Matza Louis S, Devine Mary K, Haynes Virginia Sutton, Davies Evan W, Kostelec Jacqueline M, Televantou Foula, Jordan Jessica B
Outcomes Research, Evidera, Bethesda, MD, USA.
Eli Lilly and Company, Indianapolis, IN, USA.
Patient Prefer Adherence. 2014 Jul 17;8:997-1006. doi: 10.2147/PPA.S62776. eCollection 2014.
With growing awareness of the importance of adult attention-deficit/hyperactivity disorder (ADHD) treatment, cost-effectiveness analyses, including utilities, are needed to compare the value of treatment options. Although utilities have been reported for childhood ADHD, little is known about utilities representing adult ADHD. Therefore, the purpose of this study was to estimate utilities associated with adult ADHD.
Health-state descriptions of adult ADHD were drafted based on literature review, interviews with four clinicians, and clinical trial data. Health states were revised based on a pilot study with 26 participants. Final health states were rated in time trade-off interviews with general population respondents in London and Edinburgh, UK.
A total of 158 participants completed interviews (mean age =47.0 years; 49.4% female; Edinburgh =80 participants). Mean (standard deviation [SD]) utilities were 0.82 (0.17), 0.68 (0.28), and 0.67 (0.28) for health states describing treatment responders (health state A), nonresponders (health state B), and untreated patients (health state C), respectively. Most participants rated health state A as preferable to B (n=92; 58.2%) and C (n=97; 61.4%). The majority rated B and C as equal (n=125; 79.1%). Paired Student's t-tests found that A had a significantly greater mean utility than B (t=10.0; P<0.0001) and C (t=10.2; P<0.0001).
The current study provides utilities that may be used in cost-utility models of treatment for adult ADHD. Results reflected clear differences between health states representing treatment responders and nonresponders/untreated patients. Current utilities were comparable to those previously reported for childhood ADHD.
随着对成人注意力缺陷多动障碍(ADHD)治疗重要性的认识不断提高,需要进行包括效用分析在内的成本效益分析,以比较治疗方案的价值。虽然已有关于儿童ADHD效用的报道,但对于代表成人ADHD的效用知之甚少。因此,本研究的目的是估计与成人ADHD相关的效用。
基于文献综述、对四位临床医生的访谈以及临床试验数据,起草了成人ADHD的健康状态描述。根据一项有26名参与者的预试验对健康状态进行了修订。最终的健康状态在英国伦敦和爱丁堡对普通人群受访者进行的时间权衡访谈中进行了评分。
共有158名参与者完成了访谈(平均年龄=47.0岁;49.4%为女性;爱丁堡=80名参与者)。描述治疗有反应者(健康状态A)、无反应者(健康状态B)和未治疗患者(健康状态C)的健康状态的平均(标准差[SD])效用分别为0.82(0.17)、0.68(0.28)和0.67(0.28)。大多数参与者将健康状态A评为优于B(n=92;58.2%)和C(n=97;61.4%)。大多数人将B和C评为相等(n=125;79.1%)。配对学生t检验发现,A的平均效用显著高于B(t=10.0;P<0.0001)和C(t=10.2;P<0.00)。
本研究提供了可用于成人ADHD治疗成本效用模型的效用。结果反映了代表治疗有反应者和无反应者/未治疗患者的健康状态之间的明显差异。当前的效用与先前报道的儿童ADHD的效用相当。