Daisuke Fujisawa1,2, Hironobu Inoguchi2, Haruki Shimoda3,4, Kazuhiro Yoshiuchi5, Shinichiro Inoue6, Asao Ogawa2, Toru Okuyama7, Tatsuo Akechi7, Masaru Mimura1, Ken Shimizu2, Yosuke Uchitomi8. 1. Department of Neuropsychiatry and Palliative Care Center, Keio University School of Medicine, Japan. 2. Department of Psycho-Oncology, National Cancer Center, Japan. 3. Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan. 4. Department of Mental Health, University of Tokyo, Japan. 5. Department of Stress Science and Psychosomatic Medicine, University of Tokyo, Japan. 6. Department of Neuropsychiatry, Okayama University, Japan. 7. Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University, Japan. 8. Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center, Japan.
Abstract
OBJECTIVE: The quality-adjusted life year, which is usually calculated from the health utility value, is now a standard measurement used in political decision-making in health. Although depression is the leading cause of decrement in health utility in general population, impact of comorbid depression among cancer patients has not been studied sufficiently. Therefore, this study aimed to measure the impact of depression on cancer patients' health utility score, according to the severity of depression. METHODS: Impact of depression severity (measured by the Patient Health Questionnaire) on health utility score (measured by the EuroQoL-5 scale) was evaluated in a sample of 328 Japanese cancer patients, controlling for performance status, symptom burden, and demographic variables. RESULTS: The patients with depression had significantly lower health utility value than those without depression (mean decrement = 0.14). Decrements in health utility of 0.13, 0.18, and 0.19 were observed for mild, moderate, and moderately severe to severe level of depression, respectively. The difference was significant between groups. Depression severity was a significant predictor for health utility (standardized coefficient beta = -0.25), which was comparable with physical symptom burden and performance status. Participants' age, gender, cancer stage, and comorbid illness were not significant. The model explained 37.9% of the variance. CONCLUSIONS: Even mild level of depression caused clinically meaningful decrement in health utility value in cancer patients, which was comparable with decrements due to major physical complications of cancer. Influence of depression should be carefully investigated when interpreting the quality-adjusted life year among cancer patients.
OBJECTIVE: The quality-adjusted life year, which is usually calculated from the health utility value, is now a standard measurement used in political decision-making in health. Although depression is the leading cause of decrement in health utility in general population, impact of comorbid depression among cancerpatients has not been studied sufficiently. Therefore, this study aimed to measure the impact of depression on cancerpatients' health utility score, according to the severity of depression. METHODS: Impact of depression severity (measured by the Patient Health Questionnaire) on health utility score (measured by the EuroQoL-5 scale) was evaluated in a sample of 328 Japanese cancerpatients, controlling for performance status, symptom burden, and demographic variables. RESULTS: The patients with depression had significantly lower health utility value than those without depression (mean decrement = 0.14). Decrements in health utility of 0.13, 0.18, and 0.19 were observed for mild, moderate, and moderately severe to severe level of depression, respectively. The difference was significant between groups. Depression severity was a significant predictor for health utility (standardized coefficient beta = -0.25), which was comparable with physical symptom burden and performance status. Participants' age, gender, cancer stage, and comorbid illness were not significant. The model explained 37.9% of the variance. CONCLUSIONS: Even mild level of depression caused clinically meaningful decrement in health utility value in cancerpatients, which was comparable with decrements due to major physical complications of cancer. Influence of depression should be carefully investigated when interpreting the quality-adjusted life year among cancerpatients.
Authors: M Moskovitz; K Jao; J Su; M C Brown; H Naik; L Eng; T Wang; J Kuo; Y Leung; W Xu; N Mittmann; L Moody; L Barbera; G Devins; M Li; D Howell; G Liu Journal: Curr Oncol Date: 2019-12-01 Impact factor: 3.677