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Health-related quality of life advantage of long-acting injectable antipsychotic treatment for schizophrenia: a time trade-off study.

Osborne RH, Dalton A, Hertel J, Schrover R, Smith DK - Health Qual Life Outcomes (2012)

Bottom Line: Ninety-eight people completed the TTO interview.The vignettes were presented in random order to prevent possible ordering effects.The treated health states were rated at much higher utilities and were statistically significantly different (p < 0.001) from each other: (1) 2-weekly: mean (median) utility = 0.61 (0.65); (2) 4-weekly: mean (median) utility = 0.65 (0.70); (3) 3-monthly: mean (median) utility = 0.70 (0.75).

View Article: PubMed Central - HTML - PubMed

Affiliation: Public Health Innovation, Population Health Strategic Research Centre, Deakin University, 221 Burwood Highway, Burwood, VIC, Australia. richard.osborne@deakin.edu.au

ABSTRACT

Background: This study was undertaken to estimate utility values for alternative treatment intervals for long acting antipsychotic intramuscular injections for the treatment of schizophrenia.

Methods: Vignettes were developed using the published literature and an iterative consultation process with expert clinicians and patient representative groups. Four vignettes were developed. The first was a vignette of relapsed/untreated schizophrenia. The other three vignettes presented a standardised picture of well-managed schizophrenia with variations in the intervals between injections: once every 2-weeks, 4-weeks and 3-months. A standardised time trade off (TTO) approach was used to obtain utility values for the vignettes. As a societal perspective was sought, a representative sample of individuals from across the community (Sydney, Australia) was recruited. Ninety-eight people completed the TTO interview. The vignettes were presented in random order to prevent possible ordering effects.

Results: A clear pattern of increasing utility was observed with increasing time between injections. Untreated schizophrenia was rated as very poor health-related quality of life with a mean (median) utility of 0.27 (0.20). The treated health states were rated at much higher utilities and were statistically significantly different (p < 0.001) from each other: (1) 2-weekly: mean (median) utility = 0.61 (0.65); (2) 4-weekly: mean (median) utility = 0.65 (0.70); (3) 3-monthly: mean (median) utility = 0.70 (0.75).

Conclusions: This study has provided robust data indicating that approximately a 0.05 utility difference exists between treatment options, with the highest utility assigned to 3-monthly injections.

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Related in: MedlinePlus

Frequency distribution of respondents scores across the four treatment regimens (0.0 = death equivalent health-related quality of life, 1.0 = full health).
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Figure 2: Frequency distribution of respondents scores across the four treatment regimens (0.0 = death equivalent health-related quality of life, 1.0 = full health).

Mentions: Scores within each vignette were distributed across the entire life/death scale, reflecting widely held beliefs or reactions to trading years of life in the TTO exercise, including the position of a minority of people who refused to trade. The few individuals who refused to trade or traded very little (i.e. with scores >0.80, n = 4) can be seen in Figure 2, Vignette 1 (untreated schizophrenia), at the extreme right of the dot plot. Given that only a few people did not trade, data from all individuals was included in the analysis.


Health-related quality of life advantage of long-acting injectable antipsychotic treatment for schizophrenia: a time trade-off study.

Osborne RH, Dalton A, Hertel J, Schrover R, Smith DK - Health Qual Life Outcomes (2012)

Frequency distribution of respondents scores across the four treatment regimens (0.0 = death equivalent health-related quality of life, 1.0 = full health).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369822&req=5

Figure 2: Frequency distribution of respondents scores across the four treatment regimens (0.0 = death equivalent health-related quality of life, 1.0 = full health).
Mentions: Scores within each vignette were distributed across the entire life/death scale, reflecting widely held beliefs or reactions to trading years of life in the TTO exercise, including the position of a minority of people who refused to trade. The few individuals who refused to trade or traded very little (i.e. with scores >0.80, n = 4) can be seen in Figure 2, Vignette 1 (untreated schizophrenia), at the extreme right of the dot plot. Given that only a few people did not trade, data from all individuals was included in the analysis.

Bottom Line: Ninety-eight people completed the TTO interview.The vignettes were presented in random order to prevent possible ordering effects.The treated health states were rated at much higher utilities and were statistically significantly different (p < 0.001) from each other: (1) 2-weekly: mean (median) utility = 0.61 (0.65); (2) 4-weekly: mean (median) utility = 0.65 (0.70); (3) 3-monthly: mean (median) utility = 0.70 (0.75).

View Article: PubMed Central - HTML - PubMed

Affiliation: Public Health Innovation, Population Health Strategic Research Centre, Deakin University, 221 Burwood Highway, Burwood, VIC, Australia. richard.osborne@deakin.edu.au

ABSTRACT

Background: This study was undertaken to estimate utility values for alternative treatment intervals for long acting antipsychotic intramuscular injections for the treatment of schizophrenia.

Methods: Vignettes were developed using the published literature and an iterative consultation process with expert clinicians and patient representative groups. Four vignettes were developed. The first was a vignette of relapsed/untreated schizophrenia. The other three vignettes presented a standardised picture of well-managed schizophrenia with variations in the intervals between injections: once every 2-weeks, 4-weeks and 3-months. A standardised time trade off (TTO) approach was used to obtain utility values for the vignettes. As a societal perspective was sought, a representative sample of individuals from across the community (Sydney, Australia) was recruited. Ninety-eight people completed the TTO interview. The vignettes were presented in random order to prevent possible ordering effects.

Results: A clear pattern of increasing utility was observed with increasing time between injections. Untreated schizophrenia was rated as very poor health-related quality of life with a mean (median) utility of 0.27 (0.20). The treated health states were rated at much higher utilities and were statistically significantly different (p < 0.001) from each other: (1) 2-weekly: mean (median) utility = 0.61 (0.65); (2) 4-weekly: mean (median) utility = 0.65 (0.70); (3) 3-monthly: mean (median) utility = 0.70 (0.75).

Conclusions: This study has provided robust data indicating that approximately a 0.05 utility difference exists between treatment options, with the highest utility assigned to 3-monthly injections.

Show MeSH
Related in: MedlinePlus