PUK35 - WORK PRODUCTIVITY AND EQ-5D UTILITY OF PATIENTS WITH CHRONIC KIDNEY DISEASE BY ANEMIA SEVERITY: POOLED RESULTS FROM THREE CROSS-SECTIONAL INTERNATIONAL SURVEYS

Abstract

Patients with chronic kidney disease (CKD) frequently suffer from the low hemoglobin (Hb) levels that define anemia, which is associated with reduced quality of life (QOL). This study aims to determine the association between anemia and work productivity and derive health state utility values for various Hb levels in patients with CKD. Data were extracted from the 2012, 2015 and 2018 Adelphi CKD Disease Specific Programmes; point-in-time surveys with physicians and a random sample of their CKD patients across France, Germany, Italy, Spain, United Kingdom (EU5), USA and China. Demographics and disease characteristics (including Hb levels) were provided by the physicians. Patients completed the Work Productivity and Activity Impairment (WPAI) and the EuroQol-5D-3L (EQ-5D) questionnaires. Descriptive analyses were performed on WPAI and EQ-5D utilities, and the latter was dichotomized (<0.8 or ≥0.8) and additionally analyzed through logistic regression, with Hb level as a continuous variable and adjusting for age, sex, CKD stage, common comorbidities and CV risk. WPAI and EQ-5D results were available for 4248 and 4538 patients, respectively, and 38% were dialysis dependent (DD). Mean population age was 61.1 (SD 14.29) and 16% were working full-time. Overall work and activity impairment was higher in patients with lower Hb levels. In non-DD patients, 38.2% of patients with Hb<10g/dL versus 22.5% with Hb>12g/dL reported work impairment. A similar pattern was observed in DD patients and across WPAI domains. EQ-5D utilities for Hb<10, 10-12 and >12 g/dL were 0.74, 0.79 and 0.85 for non-DD patients and 0.7, 0.73 and 0.77 for DD patients. Higher Hb levels were significantly associated with the probability of a utility score of ≥0.8 (p<0.0001). In this large population sample, there was a consistent association between lower Hb levels, work & activity impairment and reduced EQ-5D utility scores, which was strongest in non-DD CKD.