scholarly journals Measurement properties of EQ-5D-3L and EQ-5D-5L in recording self-reported health status in older patients with substantial multimorbidity and polypharmacy

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Arjun Bhadhuri ◽  
Paul Kind ◽  
Paola Salari ◽  
Katharina Tabea Jungo ◽  
Benoît Boland ◽  
...  

Abstract Background The EQ-5D-3L and EQ-5D-5L are two generic health-related quality of life measures, which may be used in clinical and health economic research. They measure impairment in 5 aspects of health: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The aim of this study was to assess the performance of the EQ-5D-3L and EQ-5D-5L in measuring the self-reported health status of older patients with substantial multimorbidity and associated polypharmacy. Methods Between 2017 and 2019, we administered EQ-5D-3L and EQ-5D-5L to a subset of patients participating in the OPERAM trial at 6 months and 12 months after enrolment. The OPERAM trial is a two-arm multinational cluster randomised controlled trial of structured medication review assisted by a software-based decision support system versus usual pharmaceutical care, for older people (aged ≥ 70 years) with multimorbidity and polypharmacy. In the psychometric analyses, we only included participants who completed the measures in full at 6 and 12 months. We assessed whether responses to the measures were consistent by assessing the proportion of EQ-5D-5L responses, which were 2 or more levels away from that person’s EQ-5D-3L response. We also compared the measures in terms of informativity, and discriminant validity and responsiveness relative to the Barthel Index, which measures independence in activities of daily living. Results 224 patients (mean age of 77 years; 56% male) were included in the psychometric analyses. Ceiling effects reported with the EQ-5D-5L (22%) were lower than with the EQ-5D-3L (29%). For the mobility item, the EQ-5D-5L demonstrated better informativity (Shannon’s evenness index score of 0.86) than the EQ-5D-3L (Shannon’s evenness index score of 0.69). Both the 3L and 5L versions of EQ-5D demonstrated good performance in terms of discriminant validity, i.e. (out of all items of the EQ-5D-3L and EQ-5D-5L, the pain/discomfort and anxiety/depression items had the weakest correlation with the Barthel Index. Both the 3L and 5L versions of EQ-5D demonstrated good responsiveness to changes in the Barthel Index. Conclusion Both EQ-5D-3L and EQ-5D-5L demonstrated validity and responsiveness when administered to older adults with substantial multimorbidity and polypharmacy who were able to complete the measures.

2016 ◽  
Vol 24 (6) ◽  
pp. 750-760 ◽  
Author(s):  
Arlette J Ngoubene-Atioky ◽  
Claudette Williamson-Taylor

This study examined whether Sub-Saharan African adult immigrants maintained cultural preferences for curvier/higher body size post-migration to the United States. Linear and multiple regression analyses were utilized to discern the predicting effects of Sub-Saharan African immigrants’ body mass index score on their self-reported health status at two post-migration data collection points. The initial assessment reveals that Sub-Saharan African immigrants’ overweight body mass index score predicted better self-reported health status. Four to six years later, higher body mass index score predicted a better self-reported health status and lower dietary acculturation moderated the predicting effect of body mass index on self-reported health status. Limitations of the study and implications for research and practice are explored.


2013 ◽  
Vol 12 (2) ◽  
pp. 106-120 ◽  
Author(s):  
Chloe Morris ◽  
Kenneth James ◽  
Desmale Holder-Nevins ◽  
Denise Eldemire-Shearer

2001 ◽  
Vol 7 (2) ◽  
pp. 85-98 ◽  
Author(s):  
Evelyn P. Whitlock

We investigated HMO members' use of complementary and alternative medicine (CAM) providers outside the HMO in 1995-1996. A random 2% survey of Kaiser Permanente Northwest members addressed HMO service satisfaction, self-reported health status and behaviors, and HMO utilization. Among respondents, 15.7% (n = 380) used CAM providers (chiropractors, naturopaths, acupuncturists, others) in the prior 12 months, while 35% were ever users. Multivariate analysis found that those more likely to consult CAM providers were females, more educated, and more dissatisfied with the HMO. These results suggest that HMOs may wish to focus efforts to improve patient satisfaction among CAM service users.


BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017865 ◽  
Author(s):  
Neda Khalil Zadeh ◽  
Kirsten Robertson ◽  
James A Green

ObjectivesThe factors determining individuals’ self-reported behavioural responses to direct to consumer advertising of prescription drugs were explored with an emphasis on ‘at-risk’ individuals’ responses.DesignNationally representative cross-sectional survey.SettingCommunity living adults in New Zealand.Participants2057 adults (51% women).Primary outcome measuresSelf-reported behavioural responses to drug advertising (asking a physician for a prescription, asking a physician for more information about an illness, searching the internet for more information regarding an illness and asking a pharmacist for more information about a drug).MethodsMultivariate logistic regressions determined whether participants’ self-reported behavioural responses to drug advertising were predicted by attitudes towards advertising and drug advertising, judgements about safety and effectiveness of advertised drugs, self-reported health status, materialism, online search behaviour as well as demographic variables.ResultsIdentifying as Indian and to a less extent Chinese, Māori and ‘other’ ethnicities were the strongest predictors of one or more self-reported responses (ORs 1.76–5.00, Ps<0.05). Poorer self-reported health status (ORs 0.90–0.94, all Ps<0.05), favourable attitude towards drug advertising (ORs 1.34–1.61, all Ps<0.001) and searching for medical information online (ORs 1.32–2.35, all Ps<0.01) predicted all self-reported behavioural outcomes. Older age (ORs 1.01–1.02, Ps<0.01), less education (OR 0.89, P<0.01), lower income (ORs 0.89–0.91, Ps<0.05) and higher materialism (ORs 1.02–1.03, Ps<0.01) also predicted one or more self-reported responses.ConclusionsTaken together, the findings suggest individuals, especially those who are ‘at-risk’ (ie, with poorer self-reported health status, older, less educated, lower income and ethnic minorities), may be more vulnerable to drug advertising and may make uninformed decisions accordingly. The outcomes raise significant concerns relating to the ethicality of drug advertising and suggest a need for stricter guidelines to ensure that drug advertisements provided by pharmaceutical companies are ethical.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
SangNam Ahn ◽  
Seonghoon Kim ◽  
Kanghyock Koh

Abstract Background The COVID–19 pandemic has challenged the capacity of healthcare systems around the world and can potentially compromise healthcare utilization and health outcomes among non-COVID–19 patients. Objectives To examine the associations of the COVID-19 pandemic with healthcare utilization, out-of-pocket medical costs, and perceived health among middle-aged and older individuals in Singapore. Method Utilizing data collected from a monthly panel survey, a difference-in-differences approach was used to characterize monthly changes of healthcare use and spending and estimate the probability of being diagnosed with a chronic condition and self-reported health status before and during the COVID-19 outbreak in 2020. Subjects Data were analyzed from 7569 nationally representative individuals from 2019 January and 2020 December. Measures Healthcare utilization and healthcare spending by medical service categories as well as self-reported health status. Results Between January and April 2020 (the first peak period of COVID-19 in Singapore), doctor visits decreased by 30%, and out-of-pocket medical spending decreased by 23%, mostly driven by reductions in inpatient and outpatient care. As a result, the probability of any diagnosis of chronic conditions decreased by 19% in April 2020. The decreased healthcare utilization and spending recovered after lifting the national lockdown in June, 2020 and remained similar to the pre-pandemic level through the rest of 2020. Conclusions Middle-aged and older Singaporeans’ healthcare utilization and the diagnosis of chronic conditions substantially decreased during the first peak period of the COVID-19 outbreak. Further studies to track the longer-term health effect of the pandemic among non-COVID-19 patients are warranted.


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