Swipe om te navigeren naar een ander artikel
The negative impact of hypoglycaemic events on health-related quality of life (HRQoL) may be evaluated by attaching published disutilities to these events. It is suggested that the marginal negative impact of individual hypoglycaemic events on HRQoL may decrease as the overall frequency increases.
Using disutility values from a large-scale (>8,000 respondents), time trade-off (TTO) study, nonlinear regression curves were fitted to the total disutility of different frequencies of non-severe daytime and nocturnal hypoglycaemic events. Nonparametric bootstrapping was applied to characterise the uncertainty of the marginal disutility.
Power function regression curves were estimated at U d = 0.0141x 0.3393 and U d = 0.0221x 0.3277. An increase from 0 to 1 hypoglycaemic event per year produced a utility decrease of 0.0141 and 0.0221 for non-severe daytime and nocturnal events, respectively. An increase from 25 to 26 events per year produced a marginal impact of 0.0006 and 0.0008 for non-severe daytime and nocturnal events, respectively.
These data concur with the noted phenomenon of “first being worst” as regards hypoglycaemic events. This finding may reflect a coping mechanism on the part of patients, a maximum limit for trading off remaining lifetime or the nature of the study.
Applying nonlinear functions to the TTO data might improve the precision of the measured impact of hypoglycaemic events.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
UK Prospective Diabetes Study (UKPDS) Group. (1998). Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet, 352, 837–853. CrossRef
Hepburn, D. A. (1993). Symptoms of hypoglycemia. In B. M. Frier (Ed.), Hypoglycemia and diabetes: Clinical and physiological aspects. London: Edward Arnold.
American Diabetes Association Workgroup on Hypoglycaemia. (2005). Defining and reporting hypoglycemia in diabetes: A report from the American Diabetes Association workgroup on hypoglycemia. Diabetes Care, 28, 1245–1249. CrossRef
Yale, J.-F., Begg, I., Gerstein, H., Houlden, R., Jones, H., Maheux, P., et al. (2002). 2001 Canadian Diabetes Association clinical practice guidelines for the prevention and management of hypoglycemia in diabetes. Canadian Journal of Diabetes, 26, 22–35.
Donnelly, L. A., Morris, A. D., Frier, B. M., Ellis, J. D., Donnan, P. T., Durrant, R., et al. (2009). Frequency and predictors of hypoglycaemia in Type 1 and insulin-treated Type 2 diabetes: A population-based study. Diabetic Medicine, 22, 749–755. CrossRef
National Institute for Health and Clinical Excellence. (2013). Guide to the methods of technology appraisal. http://www.nice.org.uk/media/B52/A7/TAMethodsGuideUpdatedJune2008.pdf. Accessed May 2013.
National Institute for Health and Care Excellence. (2013). Process and methods guides. Guide to methods of technology appraisal. http://www.nice.org.uk/media/D45/1E/GuideToMethodsTechnologyAppraisal2013.pdf. Accessed Aug 2013.
CADTH. (2006). HTA Guidelines for the economic evaluation of health technologies: Canada 3rd Edition. http://www.cadth.ca/media/pdf/186_EconomicGuidelines_e.pdf. Accessed Aug 2013.
Scottish Medicines Consortium. (2013). Guidance to manufacturers for completion of new product assessment form (NPAF). http://www.scottishmedicines.org.uk/Submission_Process/Submission_Guidance_and_Templates_for_Industry/Templates-Guidance-for-Submission/Templates-Guidance-for-Submission. Accessed Aug 2013.
TLV. (2013). Läkemedelsförmånsnämndens allmänna råd. Läkemedelsförmånsnämndens allmänna råd om ekonomiska utvärderingar. http://www.tlv.se/Upload/Lagar_och_foreskrifter/LAG-lfnar-2003-2.pdf. Accessed Aug 2013.
Evans, M., Khunti, K., Mamdani, M., Galbo-Jørgensen, C., Gundgaard, J., Bøgelund, M., et al. (2013). Health-related quality of life associated with daytime and nocturnal hypoglycaemic events: A time trade-off survey in five countries. Health and Quality of Life Outcomes, 11, 90. doi: 10.1186/1477-7525-11-90. PubMedCrossRefPubMedCentral
Efron, B., & Tibshirani, R. (1993). An introduction to the bootstrap. Boca Raton, FL: Chapman and Hall/CRC. CrossRef
Marrett, E., Radican, L., Davies, M. J., & Zhang, Q. (2011). Assessment of severity and frequency of self-reported hypoglycemia on quality of life in patients with type 2 diabetes treated with oral antihyperglycemic agents: A survey study. BMC Research Notes, 4, 251. doi: 10.1186/1756-0500-4-251. PubMedCrossRefPubMedCentral
Greene, W. H. (1999). Econometric analysis (4th ed.). Upper Saddle River, New Jersey: Prentice Hall.
Briggs, A., Claxton, K., & Sculpher, M. (2006). Decision modelling for health economic evaluation. UK: Oxford.
Wooldridge, J. M. (2012). Introductory econometric analysis: A modern approach south-western/CENGAGE learning (4th ed.). UK: Hampshire.
Harris, S. B., Khunti, K., Landin-Olsson, M., Galbo-Jørgensen, C. B., Bøgelund, M., Chubb, M., et al. (2013). Descriptions of health states associated with increasing severity and frequency of hypoglycemia: A patient-level perspective. Patient Preference and Adherence, 16, 925–936. CrossRef
Feeny, D. (2005). Preference-based measures: Utility and quality-adjusted life years, Chapter 6.2. In P. Fayers & R. Hays (Eds.), Assessing quality of life in clinical trials (2nd ed., pp. 405–429). Oxford: Oxford University Press.
- Diminishing marginal disutility of hypoglycaemic events: results from a time trade-off survey in five countries
Jørgen T. Lauridsen
Henrik Holm Jensen
- Springer International Publishing