disorder. Compr Psychiatry 2001, 42: 57–63. 10.1053/comp.2001.19753PubMedCrossRef
32.
go back to reference Angst J, Angst F, Stassen HH: Suicide risk in patients with major depressive disorder. J Clin Psychiatry 1999, 60: 57–62.PubMed Angst J, Angst F, Stassen HH: Suicide risk in patients with major depressive disorder. J Clin Psychiatry 1999, 60: 57–62.PubMed
33.
go back to reference Bennett KJ, Torrance GW, Boyle MH, Guscott R, Moran LA: Development and testing of a utility measure for major, unipolar depression (McSad). Qual Life Res 2000, 9: 109–20. 10.1023/A:1008952602494PubMedCrossRef Bennett KJ, Torrance GW, Boyle MH, Guscott R, Moran LA: Development and testing of a utility measure for major, unipolar depression (McSad). Qual Life Res 2000, 9: 109–20. 10.1023/A:1008952602494PubMedCrossRef
34.
go back to reference Pyne JM, Patterson TL, Kaplan RM, Ho S, Gillin JC, Goldshan S, Grant I: Preliminary longitudinal assessment of quality of life in patients with major depression. Psychopharmacol Bull 1997, 33: 23–9.PubMed Pyne JM, Patterson TL, Kaplan RM, Ho S, Gillin JC, Goldshan S, Grant I: Preliminary longitudinal assessment of quality of life in patients with major depression. Psychopharmacol Bull 1997, 33: 23–9.PubMed
35.
go back to reference Pyne JM, Patterson TL, Kaplan RM, Gillin JC, Koch WL, Grant I: Assessment of quality of life of patients with major depression. Psychiatr Serv 1997, 48: 224–30.PubMedCrossRef Pyne JM, Patterson TL, Kaplan RM, Gillin JC, Koch WL, Grant I: Assessment of quality of life of patients with major depression. Psychiatr Serv 1997, 48: 224–30.PubMedCrossRef
36.
go back to reference Torrance GW, Feeny D: Utilities and quality-adjusted life years. Int J Technol Assess Health Care 1989, 5: 559–75.PubMedCrossRef Torrance GW, Feeny D: Utilities and quality-adjusted life years. Int J Technol Assess Health Care 1989, 5: 559–75.PubMedCrossRef
37.
go back to reference Revicki DA, Kaplan RM: Relationship between psychometric and utility-based approaches to the measurement of health-related quality of life. Qual Life Res 1993, 2: 477–87.PubMedCrossRef Revicki DA, Kaplan RM: Relationship between psychometric and utility-based approaches to the measurement of health-related quality of life. Qual Life Res 1993, 2: 477–87.PubMedCrossRef
38.
go back to reference Apolone G, De Carli G, Brunetti M, Garattini S: Health-related quality of life (HR-QOL) and regulatory issues. An assessment of the EMEA recommendations on the use of HR-QOL measures in drug approval. Pharmacoeconomics 2001, 19: 187–95.PubMedCrossRef Apolone G, De Carli G, Brunetti M, Garattini S: Health-related quality of life (HR-QOL) and regulatory issues. An assessment of the EMEA recommendations on the use of HR-QOL measures in drug approval. Pharmacoeconomics 2001, 19: 187–95.PubMedCrossRef
39.
go back to reference Simon GE, VonKorff M, Heiligenstein JH, Revicki DA, Grothaus L, Katon W, Wagner EH: Initial antidepressant choice in primary care: effectiveness and cost of fluoxetine versus tricyclic antidepressants. JAMA 1996, 275: 1897–902. 10.1001/jama.275.24.1897PubMedCrossRef Simon GE, VonKorff M, Heiligenstein JH, Revicki DA, Grothaus L, Katon W, Wagner EH: Initial antidepressant choice in primary care: effectiveness and cost of fluoxetine versus tricyclic antidepressants. JAMA 1996, 275: 1897–902. 10.1001/jama.275.24.1897PubMedCrossRef
40.
go back to reference Gold MR, Siegal JE, Russell LB, Weinstein MC, eds: Cost-Effectiveness in Health and Medicine. New York: Oxford University Press 1996. Gold MR, Siegal JE, Russell LB, Weinstein MC, eds: Cost-Effectiveness in Health and Medicine. New York: Oxford University Press 1996.
Metadata
Title
Usefulness of EQ-5D in Assessing Health Status in Primary Care Patients with Major Depressive Disorder
Authors
Christophe Sapin
Bruno Fantino
Marie-Laure Nowicki
Paul Kind
Publication date
01-12-2004
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2004
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-2-20

Other articles of this Issue 1/2004

Health and Quality of Life Outcomes 1/2004 Go to the issue