HEALTH-RELATED QUALITY OF LIFE MEASURES FAIL TO CAPTURE PART OF THE BROADER IMPACT OF DISEASE ON SUBJECTIVE WELL-BEING

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Posted: Wednesday, August 6, 2014

London, United Kingdom - With the growing recognition that significantly increased Gross Domestic Product, wealth and health in the western world over the past 50 years has not increased levels of happiness, governments and organizations have started to look for alternative subjective measures of happiness to reflect the welfare of society, and thus inform public policy decisions.

As a result, in the context of health, there is a growing interest in understanding how measures of health-related quality of life relate to subjective well-being, and whether subjective well-being (SWB) could provide a basis for resource allocation decisions in the future. Researchers from the United Kingdom investigated the relationship between health-related quality of life, as measured by EQ-5D, and subjective well-being in Parkinson’s disease.

As detailed in, “A Study of the Relationship between Health and Subjective Well-Being in Parkinson’s Disease Patients,” the researchers administered a paper questionnaire, including the EQ-5D, four key subjective well-being questions taken from the Integrated Household Survey in England and other demographic details, to people with Parkinson’s disease (PD) in the UK. Responses were used to estimate multiple regression models explaining subjective well-being using the EQ-5D Index (UK weights), EQ-5D dimensions and EQ-VAS and patient socio-demographic characteristics.

A total of 199 responses were received. Regression analysis determined that the EQ-5D questionnaire, both its index and dimensions, have a moderate explanatory power for SWB in PD in terms of life satisfaction, life being worthwhile, happiness, and anxiety. Combining EQ-VAS and EQ-5D dimensions, especially anxiety/depression and, to a lesser extent, mobility, yielded the best-fitting models. Patients with PD living with partners or relatives are more likely than those living alone to report higher levels of SWB. However, Parkinson’s disease patients living in care homes report lower levels of subjective well-being than those living alone in the same health condition.

The researchers conclude that usual health-related quality of life measures can partially explain different well-being dimensions, yet they fail to capture part of the broader impact of disease on subjective well-being. The findings suggest that there may be a role for using SWB, as a complement to conventional generic measures of health-related quality of life, as a basis for evaluations, where 1) interventions may affect both health and social care outcomes, beyond those captured by measures such as the EQ-5D questionnaire, and 2) where it is important to be able to compare outcomes and resource allocation across different areas of the public sector. Further empirical research into the relationship between subjective well-being and EQ-5D longitudinally, and in different disease areas, is required, and further standardization of subjective well-being measures is recommended.


Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research as well as policy papers to help health care leaders make evidence-based decisions. The journal is published bi-monthly and has over 8,000 subscribers (clinicians, decision-makers, and researchers worldwide).

International Society for Pharmacoeconomics and Outcomes Research (ISPOR) is a nonprofit, international, educational and scientific organization that strives to increase the efficiency, effectiveness, and fairness of health care resource use to improve health. 

For more information: www.ispor.org

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