IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0315944.html
   My bibliography  Save this article

Health-related quality of life implications of plantar ulcers resulting from neuropathic damage caused by leprosy: An analysis from the trial of autologous blood products (TABLE trial) in Nepal

Author

Listed:
  • Naomi Kate Gibbs
  • Jessica Ochalek
  • Indra Bahadur Napit
  • Dilip Shrestha
  • Pedro Saramago Goncalves
  • Richard J Lilford
  • Mark Sculpher

Abstract

Introduction: Leprosy is a curable disease, treated by multidrug therapy. However, patients are often left with neuropathic damage leading to lifelong vulnerability to ulcers. Quantifying the value of interventions to improve ulcer healing is challenging as data on the health impact of plantar ulcers are scarce, especially in low- and middle-income countries. We aim to quantify the impact of plantar ulcers on patients’ health-related quality of life (HRQoL) using methods which can inform decisions about the effectiveness and cost-effectiveness of alternative forms of management. Methods: Generic HRQoL data were collected using the EuroQol (EQ)-5D-3L questionnaire in a randomised control trial in Nepal, treating plantar ulcers with leukocyte and platelet-rich fibrin or usual care. The trial followed 130 patients resulting in 600 observations. EQ-5D data were converted into a single ‘utility’ score by weighting the instrument’s different dimensions using the preferences of the Sri Lankan population. Utility data were analysed using general estimating equation regressions. The impact of an ulcer on HRQoL was estimated whilst controlling for clinical and demographic covariables. Results: Estimated mean utility (standard error) for the sample across all time points was 0.52 (0.02) for patients with an ulcer and 0.64 (0.01) with a healed ulcer. Controlling for clinical and demographic covariates, we estimate that the presence of an ulcer leads to a 0.12 (0.02) decrement in HRQoL compared with a healed ulcer. Discussion: Based on the levels of health they report and the values of the general public, patients with a history of leprosy are at risk of significant HRQoL burden from neuropathic plantar ulcers. Quantifying this health impact provides important evidence to assess the effectiveness and cost-effectiveness of leprosy ulcer interventions and ensures that interventions for leprosy ulcers can be appropriately considered for funding under Universal Health Coverage against other potential uses of the same money.

Suggested Citation

  • Naomi Kate Gibbs & Jessica Ochalek & Indra Bahadur Napit & Dilip Shrestha & Pedro Saramago Goncalves & Richard J Lilford & Mark Sculpher, 2025. "Health-related quality of life implications of plantar ulcers resulting from neuropathic damage caused by leprosy: An analysis from the trial of autologous blood products (TABLE trial) in Nepal," PLOS ONE, Public Library of Science, vol. 20(2), pages 1-12, February.
    • Handle: RePEc:plo:pone00:0315944
    DOI: 10.1371/journal.pone.0315944
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0315944
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0315944&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0315944?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Salma Oktaria & Norma Sofisa Hurif & Wardiansyah Naim & Hok Bing Thio & Tamar E C Nijsten & Jan Hendrik Richardus, 2018. "Dietary diversity and poverty as risk factors for leprosy in Indonesia: A case-control study," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 12(3), pages 1-15, March.
    2. Nord, Erik, 2013. "Disability weights in the Global Burden of Disease 2010: Unclear meaning and overstatement of international agreement," Health Policy, Elsevier, vol. 111(1), pages 99-104.
    3. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884, Decembrie.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Magdalena Muszyńska-Spielauer & Marc Luy, 2022. "Well-Being Adjusted Health Expectancy: A New Summary Measure of Population Health," European Journal of Population, Springer;European Association for Population Studies, vol. 38(5), pages 1009-1031, December.
    2. Irina Pokhilenko & Luca M. M. Janssen & Aggie T. G. Paulus & Ruben M. W. A. Drost & William Hollingworth & Joanna C. Thorn & Sian Noble & Judit Simon & Claudia Fischer & Susanne Mayer & Luis Salvador-, 2023. "Development of an Instrument for the Assessment of Health-Related Multi-sectoral Resource Use in Europe: The PECUNIA RUM," Applied Health Economics and Health Policy, Springer, vol. 21(2), pages 155-166, March.
    3. Chiranjeev Sanyal & Don Husereau, 2020. "Systematic Review of Economic Evaluations of Services Provided by Community Pharmacists," Applied Health Economics and Health Policy, Springer, vol. 18(3), pages 375-392, June.
    4. Yesim Tozan & Joshua Kiyingi & Sooyoung Kim & Flavia Namuwonge & Florence Namuli & Vicent Ssentumbwe & Rashida Namirembe & Edwinnah Kasidi & Ozge Sensoy Bahar & Mary M Mckay & Fred M Ssewamala, 2024. "Micro-costing analysis of a combination intervention for improved mental health and HIV risk behaviors among school-going adolescent girls in Uganda," PLOS Mental Health, Public Library of Science, vol. 1(7), pages 1-14, December.
    5. Dong-Won Kang & Patricio B. Lynn & Li Wang & Shouhao Zhou & Chan Shen, 2025. "Cost-Effectiveness of Fruquintinib for Refractory Metastatic Colorectal Cancer in the USA," PharmacoEconomics - Open, Springer, vol. 9(1), pages 93-101, January.
    6. Andrew J. Mirelman & Miqdad Asaria & Bryony Dawkins & Susan Griffin & Richard Cookson & Peter Berman, 2020. "Fairer Decisions, Better Health for All: Health Equity and Cost-Effectiveness Analysis," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 4, pages 99-132, World Scientific Publishing Co. Pte. Ltd..
    7. Valentina Prevolnik Rupel & Marko Ogorevc, 2023. "EQ-5D-5L Value Set for Slovenia," PharmacoEconomics, Springer, vol. 41(11), pages 1515-1524, November.
    8. Julie A. Campbell & Glen J. Henson & Valery Fuh Ngwa & Hasnat Ahmad & Bruce V. Taylor & Ingrid Mei & Andrew J. Palmer, 2025. "Estimation of Transition Probabilities from a Large Cohort (> 6000) of Australians Living with Multiple Sclerosis (MS) for Changing Disability Severity Classifications, MS Phenotype, and Disease-Modif," PharmacoEconomics, Springer, vol. 43(2), pages 223-239, February.
    9. Christopher M Doran & Irina Kinchin, 2020. "Economic and epidemiological impact of youth suicide in countries with the highest human development index," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-11, May.
    10. Boniface Oyugi & Olena Nizalova & Sally Kendall & Stephen Peckham, 2024. "Does a free maternity policy in Kenya work? Impact and cost–benefit consideration based on demographic health survey data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(1), pages 77-89, February.
    11. Kaspar Walter Meili & Anna Månsdotter & Linda Richter Sundberg & Jan Hjelte & Lars Lindholm, 2022. "An initiative to develop capability-adjusted life years in Sweden (CALY-SWE): Selecting capabilities with a Delphi panel and developing the questionnaire," PLOS ONE, Public Library of Science, vol. 17(2), pages 1-21, February.
    12. Muchandifunga Trust Muchadeyi & Karla Hernandez-Villafuerte & Gian Luca Tanna & Rachel D. Eckford & Yan Feng & Michela Meregaglia & Tessa Peasgood & Stavros Petrou & Jasper Ubels & Michael Schlander, 2024. "Quality Appraisal in Systematic Literature Reviews of Studies Eliciting Health State Utility Values: Conceptual Considerations," PharmacoEconomics, Springer, vol. 42(7), pages 767-782, July.
    13. Lili Wang & Lei Si & Fiona Cocker & Andrew J. Palmer & Kristy Sanderson, 2018. "A Systematic Review of Cost-of-Illness Studies of Multimorbidity," Applied Health Economics and Health Policy, Springer, vol. 16(1), pages 15-29, February.
    14. Etienne Nédellec & Judith Pineau & Patrice Prognon & Nicolas Martelli, 2018. "Level of Evidence in Economic Evaluations of Left Atrial Appendage Closure Devices: A Systematic Review," Applied Health Economics and Health Policy, Springer, vol. 16(6), pages 793-802, December.
    15. Qi Cao & Erik Buskens & Hans L. Hillege & Tiny Jaarsma & Maarten Postma & Douwe Postmus, 2019. "Stratified treatment recommendation or one-size-fits-all? A health economic insight based on graphical exploration," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 475-482, April.
    16. Hensher, Martin & Canny, Ben & Zimitat, Craig & Campbell, Julie & Palmer, Andrew, 2020. "Health care, overconsumption and uneconomic growth: A conceptual framework," Social Science & Medicine, Elsevier, vol. 266(C).
    17. Dongzhe Hong & Lei Si & Minghuan Jiang & Hui Shao & Wai-kit Ming & Yingnan Zhao & Yan Li & Lizheng Shi, 2019. "Cost Effectiveness of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists, and Dipeptidyl Peptidase-4 (DPP-4) Inhibitors: A Systematic Review," PharmacoEconomics, Springer, vol. 37(6), pages 777-818, June.
    18. Werner Brouwer & Kaya Verbooy & Renske Hoefman & Job Exel, 2023. "Production Losses due to Absenteeism and Presenteeism: The Influence of Compensation Mechanisms and Multiplier Effects," PharmacoEconomics, Springer, vol. 41(9), pages 1103-1115, September.
    19. Yakubu Adole Agada-Amade & Daniel Chukwuemeka Ogbuabor & Eric Obikeze & Ejemai Eboreime & Obinna Emmanuel Onwujekwe, 2024. "Cost-benefit analysis of haemodialysis in patients with end-stage kidney disease in Abuja, Nigeria," Health Economics Review, Springer, vol. 14(1), pages 1-8, December.
    20. Simon Pol & Paula Rojas Garcia & Fernando Antoñanzas Villar & Maarten J. Postma & Antoinette D. I. Asselt, 2021. "Health-Economic Analyses of Diagnostics: Guidance on Design and Reporting," PharmacoEconomics, Springer, vol. 39(12), pages 1355-1363, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0315944. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.