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An exploratory study of long-term publicly waitlisted bariatric surgery patientsí quality of life before and 1 year after bariatric surgery, and considerations for healthcare planners

Citation

Campbell, JA and Hensher, M and Neil, A and Venn, A and Wilkinson, S and Palmer, AJ, An exploratory study of long-term publicly waitlisted bariatric surgery patients' quality of life before and 1 year after bariatric surgery, and considerations for healthcare planners, PharmacoEconomics - Open pp. 1-14. ISSN 2509-4254 (2017) [Refereed Article]


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DOI: doi:10.1007/s41669-017-0038-z

Abstract

Background: Long-term publicly waitlisted bariatric surgery patients typically experience debilitating physical/ psychosocial obesity-related comorbidities that profoundly affect their quality of life.

Objectives: We sought to measure quality-of-life impacts in a study population of severely obese patients who had multiyear waitlist times and then underwent bariatric surgery.

Methods: Participants were recruited opportunistically following a government-funded initiative to provide bariatric surgery to morbidly obese long-term waitlisted patients. Participants self-completed the EQ-5D-5L and AQoL-8D questionnaires pre- and postoperatively. Utility valuations (utilities) and individual/super dimension scores (AQoL- 8D only) were generated.

Results: Participantsí (n = 23) waitlisted time was mean [standard deviation (SD)] 6.5 (2) years, body mass index reduced from 49.3 (9.35) kg/m2 preoperatively to 40.8 (7.01) 1 year postoperatively (p = 0.02). One year utilities revealed clinical improvements (both instruments). AQoL-8D improved significantly from baseline to 1 year, with the change twice that of the EQ-5D-5L [EQ-5D-5L: mean (SD) 0.70 (0.25) to 0.78 (0.25); AQoL-8D: 0.51 (0.24) to 0.67 (0.23), p = 0.04], despite the AQoL-8Dís narrower algorithmic range. EQ-5D-5L utility plateaued from 3 months to 1 year. AQoL-8D 1-year utility improvements were driven by Happiness/ Coping/Self-worth (p <0.05), and the Psychosocial super dimension score almost doubled at 1 year (p <0.05). AQoL-8D revealed a wider dispersion of individual utilities.

Conclusions: Ongoing improvements in psychosocial parameters from 3 months to 1 year post-surgery accounted for improvements in overall utilities measured by the AQoL-8D that were not detected by EQ- 5D-5L. Selection of a sensitive instrument is important to adequately assess changes in quality of life and to accurately reflect changes in quality-adjusted life-years for cost-utility analyses and resource allocation in a public healthcare resource-constrained environment.

Item Details

Item Type:Refereed Article
Keywords:Health-related quality of life, bariatric surgery, long-term waitlisted, AQoL-8D, EQ-5D
Research Division:Economics
Research Group:Applied Economics
Research Field:Health Economics
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Evaluation of Health Outcomes
Author:Campbell, JA (Mrs Julie Nermut)
Author:Neil, A (Dr Amanda Neil)
Author:Venn, A (Professor Alison Venn)
Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:121560
Year Published:2017
Funding Support:National Health and Medical Research Council (1076899)
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-10-03
Last Modified:2017-10-17
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