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Published on: July 14, 2023
Health state preference assessment in diabetic peripheral neuropathy
Sean D Sullivan1, Doris P Lew, E Beth Devine
1Department of Pharmacy, University of Washington, Seattle, Washington 98195-7630, USA. sdsull@u.washington.edu
Objective:
To assess patient preferences for health states associated with diabetic peripheral neuropathy (DPN).
Design And Intervention:
Seven health states describing varying stages of disease severity in DPN were developed: mild neuropathy, painful neuropathy, severe neuropathy, minor ulcer, severe ulcer, minor amputation and major amputation. Using a computer interview, both rating scale (RS) and standard gamble (SG) preference scores were elicited from 52 patients with diabetes mellitus.
Setting:
A US university medical centre and a Veterans Affairs clinic.
Study Participants:
Adult patients with type 1 and type 2 diabetes mellitus between the ages of 18 and 80 years. Patients were excluded if they had been diagnosed with DPN.
Results:
Preference scores decreased in accordance with greater symptomatic and functional impairment. Median RS scores ranged from 0.89 to 0.23 for the seven health states. Median SG scores ranged from 0.96 to 0.65.
Conclusions:
Patient preferences for health states decrease as a function of increasing disease severity in DPN. The result is robust across the RS and SG methods of preference measurement. These results may be useful in informing policy analyses for resource allocation in patients with diabetes mellitus.
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Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...