Growth hormone replacement in hypopituitary adults with growth hormone deficiency evaluated by a utility-weighted quality of life index: a precursor to cost-utility analysis
2007 (English)In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 68, no 1, 122-129 p.Article in journal (Refereed) Published
Objectives To examine quality of life (QoL) measured by a utility-weighted index in GH-deficient adults on GH replacement and analyse the impact of demographic and clinical characteristics on changes in utilities during treatment. Design Utilities for items in the QoL-Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDAutility) were estimated based on data obtained from the general population in England and Wales (E&W). These estimates were used to calculate QoL changes in GH-treated patients and compare these with normative population values. Patients A total of 894 KIMS patients (53% women) from E&W were followed for 1 to 6 years. Measurements QoL-AGHDAutility at baseline and at the last reported visit, total QoL-AGHDAutility gain and QoL-AGHDAutility gain per year of follow-up. Results QoL-AGHDAutility in patients before GH treatment differed from the expected population values [0·67 (SD 0·174) vs. 0·85 (SD 0-038),P < 0·0001], constituting a mean deficit of -0·19 (SD 0·168). There was a difference in the mean QoL-AGHDAutility deficit for men [-0·16 (SD 0-170)] and women [-0·21 (SD 0-162)] (P < 0·001). The main improvement occurred during the first year of treatment [reduction of a deficit to -0·07 (SD 0·163) (P < 0·001) in the total cohort]; however, patients' utilities remained lower than those recorded for the general population during subsequent follow-up (P < 0·001). Despite an observed impact of age, primary aetiology, disease onset and comorbidities on QoL-AGHDAutility, all patients showed a similar beneficial response to treatment. Conclusions QoL-AGHDAutility efficiently monitors treatment effects in patients with GHD. The study confirmed the QoL-AGHDAutility deficit before treatment and a similar QoL-AGHDAutility gain observed after commencement of GH replacement in all patients.
Place, publisher, year, edition, pages
2007. Vol. 68, no 1, 122-129 p.
Corporal biometry, Pituitary diseases, Adenohypophyseal hormone, Human, Endocrinology, Health economy, Cost analysis, Precursor, Index, Quality of life, Body weight, Deficiency, Endocrinopathy, Adult, Hypophyseal insufficiency, Hormone therapy, Replacement therapy, Somatotropin
IdentifiersURN: urn:nbn:se:uu:diva-96562DOI: 10.1111/j.1365-2265.2007.03010.xISI: 000252532800020PubMedID: 17803700OAI: oai:DiVA.org:uu-96562DiVA: diva2:171177