Kidney Week

Abstract: TH-PO297

Impact of Extended Hours Dialysis on Quality of Life Measured by EQ-5D and SF-6D Utility Instruments

Session Information

• Dialysis: Cost, Socioeconomics, Quality of Life
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Smyth, Brendan, University of Sydney, Sydney, New South Wales, Australia

Brendan Smyth,

• Howard, Kirsten, University of Sydney, Sydney, New South Wales, Australia

Kirsten Howard,

• de Zoysa, Janak Rashme, Waitemata District Health Board, AUCKLAND, New Zealand

Janak Rashme de Zoysa,

• Gray, Nicholas A., Sunshine Coast University Hospital , Birtinya, Queensland, Australia

Nicholas A. Gray,

• Cass, Alan, Menzies School of Health Research, Darwin, Northern Territory, Australia

Alan Cass,

• Gallagher, Martin P., The George Institute for Global Health, UNSW, Newtown, New South Wales, Australia

Martin P. Gallagher,

• Perkovic, Vlado, The George Institute for Global Health, UNSW, Newtown, New South Wales, Australia

Vlado Perkovic,

• Jardine, Meg J., The George Institute for Global Health, UNSW, Newtown, New South Wales, Australia

Meg J. Jardine,

Background

Health economic evaluations often rely on measurements of health utility. Validated health utility assessment tools are available but whether they perform similarly is rarely assessed. We aimed to estimate the effect of extended hours dialysis on utility-based quality of life (QOL) using two multi-attribute utility instruments.

Methods

The ACTIVE Dialysis trial randomised 200 participants to extended hours (≥24 hours/week) or standard hours (≤18 hours/week) haemodialysis for 12 months. Utility-based QOL was assessed every three months by the EuroQOL-5 Dimensions (EQ-5D) and Short Form-6 Dimensions (SF-6D). The mean difference in utility weights between groups was obtained by mixed linear regression. Quality adjusted life years (QALYs), a measure that combines survival and quality of life, were calculated.

Results

Extended dialysis hours did not improve utility-based QOL measured by the EQ-5D (0.036 [95%CI -0.022, 0.093]; p=0.223) but did significantly improve it when measured by the SF-6D (0.027 [95%CI 0.003, 0.052]; p=0.026). There was no significant difference in mean QALYs gained per patient from extended over standard dialysis as measured by the SF-6D (0.015 [95%CI -0.070, 0.041]) or the EQ-5D (0.029 [95%CI -0.108, 0.049]) - equivalent to a mean per patient gain of 5.5 (95%CI -25.6, 15.0) and 10.6 (95%CI -39.4, 17.9) days of perfect health, respectively.

Conclusion

The EQ-5D and SF-6D resulted in distinct interpretations of utility-based QOL differences in extended hours dialysis, although the significant improvement in utility-based QOL found with the SF-6D did not translate into a significant gain in QALYs. These results emphasise the need for a better understanding of the impact of different scoring algorithms and instrument properties on the performance of multi-attribute utility instruments to measure QOL in dialysis patients.

Funding

• Commercial Support –