Patient- and proxy-reported utility in Alzheimer`s disease using the EuroQoL
Linus Jönsson, Niela Andreasen, Lena Kilander, Hilkka Soininen, Merja Hallikainen, Gunhild Waldemar, Harald Nygaard, Bengt Winblad, Maria Eriksdotter Jönhagne, Anders Wimo
Bok Svensk 2003
| Utgitt | 2003
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| Omfang | 9 s. + vedl.
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| Opplysninger | Abstract: This study aims to estimate the utility in different stages of Alzheimer`s disease (AD) using the EuroQoL (EQ-5D) instrument, compare patient- and proxy-ratings on the EQ-5D, test the responsiveness of the instruments to changes over time and to identify factors influencing the utility in AD. 272 patients and their primary caregiver were enrolled in a prospective observational study and underwent three consecutive interviews, 6 months apart. Average Minimal Mental State Examination (MMSE) scores were 19.3, 18.0 and 16.4 at the three interviews; scores ranged from 0 to 30. Utility was estimated from responses to the EQ-5D instrument using previously published population-based weights. Patients rated their own utility to on average 0.833 with little variation across severity levels. Proxy-rated utility was 0.690 (MMSE>25), 0.644 (MMSE 21-25), 0.502 (MMSE 15-20), 0.494 (MMSE 10-14) and 0.329 (MMSE <10). Proxy-rated utility, as well as changes in utility over time, was significantly related to MMSE scores and inversely related to scores on a brief version of the neuropsychiatric inventory and institutionalisation. The utility estimates were highly correlated with the disease-specific quality of life instrument QoL-AD. The study shows that teh EQ-5D can be used to obtain estimates of utility in AD, but there are important differences between patient- and proxy ratings.
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