How does the Canadian general public view moderate Alzheimer's disease? determination of health utility scores

Abstract

Economic evaluations are playing an important role in decision making. Guidelines for the conduct of economic evaluations recommend eliciting preferences or health utility scores from members of the general public. The objectives of this study were to (1) To elicit health utility scores for moderate Alzheimer's disease (AD) using the Canadian general public; (2) to compare utility scores for Canadians' self-assessed health status with utility scores for health status defined as moderate AD; (3) to measure awareness of AD; and (4) to determine factors that influence utility scores. Five-hundred Canadians were chosen randomly to participate in a 13-minute telephone interview. The sample was national in scope and stratified by income. The EQ-5D was administered to measure utility for respondents' current health status (i.e., no AD). After describing moderate AD, respondents were asked to answer the EQ-5D again, this time imagining they had moderate AD. AD awareness was measured with the Alzheimer's Disease Knowledge Test (ADKT). Respondents were also asked about socio-demographics and whether they knew someone with AD. OLS regressions were conducted to identify determinants of EQ-5D utility scores. The mean age of respondents was 51 years, 61% were female, and 42% knew someone with AD (e.g., family member). Mean ADKT score was 3.4 (SD: 1.1) out of 5 (higher scores indicate better knowledge of AD). Respondents' mean EQ-5D score for their current health status was 0.857 (SD: 0.15). Mean EQ-5D score for a hypothetical, moderate AD health status was 0.638 (SD: .20), a utility decrement of 0.22. For the VAS component of the EQ-5D, scores were higher for the current health status (79.16 versus 57.66). Age and income were significant explanatory variables for current health status utilities, but only age was significant in the determination of the utility score under the assumption of moderate AD. Gender, knowledge of someone with AD, or AD awareness scores had no impact. When measured by the EQ-5D, Canadians would expect to assign a lower utility to their health status when they have moderate AD.