Abstract
BackgroundEvidence of quality of life implications of asthma attacks are limited, particularly when measured on a utility scale, which enables calculating Quality-Adjusted Life-Years (QALYs) and comparisons with other health conditions and services. Therefore, this study sought to estimate the utility loss associated with an asthma-related crisis event (accident and emergency (A&E) attendance or hospital admission).MethodsParticipants were recruited in a cohort study from A&E and hospital admissions at three UK hospitals. They completed the EuroQol-5 Dimensions 5-Level (EQ-5D-5 L), Asthma Quality of Life Questionnaire (AQLQ), Time trade-off (TTO), and peak flow and symptom diary over 8 weeks, where three different methods (EQ-5D-5 L, AQLQ, and TTO), were used to estimate utilities. The mean difference between two time points were estimated using the Wilcoxon signed rank test.ResultsFrom baseline to week 8, mean increases (95% CI) were estimated to be 0.086 (0.019–0.153), 0.154 (0.112–0.196) and 0.132 (0.063–0.201) for EQ-5D-5 L, AQL-5D (preference-based measure derived from AQLQ), and TTO respectively over 8 weeks (p < 0.01).ConclusionAsthma crisis events are estimated to be associated with a mean utility loss of between 0.086 and 0.132. The utility decrement can be used to assign values to asthma-related crisis events, which can enhance economic evaluations.Trial registrationNCT02771678. Registered 13 May 2016.
Highlights
Asthma has a prevalence of over 300 million people worldwide, and it can be a severe and life threatening condition [1]
If a follow up time point occurred during an asthma-related event, using the linear interpolation method could result in underestimating overall quality of life
With the above method, there is a potential for the utility estimates (a scale on which 0 is Crossman-Barnes et al Health and Quality of Life Outcomes (2019) 17:58 equivalent to death and 1 is full health), Quality-Adjusted Life-Years (QALYs) values, and cost-effectiveness to be inaccurate, with the possibility that treatments could be recommended for provision when they are not cost-effective, or not recommended when they are cost-effective
Summary
Asthma has a prevalence of over 300 million people worldwide, and it can be a severe and life threatening condition [1]. Many asthma-related studies have used PROMs [4,5,6], they mostly measure PROMs at specific time points (e.g. baseline and 6 months) and (as they have no information as to what happens in between) assume linear interpolation (a gradual straight line change) between such points [7]. If they occur between specific time points of measurement (e.g. baseline and 6 months), the loss associated with an event may not be captured and overall quality of life could potentially be overestimated. If a follow up time point occurred during an asthma-related event, using the linear interpolation method could result in underestimating overall quality of life. This study sought to estimate the utility loss associated with an asthma-related crisis event (accident and emergency (A&E) attendance or hospital admission)
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