Close-Person Spill-Overs in End-of-Life Care: Using Hierarchical Mapping to Identify Whose Outcomes to Include in Economic Evaluations

Canaway, Alastair; Al‐Janabi, Hareth; Kinghorn, Philip; Bailey, Cara; Coast, Joanna

doi:10.1007/s40273-019-00786-5

Cited by 22 publications

(38 citation statements)

References 40 publications

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“…Brown et al and Lavelle et al measure health spillover effects in caregivers or parents of children with autism; Brown et al using indirect methods (EQ-5D and SF-6D) and Lavelle et al using a direct assessment (time trade-off questions) [12,13]. An overview paper by Wittenberg et al provides a comprehensive catalog of caregiver/ family member utilities in the literature organized into three groupings: health utilities that isolate the change in quality of life associated with spillover, health utilities of a caregiver/family member sample and a comparison or control group, and health utilities of caregivers/family members alone (no comparison group) [14]. Finally, Canaway et al present qualitative findings collected at end of life on who is considered "close" when assessing spillover in economic evaluations [15].…”

Section: Topics In This Issuementioning

confidence: 99%

“…Papers using qualitative approaches suggest a direct valuation approach for spillover may be exceedingly difficult for respondents-to disentangle their own health and simultaneously balance the positive and negative aspects of having an ill family member, especially for caregivers [20]. A superior approach is likely to be the use of a comparison group as described in one set of papers reviewed in Wittenberg et al [14]. For this type of study design, though, additional resources will be needed to include a comparison sample.…”

Section: Emerging Themesmentioning

confidence: 99%

“…Questions on whose effects should be included require additional debate. The paper in this issue by Canaway et al presents a qualitative approach to identifying these increasingly inclusive circles of family members and carers [15].…”

Section: Emerging Themesmentioning

confidence: 99%

“…This issue provides several tools for analysts-methods for valuing informal care [7], a comprehensive catalog of caregiver utilities [14], and an algorithm for generating caregiver time using patient-level EQ-5D data [11]. Much guidance is still needed especially in best practices for valuing informal care time and measuring spillover burden via health utilities.…”

Section: Future Questionsmentioning

confidence: 99%

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Advances in Methods and Novel Applications for Measuring Family Spillover Effects of Illness

Prosser

Wittenberg²

2019

PharmacoEconomics

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Section: Topics In This Issuementioning

confidence: 99%

Section: Emerging Themesmentioning

confidence: 99%

Section: Emerging Themesmentioning

confidence: 99%

Section: Future Questionsmentioning

confidence: 99%

See 2 more Smart Citations

Advances in Methods and Novel Applications for Measuring Family Spillover Effects of Illness

Prosser

Wittenberg²

2019

PharmacoEconomics

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“…Whose QALYs to include in spillover is also an unanswered question as evidence suggests effects extend beyond the primary caregiver [39] and perceptions of relevance (i.e. 'closeness') vary across individuals [40]. The articles in this review provide the data to inform family-based CEAs but do not inform the questions underlying appropriate incorporation approaches.…”

Section: How and Under What Circumstances Should Spillover Be Includementioning

confidence: 99%

Spillover Effects on Caregivers’ and Family Members’ Utility: A Systematic Review of the Literature

2019

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Background A growing body of research has identified health-related quality-of-life effects for caregivers and family members of ill patients (i.e. 'spillover effects'), yet these are rarely considered in cost-effectiveness analyses (CEAs). Objective The objective of this study was to catalog spillover-related health utilities to facilitate their consideration in CEAs. Methods We systematically reviewed the medical and economic literatures (MEDLINE, EMBASE, and EconLit, from inception through 3 April 2018) to identify articles that reported preference-based measures of spillover effects. We used keywords for utility measures combined with caregivers, family members, and burden. Results Of 3695 articles identified, 80 remained after screening: 8 (10%) reported spillover utility per se, as utility or disutility (i.e. utility loss); 25 (30%) reported a comparison group, either population values (n = 9) or matched, non-caregiver/ family member or unaffected individuals' utilities (n = 16; 3 reported both spillover and a comparison group); and 50 (63%) reported caregiver/family member utilities only. Alzheimer's disease/dementia was the most commonly studied disease/ condition, and the EQ-5D was the most commonly used measurement instrument. Conclusions This comprehensive catalog of utilities showcases the spectrum of diseases and conditions for which caregiver and family members' spillover effects have been measured, and the variation in measurement methods used. In general, utilities indicated a loss in quality of life associated with being a caregiver or family member of an ill relative. Most studies reported caregiver/family member utility without any comparator, limiting the ability to infer spillover effects. Nevertheless, these values provide a starting point for considering spillover effects in the context of CEA, opening the door for more comprehensive analyses. Key PointsInclusion of caregiver and family member ('spillover') quality-adjusted life-years (QALYs) in cost-effectiveness analyses (CEAs) is recommended by multiple national guidance bodies.Caregiver and family member QALYs can include spillover utilities (the independent utility loss due to a family member's illness) that are rarely reported in the literature; more common are caregivers'/family members' utilities, sometimes in combination with a comparator utility.Research gaps remain in spillover effect estimation and incorporation methods, slowing the adoption of these additional measures of burden into cost-effectiveness evaluations.

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Challenges in developing capability measures for children and young people for use in the economic evaluation of health and care interventions

et al. 2021

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Methods for measuring outcomes suitable for economic evaluations of health and care interventions have primarily focused on adults. The validity of such methods for children and young people is questionable in areas including the outcome domains measured and how they are measured and valued, with most existing measures narrowly focusing on health. Novel methods for assessing benefits beyond health by focusing on a person's capability have also concentrated on adults to date. This paper aims to set out the rationale for capability measures in children and young people. It argues for the need to expand the evaluative space beyond health functioning towards broader capabilities, with children and young people playing an integral role in capability measure development. Drawing from existing literature, specific challenges related to the identification, measurement, and valuation of capabilities in children and young people are also discussed. Finally, the practical implications for conducting economic evaluation when measuring and valuing capabilities at different stages across the life‐course are illustrated. We develop an alternative framework based on conceiving capabilities as evolving across the life‐course. This framework may also be helpful in thinking about how to model health outcomes across the life‐course.

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Close-Person Spill-Overs in End-of-Life Care: Using Hierarchical Mapping to Identify Whose Outcomes to Include in Economic Evaluations

Abstract: Please refer to published version for the most recent bibliographic citation information. If a published version is known of, the repository item page linked to above, will contain details on accessing it.

Cited by 22 publications

References 40 publications

Advances in Methods and Novel Applications for Measuring Family Spillover Effects of Illness

Advances in Methods and Novel Applications for Measuring Family Spillover Effects of Illness

Spillover Effects on Caregivers’ and Family Members’ Utility: A Systematic Review of the Literature

Challenges in developing capability measures for children and young people for use in the economic evaluation of health and care interventions

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