Department of Pain and Anaesthesia, The James Cook University Hospital, Middlesbrough, UK.
Eur J Health Econ. 2010 Jun;11(3):323-30. doi: 10.1007/s10198-009-0178-x. Epub 2009 Aug 13.
There is an absence of data on public preferences for health states (HSs) associated with severe chronic pain. The aim of this study was to develop accurate HS descriptions for severe chronic pain requiring intrathecal (IT) therapy and to derive utility weights that describe the health-related quality of life (HRQL) impact of chronic pain associated with malignant (MP) and non-malignant (NMP) aetiologies.
Eight visual analogue scale pain index (VAS-PI) HSs were defined using ranges 0-40, 41-60, 61-80 and 81-100 applied to both MP and NMP. Additionally, eight HSs representing common adverse events associated with IT therapy were identified. The content and description of the HSs were ascertained by interviews with five United Kingdom clinical experts. In total, 16 HSs were compiled. These HS descriptions and HS questionnaires were administered to 102 members of the public, utilising a time trade off (TTO) approach to estimate utilities for the HSs.
Participants generally were well matched to the general public in England and Wales, with some differences in mean age, race and education. A substantial decline in utility was observed with more severe VAS-PI values. The mean TTO utility values also decreased from mild pain to severe pain. Participants were able to differentiate between the side effects.
The study shows a clear decrement in utility moving from different severity levels of severe chronic pain.
目前缺乏有关严重慢性疼痛相关健康状态（HSs）的公众偏好数据。本研究旨在为需要鞘内（IT）治疗的严重慢性疼痛开发准确的 HS 描述，并得出描述与恶性（MP）和非恶性（NMP）病因相关慢性疼痛相关的健康相关生活质量（HRQL）影响的效用权重。
使用适用于 MP 和 NMP 的 0-40、41-60、61-80 和 81-100 范围，定义了 8 个视觉模拟量表疼痛指数（VAS-PI）HS。此外，确定了 8 个代表与 IT 治疗相关的常见不良反应的 HS。通过对 5 位英国临床专家的访谈，确定了 HS 的内容和描述。总共编制了 16 个 HS。这些 HS 描述和 HS 问卷被提交给了 102 名公众成员，使用时间权衡（TTO）方法来估计 HS 的效用。
参与者在年龄、种族和教育程度方面与英格兰和威尔士的一般公众基本匹配，但存在一些差异。随着 VAS-PI 值的增加，效用明显下降。TTO 效用的平均值也从轻度疼痛下降到严重疼痛。参与者能够区分副作用。
该研究表明，从不同严重程度的严重慢性疼痛向更严重程度的疼痛转变，效用明显下降。
