Skip to main content
Top
Gepubliceerd in: Quality of Life Research 9/2020

07-04-2020

Parental health spillover effects of paediatric rare genetic conditions

Auteurs: You Wu, Hareth Al-Janabi, Andrew Mallett, Catherine Quinlan, Ingrid E. Scheffer, Katherine B. Howell, John Christodoulou, Richard J. Leventer, Paul J. Lockhart, Zornitza Stark, Tiffany Boughtwood, Ilias Goranitis

Gepubliceerd in: Quality of Life Research | Uitgave 9/2020

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Purpose

The complexity and severity of rare genetic conditions pose substantial burden to families. While the importance of spillovers on carers’ health in resource allocation decisions is increasingly recognised, there is significant lack of empirical evidence in the context of rare diseases. The objective of this study was to estimate the health spillovers of paediatric rare genetic conditions on parents.

Methods

Health-related quality-of-life (HRQoL) data from children with rare genetic conditions (genetic kidney diseases, mitochondrial diseases, epileptic encephalopathies, brain malformations) and their parents were collected using the CHU9D and SF-12 measures, respectively. We used two approaches to estimate parental health spillovers. To quantify the ‘absolute health spillover’, we matched our parent cohort to the Australian general population. To quantify the ‘relative health spillover’, regression models were applied using the cohort data.

Results

Parents of affected children had significantly lower HRQoL compared to matched parents in the general public (− 0.06; 95% CIs − 0.08, − 0.04). Multivariable regression demonstrated a positive association between parental and child health. The mean magnitude of HRQoL loss in parents was estimated to be 33% of the HRQoL loss observed in children (95% CIs 21%, 46%).

Conclusion

Paediatric rare genetic conditions appear to be associated with substantial parental health spillovers. This highlights the importance of including health effects on family members and caregivers into economic evaluation of genomic technologies and personalised medicine. Overlooking spillover effects may undervalue the benefits of diagnosis and management in this context. This study also expands the knowledge of family spillover to the rare disease spectrum.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Literatuur
1.
go back to reference Boycott, K. M., Vanstone, M. R., Bulman, D. E., & MacKenzie, A. E. (2013). Rare-disease genetics in the era of next-generation sequencing: Discovery to translation. Nature Reviews Genetics, 14(10), 681.PubMedCrossRef Boycott, K. M., Vanstone, M. R., Bulman, D. E., & MacKenzie, A. E. (2013). Rare-disease genetics in the era of next-generation sequencing: Discovery to translation. Nature Reviews Genetics, 14(10), 681.PubMedCrossRef
3.
go back to reference Slade, A., Isa, F., Kyte, D., Pankhurst, T., Kerecuk, L., Ferguson, J., et al. (2018). Patient reported outcome measures in rare diseases: A narrative review. Orphanet Journal of Rare Diseases, 13(1), 61.PubMedPubMedCentralCrossRef Slade, A., Isa, F., Kyte, D., Pankhurst, T., Kerecuk, L., Ferguson, J., et al. (2018). Patient reported outcome measures in rare diseases: A narrative review. Orphanet Journal of Rare Diseases, 13(1), 61.PubMedPubMedCentralCrossRef
4.
go back to reference Wright, C. F., FitzPatrick, D. R., & Firth, H. V. (2018). Paediatric genomics: Diagnosing rare disease in children. Nature Reviews Genetics, 19(5), 253.PubMedCrossRef Wright, C. F., FitzPatrick, D. R., & Firth, H. V. (2018). Paediatric genomics: Diagnosing rare disease in children. Nature Reviews Genetics, 19(5), 253.PubMedCrossRef
6.
go back to reference Zurynski, Y., Deverell, M., Dalkeith, T., Johnson, S., Christodoulou, J., Leonard, H., et al. (2017). Australian children living with rare diseases: Experiences of diagnosis and perceived consequences of diagnostic delays. Orphanet Journal of Rare Diseases, 12(1), 68.PubMedPubMedCentralCrossRef Zurynski, Y., Deverell, M., Dalkeith, T., Johnson, S., Christodoulou, J., Leonard, H., et al. (2017). Australian children living with rare diseases: Experiences of diagnosis and perceived consequences of diagnostic delays. Orphanet Journal of Rare Diseases, 12(1), 68.PubMedPubMedCentralCrossRef
7.
go back to reference Pelentsov, L. J., Fielder, A. L., Laws, T. A., & Esterman, A. J. (2016). The supportive care needs of parents with a child with a rare disease: Results of an online survey. BMC Family Practice, 17(1), 88.PubMedPubMedCentralCrossRef Pelentsov, L. J., Fielder, A. L., Laws, T. A., & Esterman, A. J. (2016). The supportive care needs of parents with a child with a rare disease: Results of an online survey. BMC Family Practice, 17(1), 88.PubMedPubMedCentralCrossRef
8.
go back to reference Pelentsov, L. J., Laws, T. A., & Esterman, A. J. (2015). The supportive care needs of parents caring for a child with a rare disease: A scoping review. Disability and Health Journal, 8(4), 475–491.PubMedCrossRef Pelentsov, L. J., Laws, T. A., & Esterman, A. J. (2015). The supportive care needs of parents caring for a child with a rare disease: A scoping review. Disability and Health Journal, 8(4), 475–491.PubMedCrossRef
9.
go back to reference Wittenberg, E., James, L. P., & Prosser, L. A. (2019). Spillover effects on caregivers’ and family members’ utility: A systematic review of the literature. PharmacoEconomics, 37(4), 475–499.PubMedCrossRef Wittenberg, E., James, L. P., & Prosser, L. A. (2019). Spillover effects on caregivers’ and family members’ utility: A systematic review of the literature. PharmacoEconomics, 37(4), 475–499.PubMedCrossRef
10.
go back to reference Wittenberg, E., & Prosser, L. A. (2016). Health as a family affair. New England Journal of Medicine, 374(19), 1804–1806.PubMedCrossRef Wittenberg, E., & Prosser, L. A. (2016). Health as a family affair. New England Journal of Medicine, 374(19), 1804–1806.PubMedCrossRef
12.
go back to reference Sanders, G. D., Neumann, P. J., Basu, A., Brock, D. W., Feeny, D., Krahn, M., et al. (2016). Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: Second panel on cost-effectiveness in health and medicine. JAMA, 316(10), 1093–1103.PubMedCrossRef Sanders, G. D., Neumann, P. J., Basu, A., Brock, D. W., Feeny, D., Krahn, M., et al. (2016). Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: Second panel on cost-effectiveness in health and medicine. JAMA, 316(10), 1093–1103.PubMedCrossRef
13.
go back to reference Al-Janabi, H., McLoughlin, C., Oyebode, J., Efstathiou, N., & Calvert, M. (2019). Six mechanisms behind carer wellbeing effects: A qualitative study of healthcare delivery. Social Science & Medicine, 2, 112382.CrossRef Al-Janabi, H., McLoughlin, C., Oyebode, J., Efstathiou, N., & Calvert, M. (2019). Six mechanisms behind carer wellbeing effects: A qualitative study of healthcare delivery. Social Science & Medicine, 2, 112382.CrossRef
14.
go back to reference Brouwer, W. B. (2019). The inclusion of spillover effects in economic evaluations: Not an optional extra. PharmacoEconomics, 37(4), 451–456.PubMedCrossRef Brouwer, W. B. (2019). The inclusion of spillover effects in economic evaluations: Not an optional extra. PharmacoEconomics, 37(4), 451–456.PubMedCrossRef
15.
go back to reference Lavelle, T. A., D’Cruz, B. N., Mohit, B., Ungar, W. J., Prosser, L. A., Tsiplova, K., et al. (2019). Family spillover effects in pediatric cost-utility analyses. Applied Health Economics and Health Policy, 17(2), 163–174.PubMedCrossRef Lavelle, T. A., D’Cruz, B. N., Mohit, B., Ungar, W. J., Prosser, L. A., Tsiplova, K., et al. (2019). Family spillover effects in pediatric cost-utility analyses. Applied Health Economics and Health Policy, 17(2), 163–174.PubMedCrossRef
18.
go back to reference Schwarze, K., Buchanan, J., Taylor, J. C., & Wordsworth, S. (2018). Are whole-exome and whole-genome sequencing approaches cost-effective? A systematic review of the literature. Genetics in Medicine, 20(10), 1122.PubMedCrossRef Schwarze, K., Buchanan, J., Taylor, J. C., & Wordsworth, S. (2018). Are whole-exome and whole-genome sequencing approaches cost-effective? A systematic review of the literature. Genetics in Medicine, 20(10), 1122.PubMedCrossRef
19.
go back to reference Phillips, K. A., Deverka, P. A., Marshall, D. A., Wordsworth, S., Regier, D. A., Christensen, K. D., et al. (2018). Methodological issues in assessing the economic value of next-generation sequencing tests: Many challenges and not enough solutions. Value in Health, 21(9), 1033–1042.PubMedPubMedCentralCrossRef Phillips, K. A., Deverka, P. A., Marshall, D. A., Wordsworth, S., Regier, D. A., Christensen, K. D., et al. (2018). Methodological issues in assessing the economic value of next-generation sequencing tests: Many challenges and not enough solutions. Value in Health, 21(9), 1033–1042.PubMedPubMedCentralCrossRef
20.
go back to reference Stark, Z., Boughtwood, T., Phillips, P., Christodoulou, J., Hansen, D. P., Braithwaite, J., et al. (2019). Australian genomics: A federated model for integrating genomics into healthcare. The American Journal of Human Genetics, 105(1), 7–14.PubMedCrossRef Stark, Z., Boughtwood, T., Phillips, P., Christodoulou, J., Hansen, D. P., Braithwaite, J., et al. (2019). Australian genomics: A federated model for integrating genomics into healthcare. The American Journal of Human Genetics, 105(1), 7–14.PubMedCrossRef
21.
go back to reference Taylor, N., Best, S., Martyn, M., Long, J. C., North, K. N., Braithwaite, J., et al. (2019). A transformative translational change programme to introduce genomics into healthcare: A complexity and implementation science study protocol. British Medical Journal Open, 9(3), e024681. https://doi.org/10.1136/bmjopen-2018-024681.CrossRef Taylor, N., Best, S., Martyn, M., Long, J. C., North, K. N., Braithwaite, J., et al. (2019). A transformative translational change programme to introduce genomics into healthcare: A complexity and implementation science study protocol. British Medical Journal Open, 9(3), e024681. https://​doi.​org/​10.​1136/​bmjopen-2018-024681.CrossRef
22.
go back to reference Ware, J. E., Kosinski, M., Turner-Bowker, D. M., Gandek, B., QualityMetric, I., New England Medical Center, H., et al. (2002). How to score version 2 of the SF-12 health survey (with a supplement documenting version 1). Lincoln, R.I.; Boston, MA.: QualityMetric Inc. ; Health Assessment Lab. Ware, J. E., Kosinski, M., Turner-Bowker, D. M., Gandek, B., QualityMetric, I., New England Medical Center, H., et al. (2002). How to score version 2 of the SF-12 health survey (with a supplement documenting version 1). Lincoln, R.I.; Boston, MA.: QualityMetric Inc. ; Health Assessment Lab.
23.
go back to reference Brazier, J. E., & Roberts, J. (2004). The estimation of a preference-based measure of health from the SF-12. Medical Care, 3, 851–859.CrossRef Brazier, J. E., & Roberts, J. (2004). The estimation of a preference-based measure of health from the SF-12. Medical Care, 3, 851–859.CrossRef
24.
go back to reference Ratcliffe, J., Huynh, E., Chen, G., Stevens, K., Swait, J., Brazier, J., et al. (2016). Valuing the child health utility 9D: Using profile case best worst scaling methods to develop a new adolescent specific scoring algorithm. Social Science & Medicine, 157, 48–59.CrossRef Ratcliffe, J., Huynh, E., Chen, G., Stevens, K., Swait, J., Brazier, J., et al. (2016). Valuing the child health utility 9D: Using profile case best worst scaling methods to develop a new adolescent specific scoring algorithm. Social Science & Medicine, 157, 48–59.CrossRef
25.
go back to reference Stevens, K. (2012). Valuation of the child health utility 9D index. PharmacoEconomics, 30(8), 729–747.PubMedCrossRef Stevens, K. (2012). Valuation of the child health utility 9D index. PharmacoEconomics, 30(8), 729–747.PubMedCrossRef
26.
go back to reference Al-Janabi, H., Van Exel, J., Brouwer, W., Trotter, C., Glennie, L., Hannigan, L., et al. (2016). Measuring health spillovers for economic evaluation: A case study in meningitis. Health Economics, 25(12), 1529–1544.PubMedCrossRef Al-Janabi, H., Van Exel, J., Brouwer, W., Trotter, C., Glennie, L., Hannigan, L., et al. (2016). Measuring health spillovers for economic evaluation: A case study in meningitis. Health Economics, 25(12), 1529–1544.PubMedCrossRef
27.
go back to reference Brazier, J., Roberts, J., & Deverill, M. (2002). The estimation of a preference-based measure of health from the SF-36. Journal of Health Economics, 21(2), 271–292.PubMedCrossRef Brazier, J., Roberts, J., & Deverill, M. (2002). The estimation of a preference-based measure of health from the SF-36. Journal of Health Economics, 21(2), 271–292.PubMedCrossRef
30.
go back to reference Chen, G., Flynn, T., Stevens, K., Brazier, J., Huynh, E., Sawyer, M., et al. (2015). Assessing the health-related quality of life of Australian adolescents: an empirical comparison of the child health utility 9D and EQ-5D-Y instruments. Value in Health, 18(4), 432–438.PubMedCrossRef Chen, G., Flynn, T., Stevens, K., Brazier, J., Huynh, E., Sawyer, M., et al. (2015). Assessing the health-related quality of life of Australian adolescents: an empirical comparison of the child health utility 9D and EQ-5D-Y instruments. Value in Health, 18(4), 432–438.PubMedCrossRef
31.
go back to reference Kwon, J., Kim, S. W., Ungar, W. J., Tsiplova, K., Madan, J., & Petrou, S. (2018). A systematic review and meta-analysis of childhood health utilities. Medical Decision Making, 38(3), 277–305.PubMedCrossRef Kwon, J., Kim, S. W., Ungar, W. J., Tsiplova, K., Madan, J., & Petrou, S. (2018). A systematic review and meta-analysis of childhood health utilities. Medical Decision Making, 38(3), 277–305.PubMedCrossRef
33.
go back to reference Walters, S. J., & Brazier, J. E. (2005). Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Quality of Life Research, 14(6), 1523–1532.PubMedCrossRef Walters, S. J., & Brazier, J. E. (2005). Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Quality of Life Research, 14(6), 1523–1532.PubMedCrossRef
34.
go back to reference Tilford, J. M., Grosse, S. D., Robbins, J. M., Pyne, J. M., Cleves, M. A., & Hobbs, C. A. (2005). Health state preference scores of children with spina bifida and their caregivers. Quality of Life Research, 14(4), 1087–1098.PubMedCrossRef Tilford, J. M., Grosse, S. D., Robbins, J. M., Pyne, J. M., Cleves, M. A., & Hobbs, C. A. (2005). Health state preference scores of children with spina bifida and their caregivers. Quality of Life Research, 14(4), 1087–1098.PubMedCrossRef
35.
go back to reference Hoefman, R. J., van Exel, J., & Brouwer, W. (2013). How to include informal care in economic evaluations. PharmacoEconomics, 31(12), 1105–1119.PubMedCrossRef Hoefman, R. J., van Exel, J., & Brouwer, W. (2013). How to include informal care in economic evaluations. PharmacoEconomics, 31(12), 1105–1119.PubMedCrossRef
36.
go back to reference Al-Janabi, H., Van Exel, J., Brouwer, W., & Coast, J. (2016). A framework for including family health spillovers in economic evaluation. Medical Decision Making, 36(2), 176–186.PubMedPubMedCentralCrossRef Al-Janabi, H., Van Exel, J., Brouwer, W., & Coast, J. (2016). A framework for including family health spillovers in economic evaluation. Medical Decision Making, 36(2), 176–186.PubMedPubMedCentralCrossRef
38.
go back to reference Brown, C. C., Tilford, J. M., Payakachat, N., Williams, D. K., Kuhlthau, K. A., Pyne, J. M., et al. (2019). Measuring health spillover effects in caregivers of children with autism spectrum disorder: A comparison of the EQ-5D-3L and SF-6D. PharmacoEconomics, 37(4), 609–620.PubMedPubMedCentralCrossRef Brown, C. C., Tilford, J. M., Payakachat, N., Williams, D. K., Kuhlthau, K. A., Pyne, J. M., et al. (2019). Measuring health spillover effects in caregivers of children with autism spectrum disorder: A comparison of the EQ-5D-3L and SF-6D. PharmacoEconomics, 37(4), 609–620.PubMedPubMedCentralCrossRef
40.
go back to reference Brouwer, W., Van Exel, N., Van Gorp, B., & Redekop, W. (2006). The CarerQol instrument: A new instrument to measure care-related quality of life of informal caregivers for use in economic evaluations. Quality of Life Research, 15(6), 1005–1021.PubMedCrossRef Brouwer, W., Van Exel, N., Van Gorp, B., & Redekop, W. (2006). The CarerQol instrument: A new instrument to measure care-related quality of life of informal caregivers for use in economic evaluations. Quality of Life Research, 15(6), 1005–1021.PubMedCrossRef
41.
go back to reference Al-Janabi, H., Coast, J., & Flynn, T. N. (2008). What do people value when they provide unpaid care for an older person? A meta-ethnography with interview follow-up. Social Science & Medicine, 67(1), 111–121.CrossRef Al-Janabi, H., Coast, J., & Flynn, T. N. (2008). What do people value when they provide unpaid care for an older person? A meta-ethnography with interview follow-up. Social Science & Medicine, 67(1), 111–121.CrossRef
42.
go back to reference Al-Janabi, H., Flynn, T. N., & Coast, J. (2012). Development of a self-report measure of capability wellbeing for adults: The ICECAP-A. Quality of Life Research, 21(1), 167–176.PubMedCrossRef Al-Janabi, H., Flynn, T. N., & Coast, J. (2012). Development of a self-report measure of capability wellbeing for adults: The ICECAP-A. Quality of Life Research, 21(1), 167–176.PubMedCrossRef
Metagegevens
Titel
Parental health spillover effects of paediatric rare genetic conditions
Auteurs
You Wu
Hareth Al-Janabi
Andrew Mallett
Catherine Quinlan
Ingrid E. Scheffer
Katherine B. Howell
John Christodoulou
Richard J. Leventer
Paul J. Lockhart
Zornitza Stark
Tiffany Boughtwood
Ilias Goranitis
Publicatiedatum
07-04-2020
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 9/2020
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-020-02497-3

Andere artikelen Uitgave 9/2020

Quality of Life Research 9/2020 Naar de uitgave