Harvard Medical School, Boston, MA, USA.
Semin Arthritis Rheum. 2010 Apr;39(5):384-97. doi: 10.1016/j.semarthrit.2008.10.005. Epub 2008 Dec 18.
Psoriatic arthritis (PsA) is a seronegative inflammatory arthritis found in up to 5 to 42% of patients with psoriasis. As current instruments do not fully capture health-related quality of life (HR-QOL) in PsA from the patient's perspective, we piloted a novel application of "willingness-to-pay" (WTP) as a Patient Reported Outcome to measure the relative impact of PsA in 8 domains of HR-QOL.
Fifty-nine PsA patients were interviewed on 8 WTP HR-QOL domains (physical, emotional, sleep, work, social, self-care, intimacy, and concentration). Participants were asked to rank the 8 domains of health in order of HR-QOL impact. In each domain, participants were asked whether PsA affected that domain, whether they were willing to pay for a cure in that domain, and the amount they were willing to pay. Median WTP amounts were compared with the proportion of participants affected by and willing to pay in each domain. Responses in US dollars were interpreted as strength of preference rather than absolute monetary values.
The majority of participants were white (98%), > or =45 years of age (70%), insured (98%), and earned >$65,000/yr (66%). The physical domain was most affected by PsA; intimacy and concentration were ranked lowest. Participants reported a wide range of WTP amounts ($0 to $1,000,000), and median WTP amounts were highest in the physical, work, sleep, and self-care domains. Related domains elicited median WTP amounts that were highly correlated. No significant differences in median WTP amounts were found across ages, genders, and income levels for the different domains.
WTP is a novel quantitative patient-perspective measure that is comprehensible and feasible to administer in PsA patients. It represents a unique tool for capturing the complex manifestations of PsA and its impact on the individual, allowing the quantification of specific HR-QOL parameters and providing the potential for comparison across various disease processes in a given individual.
银屑病关节炎（PsA）是一种血清阴性炎症性关节炎，在多达 5%至 42%的银屑病患者中发现。由于目前的工具不能完全从患者的角度捕捉到银屑病关节炎相关的健康相关生活质量（HR-QOL），我们初步尝试将“支付意愿”（WTP）作为一种患者报告的结果，用于衡量 8 个 HR-QOL 领域中 PsA 的相对影响。
对 59 名 PsA 患者进行了 8 个 WTP HR-QOL 领域（身体、情感、睡眠、工作、社交、自我护理、亲密和注意力）的访谈。参与者被要求按 HR-QOL 影响的顺序对 8 个健康领域进行排名。在每个领域，参与者被问及 PsA 是否影响该领域，他们是否愿意为该领域的治愈支付费用，以及他们愿意支付的金额。中位数 WTP 金额与受影响和愿意支付的参与者比例进行了比较。以美元表示的反应仅表示偏好强度，而不是绝对货币价值。
大多数参与者为白人（98%），年龄≥45 岁（70%），有保险（98%），年收入超过 65,000 美元（66%）。身体领域受 PsA 影响最大；亲密和注意力排在最后。参与者报告了广泛的 WTP 金额（0 至 100 万美元），中位数 WTP 金额在身体、工作、睡眠和自我护理领域最高。相关领域的中位数 WTP 金额高度相关。不同领域的年龄、性别和收入水平之间的中位数 WTP 金额没有显著差异。
WTP 是一种新颖的定量患者视角衡量标准，在 PsA 患者中是可以理解和可行的。它代表了一种独特的工具，可以捕捉到 PsA 的复杂表现及其对个体的影响，允许对特定的 HR-QOL 参数进行量化，并提供在个体中比较各种疾病过程的潜力。
