Health Utility Estimation Based on Parenteral Support Days for Adult Patients With Short Bowel Syndrome and Intestinal Failure in Korea

OBJECTIVES: This study aimed to estimate the health utility weights associated with the frequency of weekly parenteral support (PS) in adult patients with short bowel syndrome and intestinal failure (SBS-IF), as perceived by the general Korean population.

METHODS: We developed scenarios depicting health states of adult SBS-IF patients based on PS frequency using previous studies, in-depth interviews with 9 SBS-IF patients, and clinical expert reviews. A general population survey in Korea measured health utility using the EQ-5D, Visual Analogue Scale (VAS), and Time Trade-Off (TTO) methods. Mean utility values were calculated across weekly PS days groups. Subgroup comparisons were performed using t-tests and ANOVA. Multilevel analysis addressed repeated measures and controlled for sociodemographic factors.

RESULTS: The analysis included 179 participants from the general Korean population. Utility scores, as measured by EQ-5D, VAS, and TTO, demonstrated a negative correlation with increasing PS days in SBS-IF patients. The mean utility value for "0 days on PS" was the highest (EQ-5D: 0.808, VAS: 0.689, TTO: 0.874) and these scores progressively decreased with each additional PS day. The mean utility value for "7 days on PS" was the lowest (EQ-5D: 0.117, VAS: 0.180, TTO: 0.272). After adjusting for covariates, PS frequency remained a significant predictor of utility values (P < 0.001).

CONCLUSIONS: This study revealed a significant increase in health-related quality of life (HRQoL) for adult SBS-IF patients with decreasing PS frequency. Interventions to minimize the number of PS days hold promise for substantially improving HRQoL in this patient population.