Health utilities in Alzheimer's disease - A cross-sectional study of patients and caregivers
Health utilities in Alzheimer's disease - A cross-sectional study of patients and caregivers
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DOI：
10.1097/00005650-199901000-00005
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发表时间：
1999-01-01
期刊：
影响因子：
3
通讯作者：
Weinstein, MC
中科院分区：
文献类型：
--
作者：
Neumann, PJ;Kuntz, KM;Weinstein, MC
目标.虽然阿尔茨海默病（AD）的广泛影响越来越多地被认识到，但很少有工作集中在阿尔茨海默病患者及其护理人员所经历的整体健康相关的生活质量上。该研究有两个主要目标：（1）测试的可行性，测量健康效用在阿尔茨海默氏病与通用偏好加权工具使用代理受访者和（2）评估效用分数的阿尔茨海默氏病患者（及其照顾者）在不同的疾病阶段和护理设置。在美国的13个地点进行了一项对679名阿尔茨海默病患者/护理人员对的横断面研究：四个学术医疗中心，四个管理式护理计划，两个辅助生活设施和三个养老院。健康效用指数马克II（HUI：2）问卷管理的照顾者的病人谁回答代理病人和自己。使用HUI：2多属性效用函数将对调查问卷的回答转换为0到1之间的全局效用分数。结果。总体效用评分在患者的阿尔茨海默病分期之间变化很大：对于评估的六个分期（可疑、轻度、中度、重度、严重和晚期），平均效用评分分别为0.73、0.69、0.53、0.38、0.27和0.14。在多元回归分析中，阿尔茨海默病分期是患者效用评分的负向和显著预测因子;设置没有产生独立影响。照顾者的效用分数对患者的阿尔茨海默病阶段和设置不敏感。患者的阿尔茨海默氏病阶段对健康效用有实质性的影响，如通过HUI测量的：2。需要更多的研究来评估使用代理受访者的有效性。
OBJECTIVES. Although the broad impacts of Alzheimer's disease (AD) are increasingly recognized, little work has focused on the overall health-related quality of life experienced by Alzheimer's disease patients and their caregivers. The study had two main objectives: (1) to test the feasibility of measuring health utilities in Alzheimer's disease with a generic preference-weighted instrument using proxy respondents and (2) to assess the utility scores of Alzheimer's disease patients (and their caregivers) in different disease stages and care setting.METHODS. A cross-sectional study of 679 Alzheimer's disease patient/caregiver pairs was conducted at 13 sites in the United States: four academic medical centers, four managed care plans, two assisted living facilities, and three nursing homes. The Health Utilities Index Mark II (HUI:2) questionnaire was administered to caregivers of patients who responded both as proxies for patients and for themselves. Responses to the questionnaire were converted into a global utility score, between 0 and 1, using the HUI:2 multi-attribute utility function.RESULTS. Global utility scores varied considerably across patients' Alzheimer's disease stage: for the six stages assessed (questionable, mild, moderate, severe, profound, and terminal), mean utility scores were 0.73, 0.69, 0.53, 0.38, 0.27, and 0.14, respectively. In multiple regression analyses, Alzheimer's disease stage was a negative and significant predictor of utility scores for patients; setting did not exert an independent effect. Utility scores for the caregivers were insensitive to patients' Alzheimer's disease stage and setting.CONCLUSIONS. Patients' Alzheimer's disease stage had a substantial influence on health utilities, as measured by the HUI:2. More research is needed to assess the validity of using proxy respondents.