Impact of Breathlessness Severity on Quality of Life, Healthcare Use, Productivity Loss and Economic Cost to the Australian Society
Author(s)
Sunjaya A1, Poulos L2, Di Tanna GL1, Lung T1, Marks GB3, Reddel HK2, Jenkins CR1
1The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia, 2The Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia, 3The University of New South Wales, Randwick, NSW, Australia
Presentation Documents
OBJECTIVES:
This study aimed to understand the impact of breathlessness severity on quality of life, healthcare use, productivity loss and economic costs to Australian adults.METHODS:
The National Breathlessness Survey was a nationwide cross-sectional web-based survey in 2019 of adult Australians (≥18 years) stratified by age-group, gender and state of residence. Severity of breathlessness was determined using the modified Medical Research Council (mMRC) dyspnoea scale (0-5), quality of life (QoL) using EQ-VAS and EQ-5D-5L, and healthcare use (HCU) and productivity loss associated with having a “breathing problem” in the past 12 months were analysed. A societal perspective was used for the health economic analysis. Quintile regression was conducted to analyse QoL and economic costs with binary logistic regression for HCU and productivity loss outcomes. All effect sizes reported were adjusted for age, gender, Indigenous background, self-reported heart and lung disease, high PHQ-4 score, multimorbidity and smoking.RESULTS:
10,072 adults (mean age 46.9±17.9 years) completed the survey. 9.54% had clinically important breathlessness (mMRC≥2). mMRC≥2 was associated with worse QoL (median reduction in EQ-VAS and EQ-5D-5L Index of -8.5 [-10.3 to -6.7] and -0.09 [-0.11 to -0.08] respectively). Pain/discomfort, anxiety/depression and mobility problems were the main contributors to the QoL reduction. Those with mMRC≥2 had twice the odds of at least one visit to a GP (OR 1.92 [95% CI 1.61-2.30]), specialist (OR 2.08 [95% CI 1.73-2.50]) or ED/hospital (OR 2.08 [95% CI 1.70-2.55]) and missing day at work/school (OR 1.91 [1.58-2.30]) in the past year for their breathing problem, though they did not have a significant increase in odds of hospitalisation compared to those with mild breathlessness (mMRC=1). Median societal costs per individual per annum for those with mMRC≥2 is higher than mMRC=1 (AUD2293[IQR 683-6382] vs AUD524[IQR 485-2262]).CONCLUSIONS:
Breathlessness carries a significant burden for patients, the healthcare system, and the economy.Conference/Value in Health Info
2023-05, ISPOR 2023, Boston, MA, USA
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Code
EE297
Topic
Economic Evaluation, Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)