Application of the EQ-5D in the Middle East: A Systematic Review Focusing on Patients Living in the Kingdom of Saudi Arabia

Abstract

Patients' quality of life (QoL) and reported outcomes are critical indicators of the burden of a disease and the benefits of healthcare intervention. This systematic review explores publications that have adapted the EQ-5D for use with a population living in Saudi Arabia. The review of the following databases: MEDLINE, EMBASE, Wiley's Database, EBSCO, and ClinicalTrials.gov was conducted on December 1, 2020. The search strategy was adapted from the SPIDER search tool, and the included articles were classified by author, year of publication, region, disease of interest, sample size, type of EQ-5D, and format. Level of EQ-5D was classified as either 3L or 5L. Thirteen articles met the search inclusion criteria. The earliest publication was conducted in 2015 and the latest in 2020. These studies were conducted in four Saudi administrative regions, and multiple conditions or treatments were studied, the most studied condition being diabetes mellitus, followed by musculoskeletal disorders, back pain, and injuries. This systematic review article finds that the EQ-5D has been well adapted in the KSA. However, continued work is needed to investigate the quality of life for major conditions such as cardiovascular disease and cancer. Moreover, QoL research is lacking in certain regions, such as southern and northern Saudi Arabia. Despite the successful application and validation of the EQ-5D, a local QoL tool is needed to capture the unique context of patients within the healthcare system in the Middle East.

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“…There is an increasing trajectory in the use of the OHIP wherein post 2015, about 81% of the articles were published (18 articles), [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] and 2020 in particular accounted for most of these publications (10 articles). [27][28][29][30][31][32][33][34][35][36] This result aligns with the literature on QoL for various healthcare services in Saudi Arabia, where recent publications focused on exploring quality of care among physicians, 48 pharmacists, 49 and nurses. 50 Healthcare researchers are expected to apply what has been a governmental goal in improving the quality of care after the launch of the Saudi Vision 2030.…”

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“…Using a scoring algorithm based on public preferences, the EQ- 5D-5L index value is calculated and ranges from 1 (perfect health) to values below zero (health states valued worse than death with zero defined as a state equivalent to death) [ 14 , 15 ]. Although the EQ-5D-5L instrument has been used in several patient populations in Saudi Arabia, there are no validated value sets that can be applied to critically ill patients [ 16 ]. Therefore, we calculated the index values based on the United States EQ-5D-5L value set [ 17 ].…”