Neil, AL and Carr, VJ and Mackinnon, A and Foley, DL and Morgan, VA, Health-related quality of life in people living with psychotic illness, and factors associated with its variation, Value in Health, 21, (8) pp. 1002-1009. ISSN 1098-3015 (2018) [Refereed Article]
Copyright 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR)
Methods: The AQoL-4D was completed by 1613 individuals with an International Classification of Diseases, Tenth Revision, psychotic illness in the 2010 Australian National Survey of Psychosis. Utilities were assessed for this sample and 20 subgroups, and were compared with general population norms. Modified Cohen d was used as an index of effect size. Utilities were collapsed into 10 health-related quality-of-life (HRQOL) bands or decades.
Results: HRQOL in people with psychotic illness was half of the maximum achievable utility (half-"full health") with a mean utility of 0.49 (95% confidence interval [CI] 0.48–0.51), and showing substantial variability across subgroups. Participants with essentially normal functioning had the highest mean utility (0.72; 95% CI 0.68–0.77), and those with very poor perceived mental health had the lowest (0.22; 95% CI 0.18–0.26). These subgroups showed the most variability. Negative symptoms also gave rise to substantial variation. Among diagnostic categories, only depressive psychosis had a large effect relative to delusional disorders. The distribution of utilities in people with psychotic illness differed markedly from that in the general population, with 6.8% versus 47.2% having values in the highest decade (>0.90–1.00). Utilities were lower in every age group in people with psychosis.
Conclusions: Profound HRQOL impacts are revealed by the AQoL-4D in people with psychotic illness, and marked variations in utilities were observed for key subjective and objective measures. We provide a suite of utility values for economic modeling studies and recommend the AQoL-4D for assessing HRQOL in people with psychotic illness.
|Item Type:||Refereed Article|
|Keywords:||economic modeling, health inequalities, psychotic disorders, schizophrenia, utility assessment|
|Research Group:||Applied economics|
|Research Field:||Health economics|
|Objective Group:||Public health (excl. specific population health)|
|Objective Field:||Mental health|
|UTAS Author:||Neil, AL (Associate Professor Amanda Neil)|
|Web of Science® Times Cited:||4|
|Deposited By:||Menzies Institute for Medical Research|
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