Systematic Literature Review of Health State Utility Values In Patients With Migraine

Abstract

GERAS is a prospective, non-interventional cohort study in AD patients and caregivers. The Zarit Burden Inventory (ZBI) and the EQ-5D were used to measure burden and HRQoL respectively. Spearman correlations were computed between EQ-5D, ZBI and T-IADL at baseline, 18-months and for change over 18-months. T-IADL and ZBI change scores were summarised by EQ-5D domain change category (better/stable/ worse). Results: 1495 caregivers were available at baseline [67 years (SD 12) and 64% female]. According to baseline patient severity, caregivers' EQ-5D health state values were 0.86, 0.85 and 0.82 and ZBI total scores were 25, 29 and 34 in mild, moderate and moderately severe/severe AD respectively. T-IADL increased from a mean of 79 hours (SD 89; median 60 hours) at baseline by a mean of 17 hours (SD 105; median 10 hours) over 18-months, and showed a stronger correlation with ZBI than with EQ-5D, although correlations were low for both (e.g. change scores 0.118 ZBI; 0.020 EQ-5D). Worsening within EQ-5D domains (mobility, self-care, usual activities, pain/ discomfort and anxiety/depression) was associated with the greatest increase in burden scores, although the majority of caregivers (68-90%) remained stable within each EQ-5D domain. Relative to these stable caregivers, larger increases in T-IADL over 18-months were associated with better ratings in mobility and usual activities but worsening in pain/discomfort. Larger increases in T-IADL were associated with both better and worse ratings in anxiety/depression [23.5 hours better (11%); 12.2 hours stable (68%); 24.8 hours worse (16%)]. ConClusions: EQ-5D health state values had low sensitivity to changes in caregiver time over an 18-month period. ZBI may better reflect the impact of caring for AD patients.

A real-world analysis of patient-reported outcomes in patients with migraine by preventive treatment eligibility status in the US and Europe

“…Previous studies have demonstrated reduced work productivity with greater headache frequencies [27,28]. In addition, the present study showed lower health utility scores, and health status ratings in the higher frequency subgroup (> 4 migraine headache days/month), which is consistent with previous studies [30].…”