Sobocki Patrik, Ekman Mattias, Agren Hans, Krakau Ingvar, Runeson Bo, Mårtensson Björn, Jönsson Bengt
Karolinska Institutet, Stockholm, Sweden.
Value Health. 2007 Mar-Apr;10(2):153-60. doi: 10.1111/j.1524-4733.2006.00162.x.
The objective of the present study was to assess the impact of depression on patients' health-related quality of life (HRQL) with the EQ-5D instrument over 6 months while on antidepressant treatment.
A total of 447 patients were recruited at 56 primary care centers to this naturalistic longitudinal observational study. Patients older than 18 years with depressive symptoms, and who initiated an antidepressant therapy because of depression were included in the study. Data on patients' sociodemographics, daily activity, and quality of life (EQ-5D) were collected using questionnaires completed during outpatient general practitioner visits for a follow-up period of 6 months.
The mean EQ-5D utility score at baseline was 0.47 (0.44-0.49). Milder cases of depression reported a health utility of 0.60, whereas moderately and severely depressed patients reported utility values of 0.46 and 0.27, respectively (P < 0.01). At end of follow up the average utility was 0.69 (0.67-0.72), corresponding to an increase of 0.23 over 6 months (P < 0.01). Regression analyses showed that, all else equal, patients who were on sick leave were associated with 10% lower utility.
Depression has a substantial impact on HRQL. Our results indicate that treatments for depression are associated with significant improvement in EQ-5D index score over a course of 6 months. Self-reported patient valuations are important outcomes for cost-utility analysis of new treatments for depression and the present study provides important evidence for future economic evaluations.
本研究的目的是使用EQ-5D工具评估在接受抗抑郁治疗的6个月期间,抑郁症对患者健康相关生活质量(HRQL)的影响。
在56个初级保健中心招募了447名患者参与这项自然主义纵向观察研究。纳入研究的患者年龄在18岁以上,有抑郁症状,且因抑郁症开始接受抗抑郁治疗。通过在门诊全科医生随访期间填写问卷,收集患者的社会人口统计学、日常活动和生活质量(EQ-5D)数据,随访期为6个月。
基线时EQ-5D效用评分的平均值为0.47(0.44 - 0.49)。轻度抑郁症患者的健康效用评分为0.60,而中度和重度抑郁症患者的效用值分别为0.46和0.27(P < 0.01)。随访结束时,平均效用为0.69(0.67 - 0.72),相当于6个月内增加了0.23(P < 0.01)。回归分析表明,在其他条件相同的情况下,休病假的患者效用低10%。
抑郁症对健康相关生活质量有重大影响。我们的结果表明,抑郁症治疗在6个月的疗程中与EQ-5D指数评分的显著改善相关。患者自我报告的评估是抑郁症新治疗成本效用分析的重要结果,本研究为未来的经济评估提供了重要证据。