OBJECTIVES: To assess the applicability of EQ-5D-3L for exploring long-term subjective health expectations (SHE) of patients with chronic diseases.

METHODS: Current and expected health states for ages 60, 70, 80 and 90 were surveyed using the EQ-5D-3L descriptive system in patients with rheumatoid arthritis (RA, N=92), psoriasis (N=167), postmenopausal osteoporosis (OP; N=224) and age-related macular degeneration (AMD; N=122) in Hungary. The UK value set was used to calculate EQ-5D-3L index scores. Subjective life expectancy was recorded. Spearman rank correlations between SHE and patient characteristics were analysed.

RESULTS: Patients mean (SD) age in RA, psoriasis, OP and AMD were 51.1 (11.9), 50.4 (12.5), 69.5 (8.9) and 75.2 (7.9) years, respectively. Complete responses on SHE for respective future ages were obtained from 99%/95%/92%/86% in RA, 93%/88%/72%/55% in psoriasis, 91%/85%/78%/70% in OP and 100%/94%/80%/56% in AMD. The proportion of patients expecting full health (‘11111’ responses) for future ages was under 20%, with two exceptions (psoriasis for age 60: 24%; AMD for age 70: 28%) indicating an overall low ceiling effect. In all the four diseases patients expected sharp deterioration of health with age, the expected EQ-5D index scores for ages 60 and 90 were: RA 0.44, -0.02; psoriasis 0.56, -0.17; OP 0.42, -0.18; AMD 0.60, 0.24. Patients who believed to be alive at the age surveyed expected significantly higher EQ-5D-3L scores than those who did not (p<0.05). SHE showed moderate or weak positive correlation with current EQ-5D-3L index score and subjective life-expectancy.

CONCLUSIONS: These first studies suggest that the EQ-5D-3L descriptive system is a feasible method to explore SHE in chronic diseases. Extending the survey to lower ages deserves consideration in diseases that affect mainly the younger population. It is strongly suggested, however, to explore in parallel the subjective life-expectancy as it influences the expected health status.