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Acceptability of less than perfect health states in rheumatoid arthritis: the patients’ perspective

Author

Listed:
  • Márta Péntek

    (Corvinus University of Budapest
    Flór Ferenc County Hospital)

  • Bernadette Rojkovich

    (Polyclinic of the Hospital Brothers of St. John of God in Budapest)

  • László Czirják

    (University of Pécs)

  • Pál Géher

    (Polyclinic of the Hospital Brothers of St. John of God in Budapest)

  • Péter Keszthelyi

    (Kálmán Pándy Hospital)

  • Attila Kovács

    (Hospital of Hungarian State Railways)

  • László Kovács

    (University of Szeged)

  • Zita Szabó

    (András Jósa Hospital)

  • Zoltán Szekanecz

    (University of Debrecen Medical and Health Science Center)

  • László Tamási

    (Semmelweis Teaching Hospital – Szent Ferenc Hospital Division)

  • Ágnes Edit Tóth

    (Flór Ferenc County Hospital)

  • Ilona Ujfalussy

    (Military Hospital)

  • Noémi Vártokné Hevér

    (Corvinus University of Budapest)

  • Bálint Strbák

    (Corvinus University of Budapest)

  • Petra Baji

    (Corvinus University of Budapest)

  • Valentin Brodszky

    (Corvinus University of Budapest)

  • László Gulácsi

    (Corvinus University of Budapest)

Abstract

Some health problems are considered by many individuals as a ‘normal’ part of ageing. Our aim was to investigate whether patients with rheumatoid arthritis (RA) consider different types and levels of health losses as acceptable beyond a certain age. A multicenter cross-sectional survey was performed involving RA patients at the initiation of the first biological therapy. The EQ-5D and the Health Assessment Questionnaire Disability Index (HAQ-DI) questionnaires were used to describe domain-specific health states. Patients were asked to indicate for each domain from what age and onward (between ages 30 and 80 years in 10 year intervals) they considered moderate and severe problems acceptable or alternatively never acceptable. Seventy-seven RA patients (females 86 %, mean age 50.3, disease duration 9.1 years) completed the questionnaire. Disease activity (DAS28), EQ-5D and HAQ-DI scores were mean 6.00 (SD 0.85), 0.35 (SD 0.36), 1.48 (SD 0.66), respectively. The majority of the patients considered age 70 and beyond as acceptable to have some health problems (EQ-5D: self-care 42 %, pain/discomfort 34 %, mobility 33 %, usual activities 33 %, anxiety/depression 27 %), whilst at ages 30 and 40 as not acceptable. Severe health problems were mostly (57–69 %) considered never acceptable, except the ‘Usual activities’ domain (acceptable from age 80 by 50.6 %). The great majority of the patients (77–96 %) were younger than what they indicated as the acceptability age limit. Similar results were found for the HAQ-DI. This small experimental study suggests that RA patients consider some health problems acceptable. This acceptability is age related and varies by health areas. Further larger studies are needed to explore explanatory variables and to compare with other diseases. Owing to the impact acceptability might have on RA patients’ self-evaluation of current health state and decision-making, the topic deserves methodological improvement and further investigation.

Suggested Citation

  • Márta Péntek & Bernadette Rojkovich & László Czirják & Pál Géher & Péter Keszthelyi & Attila Kovács & László Kovács & Zita Szabó & Zoltán Szekanecz & László Tamási & Ágnes Edit Tóth & Ilona Ujfalussy , 2014. "Acceptability of less than perfect health states in rheumatoid arthritis: the patients’ perspective," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 73-82, May.
    • Handle: RePEc:spr:eujhec:v:15:y:2014:i:1:d:10.1007_s10198-014-0596-2
    DOI: 10.1007/s10198-014-0596-2
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    1. Bleichrodt, Han & Herrero, Carmen & Pinto, Jose Luis, 2002. "A proposal to solve the comparability problem in cost-utility analysis," Journal of Health Economics, Elsevier, vol. 21(3), pages 397-403, May.
    2. Marra, Carlo A. & Woolcott, John C. & Kopec, Jacek A. & Shojania, Kamran & Offer, Robert & Brazier, John E. & Esdaile, John M. & Anis, Aslam H., 2005. "A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis," Social Science & Medicine, Elsevier, vol. 60(7), pages 1571-1582, April.
    3. Brouwer, Werner B. F. & van Exel, N. Job A. & Stolk, Elly A., 2005. "Acceptability of less than perfect health states," Social Science & Medicine, Elsevier, vol. 60(2), pages 237-246, January.
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    1. Márta Péntek, 2019. "Patient-reported outcomes: opportunities and challenges in Central Europe," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 1-3, June.
    2. Arthur E. Attema & Werner B. F. Brouwer & Jose Luis Pinto‐Prades, 2022. "Reference‐dependent age weighting of quality‐adjusted life years," Health Economics, John Wiley & Sons, Ltd., vol. 31(12), pages 2515-2536, December.
    3. Wouters, S. & van Exel, N.J.A. & Rohde, K.I.M. & Vromen, J.J. & Brouwer, W.B.F., 2017. "Acceptable health and priority weighting: Discussing a reference-level approach using sufficientarian reasoning," Social Science & Medicine, Elsevier, vol. 181(C), pages 158-167.
    4. Zoltán Hermann & Márta Péntek & László Gulácsi & Irén Anna Kopcsóné Németh & Zsombor Zrubka, 2022. "Measuring the acceptability of EQ-5D-3L health states for different ages: a new adaptive survey methodology," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1243-1255, September.
    5. Zsombor Zrubka & Zoltán Hermann & László Gulácsi & Valentin Brodszky & Fanni Rencz & Márta Péntek, 2019. "Determinants of the acceptability of health problems in different ages: exploring a new application of the EQ VAS," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 31-41, June.

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    • I19 - Health, Education, and Welfare - - Health - - - Other

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