Abstract
Background: Asthma exacerbations affect quality of life for children with asthma. A cost-utility analysis was performed alongside the PLEASANT clinical trial to assess the cost-effectiveness of a letter intervention in preventing and lessening exacerbations in school-aged children at the start of a new school term. The economic analysis relied on published literature for health utilities estimates as no patient reported outcome measures were collected in the trial. Objective: To identify preference-based utility values for children with day-to-day asthma symptoms (baseline utility) and children experiencing an asthma exacerbation, and to review the appropriateness of the utility values to be used in the PLEASANT economic analysis. Methods: A systematic review was performed in five electronic databases (Ovid MEDLINE, The Cochrane Library, EMBASE, ECONLIT and SCHARR Health Utilities Database) up to 5th July 2014 to identify studies that report preference-based utility values in children with asthma. Results were summarised narratively and utility data were assessed for quality, relevance to the economic analysis and compliance with the NICE reference case. Results: A total of 927 studies were identified from the search and 14 studies which met the inclusion criteria were included. Health utilities were elicited using various outcome measurements. EQ-5D was used in 5 studies (35.7%), HUI, PAHOM and direct valuation using vignettes were each reported in 2 studies (14.3%). Three (21.4%) studies estimated utility values from mapping between condition specific measures and the EQ-5D. None of the studies directly measured health utilities in children with asthma exacerbation using a preference-based measure. Conclusions: There is a lack of robust estimates on utility decrement in children with asthma exacerbation. Future studies in children with asthma should incorporate collection of health state utilities into the study design, taking into account the ethical and methodological considerations of quality-of-life assessment during exacerbation.
Highlights
PRS48 Exploring The Impact of Adding A Respiratory Dimension to The EQ5D-5L Hoogendoorn M1, Oppe M2, Boland MR1, Stolk E2, Goossens LM1, Rutten van Mölken M1 1Erasmus University Rotterdam, Rotterdam, The Netherlands, 2EuroQol Research Foundation, Rotterdam, The Netherlands Objectives: To evaluate the impact of adding a respiratory dimension on EQ-5D-5L health state valuations
PRS47 Adding A Decision Aid to Asthma Education: Impact on Decisional Conflict and Appropriate Medication Usage Gagné M1, Légaré F2, Moisan J2, Boulet L1 1Research Center, Quebec Heart and Lung Institute Laval University, Québec, QC, Canada, 2CHU de Quebec Research Center, Québec, QC, Canada Objectives: Decision aids (DAs) increase values-based decisions and the use of options that are beneficial to the patients but are underused
We assessed whether adding a DA to education enhanced decisional conflict and the appropriate use of pharmacotherapy among asthma patients
Summary
PRS48 Exploring The Impact of Adding A Respiratory Dimension to The EQ5D-5L Hoogendoorn M1, Oppe M2, Boland MR1, Stolk E2, Goossens LM1, Rutten van Mölken M1 1Erasmus University Rotterdam, Rotterdam, The Netherlands, 2EuroQol Research Foundation, Rotterdam, The Netherlands Objectives: To evaluate the impact of adding a respiratory dimension (a bolt-on dimension) on EQ-5D-5L health state valuations. We assessed whether adding a DA to education enhanced decisional conflict and the appropriate use of pharmacotherapy among asthma patients. Conclusions: Addition of a respiratory bolt-on on breathing problems or on limitations in physical activities due to shortness of breath to the EQ-5D-5L had a significant effect on the valuation of health states with severe levels of the bolt-on.
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