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A multi-attribute utility instrument suitable for use in individuals with psychosis – the AQoL-4D: Findings from the Second Australian National Survey of Psychosis

Published online by Cambridge University Press:  23 March 2020

A. Neil ,
V. Carr ,
A. Mackinnon ,
A. Waterreus ,
H. Stain ,
M.C. Hanlon ,
S. Korn  and
V. Morgan
A. Neil*
Affiliation:
University of Tasmania, Menzies Institute of Medical Research, Hobart, Australia
V. Carr
Affiliation:
University of New South Wales, Research Unit for Schizophrenia Epidemiology. School of Psychiatry, Sydney, Australia Monash University, Department of Psychiatry, Melbourne, Australia
A. Mackinnon
Affiliation:
The University of Melbourne, Orygen Youth Health Research Centre, Melbourne, Australia
A. Waterreus
Affiliation:
University of Western Australia, Neuropsychiatric Epidemiology Research Unit. School of Psychiatry and Clinical Neurosciences, Perth, Australia
H. Stain
Affiliation:
Durham University, Wolfson Research Institute for Health and Well-being, Stockton-On-Tees, United Kingdom
M.C. Hanlon
Affiliation:
The University of Newcastle, Centre for Brain and Mental Health Research, Newcastle, Australia Calvary Mater Newcastle, Radiation Oncology/Physics, Newcastle, Australia Hunter Medical Research Institute, Brain and Mental Health Program, Newcastle, Australia
S. Korn
Affiliation:
Melbourne, AustraliaMelbourne, Australia
V. Morgan
Affiliation:
University of Western Australia, Neuropsychiatric Epidemiology Research Unit. School of Psychiatry and Clinical Neurosciences, Perth, Australia
*
*Corresponding author.

Abstract

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Introduction

Multi-attribute utility instruments (MAUIs) are generic health-related quality of life (HRQoL) measures that enable valuation of health states relative to death (0.0) and full health (1.0). The usefulness of MAUIs in people with psychosis has been questioned, with the EQ-5D considered “insensitive”, the 15D “problematic” and the SF-6D “unsuitable”.

Objectives

Confirm the Assessment of Quality of Life (AQoL)-4D MAUI is useful and meaningful in people with psychosis.

Aims

Assess utility values across demographic, general and disease-specific health categorisations for a large nationally-representative sample with psychosis (n = 1825).

Methods

Participants underwent a comprehensive 32 module interview encompassing psychopathology to service use. Utility values were calculated by applying a standard algorithm to responses to each of 12 items of the AQoL-4D.

Results

Utility values were assessed for 1793 participants (98.2%). No ceiling effect was observed and only 6.6% of participants scored in the top decile of HRQoL [0.9–10.0]. In contrast, 10.8% scored in the lowest decile [−0.04–0.10], a floor effect observed in 0.4%. The mean utility value was 0.49 (95% CI: 0.48–0.51), significantly lower than the Australian population norm of 0.81 (95% CI: 0.81–0.82). Greatest impacts on HRQoL were for diminishing global independent functioning as measured by the MSIF (ESMSIF: 0.68–2.24), self-rated current mental health (ESMH: 0.15–1.65) and physical health status (ESPH: 0.11–1.21). Strong effects also observed for course of disorder (ESCoD: 0.08–1.13), current suicidal ideation (ESCSI1: 0.76–1.08), and labor force participation (ESLFP: 0.11–0.97).

Conclusions

The AQoL-4D had good lower end sensitivity in a large sample of people with a psychotic illness, and demonstrated responsiveness across subjective, objective and symptom measures.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
FC28
Information
European Psychiatry , Volume 33 , Issue S1: Abstracts of the 24th European Congress of Psychiatry , March 2016 , pp. S82
Copyright
Copyright © European Psychiatric Association 2016
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