Raspa M, Sacco P, Candrilli S D, Bishop E, Petrillo J
RTI International, Research Triangle Park, Durham, NC, USA.
Novartis Pharmaceuticals, East Hanover, NJ, USA.
J Intellect Disabil Res. 2016 Sep;60(9):844-55. doi: 10.1111/jir.12264. Epub 2016 Mar 1.
The purpose of this study was to assess the construct validity of the Aberrant Behaviour Checklist-utility index (ABC-UI) by examining the relationship between healthcare resource utilisation by patients with fragile X syndrome (FXS) as well as burden experienced by their caregivers.
In 2011, a total of 350 US caregivers of individuals with FXS completed a questionnaire that captured information on FXS-related burden as well as the ABC-Community. Using the ABC-UI, a condition-specific outcome measure derived from the ABC-Community, five utility index categories were created: very low (0.00-0.33); low (0.34-0.66); moderate (0.67-0.77); high (0.78-0.89); and very high (0.90-1.00). Multivariable regression models examined the association between the utility value and nine burden-related outcomes.
Approximately 2% of individuals with FXS were in the very low utility index category, 31% low, 27% moderate, 38% high and 3% very high. The median utility value was 0.74. Women with FXS and adults 18 years and older had higher values. Regression results indicate that individuals with higher utility values were more likely to have fewer specialist visits, use fewer prescription medications, need fewer hours of unpaid caregiving, inflict fewer caregiver injuries and have caregivers with fewer mental health provider visits.
The ABC-UI appears to function well as condition-specific outcome measure, and as an indicator of health-related quality-of-life and economic burden in individuals with FXS. Among patients with FXS in the US and their caregivers, significant differences in health care resource utilisation and burden exist across health state utility categories.
本研究的目的是通过检查脆性X综合征(FXS)患者的医疗资源利用情况与其照顾者所经历的负担之间的关系,来评估异常行为检查表效用指数(ABC-UI)的结构效度。
2011年,共有350名美国FXS患者的照顾者完成了一份问卷,该问卷收集了与FXS相关的负担以及ABC社区的信息。使用从ABC社区得出的特定疾病结局指标ABC-UI,创建了五个效用指数类别:极低(0.00 - 0.33);低(0.34 - 0.66);中度(0.67 - 0.77);高(0.78 - 0.89);以及极高(0.90 - 1.00)。多变量回归模型检查了效用值与九个负担相关结局之间的关联。
约2%的FXS患者处于极低效用指数类别,31%为低,27%为中度,38%为高,3%为极高。效用值中位数为0.74。患有FXS的女性以及18岁及以上的成年人效用值更高。回归结果表明,效用值较高的个体更有可能看专科医生的次数更少、使用的处方药更少、需要的无薪照顾时间更少、对照顾者造成的伤害更少,并且照顾者看心理健康提供者的次数更少。
ABC-UI似乎作为特定疾病结局指标以及FXS患者健康相关生活质量和经济负担的指标发挥良好作用。在美国FXS患者及其照顾者中,不同健康状态效用类别在医疗资源利用和负担方面存在显著差异。