An Exploratory Study of Long-Term Publicly Waitlisted Bariatric Surgery Patients’ Quality of Life Before and 1 Year After Bariatric Surgery, and Considerations for Healthcare Planners

被引：13
作者：
Campbell J.A. [1 ]
Hensher M. [2 ]
Neil A. [1 ]
Venn A. [1 ]
Wilkinson S. [3 ]
Palmer A.J. [1 ]
机构：
[1] Menzies Institute for Medical Research, University of Tasmania, Medical Sciences 2 Building, 17 Liverpool Street, Hobart, 7000, TAS
[2] Department of Health and Human Services, Level 2, 22 Elizabeth Street, Hobart, 7000, TAS
[3] Royal Hobart Hospital, 48 Liverpool Street, Hobart, 7000, TAS
来源：
PharmacoEconomics - Open | 2018年 / 2卷 / 1期
基金：
英国医学研究理事会;
关键词：
D O I：
10.1007/s41669-017-0038-z
中图分类号：
学科分类号：
摘要：
Background: Long-term publicly waitlisted bariatric surgery patients typically experience debilitating physical/psychosocial obesity-related comorbidities that profoundly affect their quality of life. Objectives: We sought to measure quality-of-life impacts in a study population of severely obese patients who had multiyear waitlist times and then underwent bariatric surgery. Methods: Participants were recruited opportunistically following a government-funded initiative to provide bariatric surgery to morbidly obese long-term waitlisted patients. Participants self-completed the EQ-5D-5L and AQoL-8D questionnaires pre- and postoperatively. Utility valuations (utilities) and individual/super dimension scores (AQoL-8D only) were generated. Results: Participants’ (n = 23) waitlisted time was mean [standard deviation (SD)] 6.5 (2) years, body mass index reduced from 49.3 (9.35) kg/m2 preoperatively to 40.8 (7.01) 1 year postoperatively (p = 0.02). One year utilities revealed clinical improvements (both instruments). AQoL-8D improved significantly from baseline to 1 year, with the change twice that of the EQ-5D-5L [EQ-5D-5L: mean (SD) 0.70 (0.25) to 0.78 (0.25); AQoL-8D: 0.51 (0.24) to 0.67 (0.23), p = 0.04], despite the AQoL-8D’s narrower algorithmic range. EQ-5D-5L utility plateaued from 3 months to 1 year. AQoL-8D 1-year utility improvements were driven by Happiness/Coping/Self-worth (p < 0.05), and the Psychosocial super dimension score almost doubled at 1 year (p < 0.05). AQoL-8D revealed a wider dispersion of individual utilities. Conclusions: Ongoing improvements in psychosocial parameters from 3 months to 1 year post-surgery accounted for improvements in overall utilities measured by the AQoL-8D that were not detected by EQ-5D-5L. Selection of a sensitive instrument is important to adequately assess changes in quality of life and to accurately reflect changes in quality-adjusted life-years for cost-utility analyses and resource allocation in a public healthcare resource-constrained environment. © 2017, The Author(s).
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页码：63 / 76
页数：13
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