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. 2017 Nov;26(11):3059-3068.
doi: 10.1007/s11136-017-1636-z. Epub 2017 Jun 29.

Long-term QALY-weights among spouses of dependent and independent midlife stroke survivors

Josefine Persson  1   2 , Mattias Aronsson  3 , Lukas Holmegaard  4 , Petra Redfors  4 , Kaj Stenlöf  5 , Katarina Jood  4 , Christina Jern  6 , Christian Blomstrand  4 , Gunilla Forsberg-Wärleby  4 , Lars-Åke Levin  4   7
Affiliations

Long-term QALY-weights among spouses of dependent and independent midlife stroke survivors

Josefine Persson et al. Qual Life Res. 2017 Nov.

Abstract

Purpose: The aim of this study was to investigate whether the dependency of midlife stroke survivors had any long-term impact on their spouses' QALY-weights.

Method: Data on stroke survivors, controls, and spouses were collected from the 7-year follow-up of the Sahlgrenska Academy Study on Ischemic Stroke. Health-related quality of life was assessed by the SF-36, and the preference-based health state values were assessed with the SF-6D. Spouses of dependent and independent stroke survivors were categorized according to their scores on the modified Rankin Scale. An ordinary least squares regression analysis was used to evaluate whether the dependency of the stroke survivors had any impact on the spouses' QALY-weights.

Result: Cohabitant dyads of 247 stroke survivors aged <70 at stroke onset and 245 dyads of controls were included in the study. Spouses of dependent stroke survivors (n = 50) reported a significant lower mean QALY-weight of 0.69 in comparison to spouses of independent stroke survivors (n = 197) and spouses of controls, (n = 245) who both reported a mean QALY-weight of 0.77. The results from the regression analysis showed that higher age of the spouse and dependency of the stroke survivor had a negative association with the spouses' QALY-weights.

Conclusion: The QALY-weights for spouses of dependent midlife stroke survivors were significantly reduced compared to spouses of independent midlife stroke survivors. This indicates that the inclusion of spouses' QALYs in evaluations of early treatment and rehabilitation efforts to reduce stroke patients' dependency would capture more of the total effect in dyads of stroke survivors.

Keywords: Health-related quality of life; Quality adjusted life years; SF-36; SF-6D; Spouses; Stroke.

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Conflict of interest statement

Conflicts of interest

The authors, Josefine Persson, Mattias Aronsson, Lukas Holmegaard, Petra Redfors, Kaj Stenlöf, Katarina Jood, Christina Jern, Christian Blomstrand, Gunilla Forsberg-Wärleby, Lars-Åke Levin, declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
mRS scores for stroke survivors included in the study compared to those not eligible for inclusion (“non eligible”) in this study from the SAHLSIS seven-year follow-up. a mRS scores at 3 months for cohabitant stroke survivors (n = 422, missing mRS data for 19 stroke survivors), b mRS scores at 3 months for “non eligible” stroke survivors before the seven-year follow-up (n = 131), c mRS scores at 7 years for cohabitant stroke survivors (n = 299; missing mRS data for 14 stroke survivors), d mRS scores at 7-years for excluded stroke survivors because researchers were not permitted to contact the spouse or because the spouse declined participation (n = 51; missing mRS data for 1 stroke survivors), e mRS scores at 7 years for included stroke survivors (n = 247)
Fig. 2
Fig. 2
Spouses’ mean QALY-weights in each of the stroke survivors mRS score, including 95% CI error bars
See this image and copyright information in PMC

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