Subjective health expectations of patients with age-related macular degeneration treated with antiVEGF drugs

BMC Geriatrics

Research Article

Petra Baji¹  László Gulácsi¹  Márta Péntek¹  Valentin Brodszky¹  Fanni Rencz²  Zsófia Kölkedi³  Zsolt Biró³  Miklós D. Resch⁴  János Németh⁴  Árpád Dunai⁴ 

[1] Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, 1093, Budapest, Hungary;Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, 1093, Budapest, Hungary;Clinical Medicine Doctoral School, Semmelweis University Budapest, Ulloi u. 26, 1085, Budapest, Hungary;Department of Ophthalmology, Pécs University of Sciences, Nyár u. 8, 7624, Pécs, Hungary;Department of Ophthalmology, Semmelweis University Budapest, Mária u. 39, 1085, Budapest, Hungary;

关键词: Age-related macular degeneration;    Health-related quality of life;    EQ-5D;    Time trade-off;    Subjective life-expectancy;    Health expectations;   

DOI  :  10.1186/s12877-017-0619-9

 received in 2016-08-30, accepted in 2017-10-02,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundSubjective expectations regarding future health may influence patients’ judgement of current health and treatment effects, as well as adherence to therapies in chronic diseases. We aimed to explore subjective expectations on longevity and future health-related quality of life (HRQOL) of patients with age-related macular degeneration (AMD) treated with antiVEGF injections and analyse the influencing factors.MethodsConsecutive AMD patients in two ophthalmology centres were included. Demographics, clinical characteristics and informal care utilisation were recorded. Current health was evaluated by the EQ-5D generic health status questionnaire and time trade-off (TTO) methods. Happiness was measured on a visual analogue scale (VAS). Subjective life-expectancy and expected EQ-5D status at ages 70, 80 and 90 were surveyed. T-test was applied to compare subgroups and Pearson correlations were performed to analyse relationships between variables.ResultsOne hundred twenty two patients were involved (females 62%) with a mean (SD) age of 75.2 (7.9) years and disease duration of 2.9 (2.5) years. The majority were in AREDS-4 state, the better eye’s ETDRS was 64.7 (15.4). EQ-5D and TTO revealed moderate deterioration of health (0.66 vs. 0.72, p = 0.131), happiness VAS was 6.3 (2.2). Correlation between EQ-5D and ETDRS was moderate (R = 0.242, p < 0.05) and having both versus one eye in AREDS-4 resulted lower TTO (0.68 vs. 0.83; p = 0.013). Subjective life-expectancy did not differ significantly from statistical life-expectancy and had no significant impact on TTO. The self-estimated mean EQ-5D score was 0.60, 0.40 and 0.24 for ages 70, 80 and 90 which is lower than the population norm of age-groups 65–74, 75–84 and 85+ (0.77, 0.63 and 0.63, respectively). Age, gender, current EQ-5D, need for informal care and happiness were deterministic factors of subjective health expectations.ConclusionAMD patients with antiVEGF treatment have comparable HRQOL as the age-matched general public but expect a more severe deterioration of health with age. Older patients with worse HRQOL have worse subjective expectations. Exploring patients’ health expectations provides an opportunity for ophthalmologists to correct misperceptions and improve the quality of AMD care. Further studies should provide evidences on the relationship between subjective expectations and actual health outcomes, and on its impact on patients’ AMD-specific health behaviour.

【 授权许可】

CC BY   
© The Author(s). 2017