利用HAQ-DI健康評估量表預估EQ-5D歐洲生活品質量表之效用值-以臺灣類風濕性關節炎患者為例

目的:類風濕性關節炎為一種慢性發炎性的關節疾病，許多研究指出該疾病之病程會影響病患健康相關生活品質，本研究期望透過利用HAQ-DI健康評估量表預估EQ-5D歐洲生活品質量表之效用值，並以台灣類風溼性關節炎患者為例。方法:本研究為橫斷性研究，採立意取樣方式，以類風溼性關節炎患者為研究對象，於2013年6月1日至2014年4月31日期間進行問卷訪談，以面對面訪談方式進行資料蒐集，分別從台灣地區北部、中部、南部及東部四家醫學中心風濕免疫科門診，有效問卷合計140份。問卷包含類風溼性關節炎病患疾病嚴重度與病史、健康評估問卷(Health Assessment Questionnaire Disability Index, HAQ-DI)、歐洲生活品質問卷(EQ-5D)及病患基本資料。結果:受訪者年齡大多分布於40-60歲，平均病史為9.65年，81.4%為女性。HAQ-DI構面、EQ-5D與疾病嚴重度有顯著差異(P<0.001)；HAQ-DI之結果與EQ-5D構面有問題之病患越多，各構面之間皆有達統計上顯著差異(P<0.01)；HAQ-DI變項對EQ-5D效用值，達統計上顯著水準(p<0.001)。結論:HAQ-DI與EQ-5D之結果間具有高度相關性，適用於預估台灣類風溼性關節炎患者之健康相關生活品質。

關鍵字

類風溼性關炎； HAQ-DI ； EQ-5D ；生活品質；經濟評估； Mapping

並列摘要

Title of Thesis: Using HAQ-DI to estimate EQ-5D utility values for patients with rheumatoid arthritis in Taiwan Author: Chia-Yu, Hsu Thesis advised by: Chao-Hsiun Tang, Ph.D. Objective: The aim of this study was to derive relation functions so that Health Assessment Questionnaire – Disability Index(HAQ-DI) scores could be used to estimate EQ-5D utility values for patients with rheumatoid arthritis (RA). Method: An observational, cross-sectional, multicenter study was conducted. A total of 140 patients aged 30years or older, with RA according to Disease Activity Score 28 for Rheumatoid Arthritis were recruited. Sociodemographic and clinical variables were recorded and patients completed two generic HRQoL questionnaires: the HAQ-DI and the EQ-5D.We used generalized linear models were used to predict EQ-5D utility values as functions of HAQ-DI scores. Result: The age of patients were between 40 and 60 years old; 81.4% of the patients were women. Mean disease duration was 9.65 years. The EQ-5D and HAQ-DI were significantly correlated to all of the dimensions of DAS. Conclusion: HAQ-DI scores can be used to estimate EQ-5D utility values for patients with RA in data obtained from studies where utility values have not been collected. Keyword: Rheumatoid arthritis, HAQ-DI, EQ-5D, Quality of life, Economic evaluation, Mapping.