Health Values in Adolescents with or without Inflammatory Bowel Disease

Objective

To examine for differences in and predictors of health value/utility scores in adolescents with or without inflammatory bowel disease (IBD).

Study design

Adolescents with IBD and healthy control subjects were interviewed in an academic health center. We collected sociodemographic data and measured health status, personal, family, and social characteristics, and spiritual well-being. We assessed time tradeoff (TTO) and standard gamble (SG) utility scores for current health. We performed bivariate and multivariable analyses with utility scores used as outcomes.

Results

Sixty-seven patients with IBD and 88 healthy control subjects 11 to 19 years of age participated. Among subjects with IBD, mean (SD) TTO scores were 0.92 (0.17), and mean (SD) SG scores were 0.97 (0.07). Among healthy control subjects, mean (SD) TTO scores were 0.99 (0.03) and mean (SD) SG scores were 0.98 (0.03). TTO scores were significantly lower (P = .001), and SG scores trended lower (P = .065) in patients with IBD when compared with healthy control subjects. In multivariable analyses controlling for IBD status, poorer emotional functioning and spiritual well-being were associated with lower TTO (R² = 0.17) and lower SG (R² = 0.22) scores.

Conclusion

Direct utility assessment in adolescents with or without IBD is feasible and may be used to assess outcomes. Adolescents with IBD value their health state highly, although less so than healthy control subjects. Emotional functioning and spiritual well-being appear to influence utility scores most strongly.

Abbreviations: HRQOL, Health-related quality of life, IBD, Inflammatory bowel disease, QALYs, Quality-adjusted life years, SG, Standard gamble, TTO, Time tradeoff, VAS, Visual analog scale