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An exploratory study of long-term publicly waitlisted bariatric surgery patients’ quality of life before and 1 year after bariatric surgery, and considerations for healthcare planners

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Campbell, JA ORCID: 0000-0002-1820-6758, Hensher, M, Neil, A ORCID: 0000-0002-1344-6672, Venn, A ORCID: 0000-0001-7090-1398, Wilkinson, S and Palmer, AJ ORCID: 0000-0002-9703-7891 2017 , 'An exploratory study of long-term publicly waitlisted bariatric surgery patients’ quality of life before and 1 year after bariatric surgery, and considerations for healthcare planners' , PharmacoEconomics Open, vol. 2, no. 1 , pp. 63-76 , doi: 10.1007/s41669-017-0038-z.

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Abstract

Background: Long-term publicly waitlisted bariatric surgery patients typically experience debilitating physical/ psychosocial obesity-related comorbidities that profoundly affect their quality of life.Objectives: We sought to measure quality-of-life impacts in a study population of severely obese patients who had multiyear waitlist times and then underwent bariatric surgery.Methods: Participants were recruited opportunistically following a government-funded initiative to provide bariatric surgery to morbidly obese long-term waitlisted patients. Participants self-completed the EQ-5D-5L and AQoL-8D questionnaires pre- and postoperatively. Utility valuations (utilities) and individual/super dimension scores (AQoL- 8D only) were generated.Results: Participants’ (n = 23) waitlisted time was mean [standard deviation (SD)] 6.5 (2) years, body mass index reduced from 49.3 (9.35) kg/m2 preoperatively to 40.8 (7.01) 1 year postoperatively (p = 0.02). One year utilities revealed clinical improvements (both instruments). AQoL-8D improved significantly from baseline to 1 year, with the change twice that of the EQ-5D-5L [EQ-5D-5L: mean (SD) 0.70 (0.25) to 0.78 (0.25); AQoL-8D: 0.51 (0.24) to 0.67 (0.23), p = 0.04], despite the AQoL-8D’s narrower algorithmic range. EQ-5D-5L utility plateaued from 3 months to 1 year. AQoL-8D 1-year utility improvements were driven by Happiness/ Coping/Self-worth (p p Conclusions: Ongoing improvements in psychosocial parameters from 3 months to 1 year post-surgery accounted for improvements in overall utilities measured by the AQoL-8D that were not detected by EQ- 5D-5L. Selection of a sensitive instrument is important to adequately assess changes in quality of life and to accurately reflect changes in quality-adjusted life-years for cost-utility analyses and resource allocation in a public healthcare resource-constrained environment.

Item Type: Article
Authors/Creators:Campbell, JA and Hensher, M and Neil, A and Venn, A and Wilkinson, S and Palmer, AJ
Keywords: health-related quality of life, bariatric surgery, long-term waitlisted, AQoL-8D, EQ-5D
Journal or Publication Title: PharmacoEconomics Open
Publisher: Adis International Ltd.
ISSN: 2509-4254
DOI / ID Number: 10.1007/s41669-017-0038-z
Copyright Information:

Copyright 2017 The Author(s). Licensed under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) https://creativecommons.org/licenses/by-nc/4.0/

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