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Health-related Utility (health-related + utility)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Characterization and comparison of health-related utility in people with diabetes with various single and multiple vascular complications

DIABETIC MEDICINE, Issue 10 2006
C. Ll.
Abstract Aims To characterize and compare health-related utility in a large cohort of patients treated in hospital with diabetes and with single and multiple comorbidities. Methods The study was conducted in Cardiff and the Vale of Glamorgan, UK. Health-related utility was measured using the EQ5Dindex, a standardized instrument for measuring health outcome. Patients from the Health Outcomes Data Repository (HODaR) were surveyed by postal questionnaire 6 weeks post discharge for in-patients and during clinics for patients attending as out-patients between January 2002 and July 2005. Patients with diabetes were identified by a previous history of in-patient admission with diabetes or as an out-patient with diabetes recorded as a coexisting diagnosis. Results, We identified 4502 patients with diabetes. Mean ages were 65.4 and 64.2 years for males and females, respectively. Of these, 2003 (45%) had no recorded vascular complication. Overall, the EQ5Dindex was 0.584 (sd 0.325) for males and 0.533 (sd 0.351) for females. For those without any vascular complications the mean EQ5Dindex was 0.735 (sd 0.288). In a general linear model, the presence of single and multiple complications had a detrimental impact on the EQ5Dindex. Conclusion The results of this study provide an indication of the true impact of diabetes in terms of health-related utility. There was a decrease in the mean EQ5Dindex for those with vascular complications. Economic models of diabetes that have used additive or multiplicative methods to assess utility in individuals with several complications may be unreliable, and direct measurements, such as this, are recommended. [source]

Health-related utility among adults with atopic dermatitis treated with 0·1% tacrolimus ointment as maintenance therapy over the long term: findings from the Protopic® CONTROL study

BRITISH JOURNAL OF DERMATOLOGY, Issue 6 2009
C.D. Poole
Summary Background, Long-term maintenance treatment with 0·1% tacrolimus ointment for the prevention of flares has been demonstrated to be well tolerated and effective in adults for the treatment of atopic dermatitis (AD) but its impact on health-related utility has not been reported. Objectives, The purpose of this study was to estimate utility changes associated with the use of tacrolimus ointment in the maintenance treatment of adults with AD. Methods, Data were collected from a clinical trial investigating long-term maintenance treatment with 0·1% tacrolimus ointment in adults with AD. All patients were treated with twice-daily tacrolimus ointment during an open-label period (OLP) of up to 6 weeks, with subsequent randomization to a double-blind disease-control period (DCP) of 12 months comparing tacrolimus ointment, used twice weekly as maintenance treatment, vs. the emollient vehicle as standard treatment. Health-related utility (EQ-5Dindex) was estimated by Monte Carlo simulation from SF-12 responses by application of a published response mapping algorithm and the U.K. tariff for EQ-5D responses and SF-6D responses, respectively. Results, Evaluable data were available for 257 patients stratified into mild, moderate or severe AD with a median age at screening of 28 years [interquartile range (IQR) 22,38] and 40% male. At screening the median EQ-5Dindex across the strata was 0·848 units (IQR 0·704,0·882) for mild cases, 0·796 (0·737,0·876) for moderate cases, and 0·760 (0·661,0·823, P < 0·001) for those with severe disease. At the end of the OLP, mean utility improvement across all strata was 0·027 [95% confidence interval (CI) ,0·011 to 0·065, P = 0·165] for mild cases, 0·046 (95% CI 0·015,0·064, P = 0·002) for moderate cases and 0·076 (95% CI 0·035,0·118, P < 0·001) for those with severe disease. At the end of the blinded DCP, repeated measures analysis showed an age- and sex-adjusted mean change of 0·045 units (P < 0·001) for subjects treated with tacrolimus ointment over those treated with emollient vehicle. Conclusions, Patients with AD of all severities showed considerable decrements in health-related utility. However, treatment with 0·1% tacrolimus ointment was associated with clinically significant improvement in health-related utility for patients with moderate and severe AD, which was sustained over a 12-month maintenance period compared with those using standard treatment with an emollient vehicle. [source]

Characterization and comparison of health-related utility in people with diabetes with various single and multiple vascular complications

DIABETIC MEDICINE, Issue 10 2006
C. Ll.
Abstract Aims To characterize and compare health-related utility in a large cohort of patients treated in hospital with diabetes and with single and multiple comorbidities. Methods The study was conducted in Cardiff and the Vale of Glamorgan, UK. Health-related utility was measured using the EQ5Dindex, a standardized instrument for measuring health outcome. Patients from the Health Outcomes Data Repository (HODaR) were surveyed by postal questionnaire 6 weeks post discharge for in-patients and during clinics for patients attending as out-patients between January 2002 and July 2005. Patients with diabetes were identified by a previous history of in-patient admission with diabetes or as an out-patient with diabetes recorded as a coexisting diagnosis. Results, We identified 4502 patients with diabetes. Mean ages were 65.4 and 64.2 years for males and females, respectively. Of these, 2003 (45%) had no recorded vascular complication. Overall, the EQ5Dindex was 0.584 (sd 0.325) for males and 0.533 (sd 0.351) for females. For those without any vascular complications the mean EQ5Dindex was 0.735 (sd 0.288). In a general linear model, the presence of single and multiple complications had a detrimental impact on the EQ5Dindex. Conclusion The results of this study provide an indication of the true impact of diabetes in terms of health-related utility. There was a decrease in the mean EQ5Dindex for those with vascular complications. Economic models of diabetes that have used additive or multiplicative methods to assess utility in individuals with several complications may be unreliable, and direct measurements, such as this, are recommended. [source]

Health-related utility among adults with atopic dermatitis treated with 0·1% tacrolimus ointment as maintenance therapy over the long term: findings from the Protopic® CONTROL study

BRITISH JOURNAL OF DERMATOLOGY, Issue 6 2009
C.D. Poole
Summary Background, Long-term maintenance treatment with 0·1% tacrolimus ointment for the prevention of flares has been demonstrated to be well tolerated and effective in adults for the treatment of atopic dermatitis (AD) but its impact on health-related utility has not been reported. Objectives, The purpose of this study was to estimate utility changes associated with the use of tacrolimus ointment in the maintenance treatment of adults with AD. Methods, Data were collected from a clinical trial investigating long-term maintenance treatment with 0·1% tacrolimus ointment in adults with AD. All patients were treated with twice-daily tacrolimus ointment during an open-label period (OLP) of up to 6 weeks, with subsequent randomization to a double-blind disease-control period (DCP) of 12 months comparing tacrolimus ointment, used twice weekly as maintenance treatment, vs. the emollient vehicle as standard treatment. Health-related utility (EQ-5Dindex) was estimated by Monte Carlo simulation from SF-12 responses by application of a published response mapping algorithm and the U.K. tariff for EQ-5D responses and SF-6D responses, respectively. Results, Evaluable data were available for 257 patients stratified into mild, moderate or severe AD with a median age at screening of 28 years [interquartile range (IQR) 22,38] and 40% male. At screening the median EQ-5Dindex across the strata was 0·848 units (IQR 0·704,0·882) for mild cases, 0·796 (0·737,0·876) for moderate cases, and 0·760 (0·661,0·823, P < 0·001) for those with severe disease. At the end of the OLP, mean utility improvement across all strata was 0·027 [95% confidence interval (CI) ,0·011 to 0·065, P = 0·165] for mild cases, 0·046 (95% CI 0·015,0·064, P = 0·002) for moderate cases and 0·076 (95% CI 0·035,0·118, P < 0·001) for those with severe disease. At the end of the blinded DCP, repeated measures analysis showed an age- and sex-adjusted mean change of 0·045 units (P < 0·001) for subjects treated with tacrolimus ointment over those treated with emollient vehicle. Conclusions, Patients with AD of all severities showed considerable decrements in health-related utility. However, treatment with 0·1% tacrolimus ointment was associated with clinically significant improvement in health-related utility for patients with moderate and severe AD, which was sustained over a 12-month maintenance period compared with those using standard treatment with an emollient vehicle. [source]