Health Related Quality of Life among Patients with Tuberculosis and HIV in Thailand
Open Access
- 11 January 2012
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 7 (1), e29775
- https://doi.org/10.1371/journal.pone.0029775
Abstract
Health utilities of tuberculosis (TB) patients may be diminished by side effects from medication, prolonged treatment duration, physical effects of the disease itself, and social stigma attached to the disease. We collected health utility data from Thai patients who were on TB treatment or had been successfully treated for TB for the purpose of economic modeling. Structured questionnaire and EuroQol (EQ-5D) and EuroQol visual analog scale (EQ-VAS) instruments were used as data collection tools. We compared utility of patients with two co-morbidities calculated using multiplicative model (UCAL) with the direct measures and fitted Tobit regression models to examine factors predictive of health utility and to assess difference in health utilities of patients in various medical conditions. Of 222 patients analyzed, 138 (62%) were male; median age at enrollment was 40 years (interquartile range [IQR], 35–47). Median monthly household income was 6,000 Baht (187 US$; IQR, 4,000–15,000 Baht [125–469 US$]). Concordance correlation coefficient between utilities measured using EQ-5D and EQ-VAS (UEQ-5D and UVAS, respectively) was 0.6. UCAL for HIV-infected TB patients was statistically different from the measured UEQ-5D (p-valueVAS (p-valueEQ-5D included age and monthly household income. Patients aged ≥40 years old rated UEQ-5D significantly lower than younger persons. Higher UEQ-5D was significantly associated with higher monthly household income in a dose response fashion. The median UEQ-5D was highest among patients who had been successfully treated for TB and lowest among multi-drug resistant TB (MDR-TB) patients who were on treatment. UCAL of patients with two co-morbidities overestimated the measured utilities, warranting further research of how best to estimate utilities of patients with such conditions. TB and MDR-TB treatments impacted on patients' self perceived health status. This effect diminished after successful treatment.Keywords
This publication has 41 references indexed in Scilit:
- Interviewer versus self-administered health-related quality of life questionnaires - Does it matter?Health and Quality of Life Outcomes, 2011
- Tuberculosis and HIV co-infection: its impact on quality of lifeHealth and Quality of Life Outcomes, 2009
- HIV care and treatment factors associated with improved survival during TB treatment in Thailand: an observational studyBMC Infectious Diseases, 2009
- Personal and Societal Health Quality Lost to TuberculosisPLOS ONE, 2009
- Measuring health-related quality of life in tuberculosis: a systematic reviewHealth and Quality of Life Outcomes, 2009
- Why Is Long-Term Therapy Required to Cure Tuberculosis?PLoS Medicine, 2007
- Multidrug-resistant Tuberculosis Management in Resource-limited SettingsEmerging Infectious Diseases, 2006
- ???Death??? and the Valuation of Health-Related Quality of LifeMedical Care, 2001
- Treatment of Multidrug-Resistant TuberculosisNew England Journal of Medicine, 1993
- EuroQol - a new facility for the measurement of health-related quality of lifeHealth Policy, 1990