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Value Health. 2017 Jul - Aug;20(7):976-984. doi: 10.1016/j.jval.2017.01.011. Epub 2017 May 12.

Estimating Health-State Utility Values in Kidney Transplant Recipients and Waiting-List Patients Using the EQ-5D-5L.

Author information

1
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK. Electronic address: bernadette.li@lshtm.ac.uk.
2
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
3
Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
4
Richard Bright Renal Unit, Southmead Hospital, Bristol, UK.
5
Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, UK.
6
NHS Blood and Transplant, Bristol, UK.
7
Scottish Renal Registry, Glasgow, UK.
8
Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
9
Department of Renal Medicine, Freeman Hospital, Newcastle upon Tyne, UK.
10
Department of Surgery, University of Cambridge and the NIHR Cambridge Biomedical Research Centre, Cambridge, UK.

Abstract

OBJECTIVES:

To report health-state utility values measured using the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) in a large sample of patients with end-stage renal disease and to explore how these values vary in relation to patient characteristics and treatment factors.

METHODS:

As part of the prospective observational study entitled "Access to Transplantation and Transplant Outcome Measures," we captured information on patient characteristics and treatment factors in a cohort of incident kidney transplant recipients and a cohort of prevalent patients on the transplant waiting list in the United Kingdom. We assessed patients' health status using the EQ-5D-5L and conducted multivariable regression analyses of index scores.

RESULTS:

EQ-5D-5L responses were available for 512 transplant recipients and 1704 waiting-list patients. Mean index scores were higher in transplant recipients at 6 months after transplant surgery (0.83) compared with patients on the waiting list (0.77). In combined regression analyses, a primary renal diagnosis of diabetes was associated with the largest decrement in utility scores. When separate regression models were fitted to each cohort, female gender and Asian ethnicity were associated with lower utility scores among waiting-list patients but not among transplant recipients. Among waiting-list patients, longer time spent on dialysis was also associated with poorer utility scores. When comorbidities were included, the presence of mental illness resulted in a utility decrement of 0.12 in both cohorts.

CONCLUSIONS:

This study provides new insights into variations in health-state utility values from a single source that can be used to inform cost-effectiveness evaluations in patients with end-stage renal disease.

KEYWORDS:

EQ-5D-5L; end-stage renal disease; health-state utility values; multivariable regression

PMID:
28712628
PMCID:
PMC5541449
DOI:
10.1016/j.jval.2017.01.011
[Indexed for MEDLINE]
Free PMC Article

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