Can urban methadone patients complete health utility assessments?

To assess the ability of methadone maintenance treatment (MMT) patients to use two standardized health assessment tools to value health states related to chronic hepatitis C virus (HCV) infection and HCV treatment-associated side effects. An estimated 65-90% of MMT patients are chronically infected with HCV.

We employed qualitative methods to explore how patients completed computerized rating scale assessments and standard gamble utility assessments by (1) having them discuss their responses in a think-aloud interview immediately after each health state assessment, and (2) allowing them the opportunity to recalibrate prior responses after considering subsequent health states.

MMT patients used the rating scale boundaries appropriately and used the standard gamble to rank the health states in an a priori logical order. A guided assessment approach that allowed recalibration provided additional insight into values assigned to the health states presented.

MMT patients are able to perform the tasks associated with rating scale assessments and standard gamble utility assessments of HCV health states.

These assessment methods should be considered as a means to elicit MMT patients' values for HCV treatment, since the treatment outcome is uncertain but it is likely that side effects will adversely affect current health.