Marseille 2007
| Abstract #120 - Quality of Life of household members of HIV infected patients | ||||
|
Session: 31.4: Quality of Life (Parallel) on Tuesday @ 11.00-12.30 in HC Chaired by Adinani Amidu, Wendee Wechsberg Authors: Presenting Author: Mr Gijs Hubben - University of Groningen, Netherlands |
||||
| Additional Authors: Dr David Bishai, Dr Sabina Haberlen, Dr Maarten Postma, Dr Andrea Tramarin, | ||||
| Aim: Most cost effectiveness evaluations focus on improvements in quality of life of a unitary patient. However, most patients live in households surrounded by individuals who care about them and whose own quality of life is affected by their health. If the care of HIV patients generates large spillover increments to household quality of life, conventional cost effectiveness estimates would underestimate the benefits of both treatment and prevention. This study aims to characterize the impact of increases in the number of symptom free days on household members of 120 HIV patients in the Veneto and Lombardi Regions of Italy. | ||||
| Method / Issue: A longitudinal sample of 120 patients with HIV infection was enrolled in 2 cities in Northeast Italy. The clinicians categorized patients into 3 categories at baseline: Never on HAART, Stable on HAART, and HAART Salvage--defined as alteration in HAART cocktail in past 12 weeks. Monthly symptom diaries were kept. The MOS-HIV survey and a quality of life rating scale were collected at baseline and at 2 successive 6 month intervals. Patients were also asked to describe the quality of life (QOL) and a brief time diary of each household member at each of the 3 rounds. Random effects regression assessed the correlation of patients symptomaticity to household members mean QOL and household labor supply. | ||||
| Results / Comments: Each additional point on a 0 to 100 scale of patient QOL was associated with a 0.323 point increase in the average QOL of the household members of the patients (p<0.001) in random effects regressions that controlled for age, sex, household size, and the labor supply of the patient. Logarithmic and quadratic models showed very little non-linearity in the relationship for patients above a quality of life of 0.25. Increases in the patients average number of asymptomatic days similarly increased the average household QOL by 0.37 QOL points for a unit increase in the average number of symptom free days per month. We also found an independent positive association with patients engaging in paid work and household QOL. | ||||
| Discussion: Household members appear to gain improvements in subjective measures of QOL in conjunction with an HIV patients improved symptom control and with the patients own QOL. Spillover QALYs gained by household members may be a large and unmeasured outcome in the evaluation of medical care. | ||||
| Go Back | ||||
