Estimating the Impact of Pill Burden on the Utility of Patients Undergoing Hemodialysis
Author(s)
Hiroo Shimoda, BS1, Masatomo Taniguchi, MD, PhD2, Suguru Yamamoto, MD, PhD3, Ataru Igarashi, PhD4, Shin Tokunaga, PhD1, Keigo Hanada, MS5, Naoki Tashiro, BS5, Tatsunori Murata, PhD5, Shinji Asada, MPH1;
1Kyowa Kirin Co., Ltd., Tokyo, Japan, 2Fukuoka Renal Clinic, Fukuoka, Japan, 3Niigata University Graduate School of Medical and Dental Science, Niigata, Japan, 4The University of Tokyo, Department of Health Policy and Public Health, Tokyo, Japan, 5CRECON Medical Assessment Inc., Tokyo, Japan
1Kyowa Kirin Co., Ltd., Tokyo, Japan, 2Fukuoka Renal Clinic, Fukuoka, Japan, 3Niigata University Graduate School of Medical and Dental Science, Niigata, Japan, 4The University of Tokyo, Department of Health Policy and Public Health, Tokyo, Japan, 5CRECON Medical Assessment Inc., Tokyo, Japan
Presentation Documents
OBJECTIVES: Patients undergoing hemodialysis (HD) have polypharmacy due to comorbidities such as hyperphosphatemia, hypertension, diabetes, anemia. HD patients have a water intake restriction and reducing the pill burden (number of medications) would possibly reduce their psychological burden and increase their quality of life (QOL). We used the vignette-based time trade-off (TTO) method to investigate the impact of pill burden on the utility score in HD patients.
METHODS: Vignettes with different pill burdens for seven health states (intake of 2, 3, 6, 9, 12, 24, and 36 pills per day) were created based on the opinions of patients and experts. Face-to-face interviews were conducted in patients recruited from the general population. We evaluated the utility scores for each vignette using the TTO method and estimated the impact of pill burden on QOL.
RESULTS: We interviewed 107 participants. The average age was 44.5 years, and 50.5% were male. The average (standard deviation) utility scores for the seven health states were: 0.373 (0.579) for 2 pills/day, 0.347 (0.591) for 3 pills/day, 0.327 (0.563) for 6 pills/day, 0.314 (0.570) for 9 pills/day, 0.290 (0.575) for 12 pills/day, 0.257 (0.568) for 24 pills/day, 0.239 (0.568) for 36 pills/day. The results of subgroup analysis based on sex and age (<44, >=44 years) were the same as in the overall population, that is, increasing pill burden and decreasing utility score had a positive association without statistical significance.
CONCLUSIONS: Using the vignette-based TTO approach in HD patients from the general population, we were able to estimate their health utility scores. The results suggested that increase in pill burden is associated with a decrease in QOL. Reducing pill burden would be beneficial for QOL and water intake restriction in HD patients.
METHODS: Vignettes with different pill burdens for seven health states (intake of 2, 3, 6, 9, 12, 24, and 36 pills per day) were created based on the opinions of patients and experts. Face-to-face interviews were conducted in patients recruited from the general population. We evaluated the utility scores for each vignette using the TTO method and estimated the impact of pill burden on QOL.
RESULTS: We interviewed 107 participants. The average age was 44.5 years, and 50.5% were male. The average (standard deviation) utility scores for the seven health states were: 0.373 (0.579) for 2 pills/day, 0.347 (0.591) for 3 pills/day, 0.327 (0.563) for 6 pills/day, 0.314 (0.570) for 9 pills/day, 0.290 (0.575) for 12 pills/day, 0.257 (0.568) for 24 pills/day, 0.239 (0.568) for 36 pills/day. The results of subgroup analysis based on sex and age (<44, >=44 years) were the same as in the overall population, that is, increasing pill burden and decreasing utility score had a positive association without statistical significance.
CONCLUSIONS: Using the vignette-based TTO approach in HD patients from the general population, we were able to estimate their health utility scores. The results suggested that increase in pill burden is associated with a decrease in QOL. Reducing pill burden would be beneficial for QOL and water intake restriction in HD patients.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PCR17
Topic
Patient-Centered Research
Topic Subcategory
Health State Utilities, Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Urinary/Kidney Disorders