Suchergebnisse

Background: Healthcare interventions that have positive effects on the stroke survivors health-related quality of life (HRQoL) and quality-adjusted life-years (QALYs) might also have positive effects for their spouses in terms of improved HRQoL and/or reduced spousal informal support. However, knowledge about stroke survivors HRQoL and QALY and the consequences for their spouses HRQoL and QALY is limited. Therefore, the aim of this study was to describe the HRQoL and QALY-weights in dyads of stroke survivors in comparison with dyads of healthy controls, and to study the relationship between the stroke survivors QALY-weights and consequences for spouses in terms of QALY-weight and annual cost of informal support, using a long-term perspective. Methods: Data on stroke survivors, controls, and spouses were collected from the seven-year follow-up of the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). HRQoL was assessed by the SF-36, and the preference-based health state values were assessed with the SF-6D. The magnitude of the support was assessed with a study specific time-diary. An ordinary least squares (OLS) regression was used to estimate the association between stroke survivors and spouses QALY-weights. A two-part econometric model was used to estimate the association between stroke survivors QALY-weights and the time spent and cost of spouses informal support. Results: Cohabitant dyads of 248 stroke survivors aged amp;lt;70 at stroke onset and 245 controls were included in the study. Stroke survivors had lower HRQoL in the SF-36 domains physical functioning, physical role, general health, vitality (P amp;lt; 0. 001), and social functioning (P = 0.005) in comparison with their cohabitant spouses. There was no significant difference in HRQoL for the dyads of controls. The results from the regression analyses showed that lower QALY-weights of the stroke survivors were associated with lower QALY-weights of their spouses and increased annual cost of spousal informal support. Conclusion: Our results show that the QALY-weights for stroke survivors had consequences for their spouses in terms of annual cost of spousal informal support and QALY-weights. Hence, economic evaluation of interventions that improve the HRQoL of the stroke survivors but ignore the consequences for their spouses may underestimate the value of the intervention. ; Funding Agencies|Swedish Research Council [K2014-64X-14, 605-12-5]; Sahlgrenska University hospital [ALFGBG-429981, ALFGBG-71890]; Swedish Heart and Lung Foundation [20130315]; Swedish Stroke Association; Rune and Ulla Amlovs Foundation; John and Brit Wennerstroms Foundation; Gothenburg Foundation

The aim of this study was to investigate whether the dependency of midlife stroke survivors had any long-term impact on their spouses QALY-weights. Data on stroke survivors, controls, and spouses were collected from the 7-year follow-up of the Sahlgrenska Academy Study on Ischemic Stroke. Health-related quality of life was assessed by the SF-36, and the preference-based health state values were assessed with the SF-6D. Spouses of dependent and independent stroke survivors were categorized according to their scores on the modified Rankin Scale. An ordinary least squares regression analysis was used to evaluate whether the dependency of the stroke survivors had any impact on the spouses QALY-weights. Cohabitant dyads of 247 stroke survivors aged amp;lt; 70 at stroke onset and 245 dyads of controls were included in the study. Spouses of dependent stroke survivors (n = 50) reported a significant lower mean QALY-weight of 0.69 in comparison to spouses of independent stroke survivors (n = 197) and spouses of controls, (n = 245) who both reported a mean QALY-weight of 0.77. The results from the regression analysis showed that higher age of the spouse and dependency of the stroke survivor had a negative association with the spouses QALY-weights. The QALY-weights for spouses of dependent midlife stroke survivors were significantly reduced compared to spouses of independent midlife stroke survivors. This indicates that the inclusion of spouses QALYs in evaluations of early treatment and rehabilitation efforts to reduce stroke patients dependency would capture more of the total effect in dyads of stroke survivors. ; Funding Agencies|Swedish Research Council [K2014-64X-14605-12-5]; Sahlgrenska University hospital [ALFGBG-429981, ALFGBG-71890]; Swedish Heart and Lung Foundation [20130315]; Swedish Stroke Association; Rune and Ulla Amlovs Foundation for Neurological Research; John and Brit Wennerstroms Foundation for Neurological Research; Gothenburg Foundation for Neurological Research; Stroke-Riksforbundet