Differences in Health Values among Patients, Family Members, and Providers for Outcomes in Schizophrenia

Objective. The objectives of this study were to determine whether there are important differences in how patients, family members, and health care providers (HCPs) value health outcomes in schizophrenia and to assess the degree to which such differences, if they exist, could adversely affect clinica...

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Published in:Medical care 2000-10, Vol.38 (10), p.1011-1021
Main Authors: Lenert, Leslie A., Ziegler, Jennifer, Lee, Tina, Sommi, Roger, Mahmoud, Ramy
Format: Article
Language:English
Subjects:
Adult
Adverse effects
Analysis of Variance
Antipsychotic agents
Antipsychotic Agents - adverse effects
Antipsychotic Agents - therapeutic use
Attitude of Health Personnel
Attitude to Health
Consumer Behavior
Cross-Sectional Studies
Drug effects
Family
Family members
Female
Gold standard
Humans
Male
Medical personnel
Mental health outcomes
Odds Ratio
Parkinson Disease, Secondary - etiology
Patient Simulation
Quality of Life
Schizophrenia
Schizophrenia - drug therapy
Schizophrenic Psychology
Symptoms
Treatment Outcome
United States
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container_title Medical care
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creator Lenert, Leslie A.
Ziegler, Jennifer
Lee, Tina
Sommi, Roger
Mahmoud, Ramy
description Objective. The objectives of this study were to determine whether there are important differences in how patients, family members, and health care providers (HCPs) value health outcomes in schizophrenia and to assess the degree to which such differences, if they exist, could adversely affect clinical and policy decision making. Methods. Participants viewed videotaped depictions of simulated patients with mild and moderate symptoms of schizophrenia, with and without a common adverse drug effect (pseudoparkinsonism), and then provided standard gamble and visual analog scale ratings of desirability of these states. Subjects. A convenience sample of unrelated patients (n = 148), family members of patients (n = 91), and HCPs (nurses, psychologists, doctors of pharmacy, and doctors of medicine; n = 99) was drawn from geographically and clinically diverse environments. Results. Patients' and family members' utilities for health states averaged 0.1 to 0.15 units higher than those of HCPs (P
doi_str_mv 10.1097/00005650-200010000-00005
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The objectives of this study were to determine whether there are important differences in how patients, family members, and health care providers (HCPs) value health outcomes in schizophrenia and to assess the degree to which such differences, if they exist, could adversely affect clinical and policy decision making. Methods. Participants viewed videotaped depictions of simulated patients with mild and moderate symptoms of schizophrenia, with and without a common adverse drug effect (pseudoparkinsonism), and then provided standard gamble and visual analog scale ratings of desirability of these states. Subjects. A convenience sample of unrelated patients (n = 148), family members of patients (n = 91), and HCPs (nurses, psychologists, doctors of pharmacy, and doctors of medicine; n = 99) was drawn from geographically and clinically diverse environments. Results. Patients' and family members' utilities for health states averaged 0.1 to 0.15 units higher than those of HCPs (P &lt;0.002 for differences between groups, ANOVA for multiple observations). The disutility of adverse drug effects was less for health professionals than patients and family members (P = 0.008). Health professionals tended to prefer states with mild symptoms with extrapyramidal side effects to states with moderate symptoms. Patients and family members found these states equally preferable (P &lt;0.007 for differences between groups). Conclusions. There are systematic differences in values for health outcomes between patients and HCPs with regard to states with adverse effects of antipsychotic drugs. Family members of patients in general had values that were more similar to those of patients than were those of health professionals. The results emphasize the importance of participation by patients (or family member proxies) in clinical decision making and guideline development.</description><identifier>ISSN: 0025-7079</identifier><identifier>EISSN: 1537-1948</identifier><identifier>DOI: 10.1097/00005650-200010000-00005</identifier><identifier>PMID: 11021674</identifier><language>eng</language><publisher>United States: J. B. Lippincott Williams and Wilkins Inc</publisher><subject>Adult ; Adverse effects ; Analysis of Variance ; Antipsychotic agents ; Antipsychotic Agents - adverse effects ; Antipsychotic Agents - therapeutic use ; Attitude of Health Personnel ; Attitude to Health ; Consumer Behavior ; Cross-Sectional Studies ; Drug effects ; Family ; Family members ; Female ; Gold standard ; Humans ; Male ; Medical personnel ; Mental health outcomes ; Odds Ratio ; Parkinson Disease, Secondary - etiology ; Patient Simulation ; Quality of Life ; Schizophrenia ; Schizophrenia - drug therapy ; Schizophrenic Psychology ; Symptoms ; Treatment Outcome ; United States</subject><ispartof>Medical care, 2000-10, Vol.38 (10), p.1011-1021</ispartof><rights>Copyright 2000 Lippincott Williams &amp; Wilkins, Inc.</rights><rights>2000 Lippincott Williams &amp; Wilkins, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3775-f912de1292e61ae7eb5a173eaa86b0999491efe9c3125c51a762247f45a7b89c3</citedby><cites>FETCH-LOGICAL-c3775-f912de1292e61ae7eb5a173eaa86b0999491efe9c3125c51a762247f45a7b89c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/3767984$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/3767984$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,58238,58471</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11021674$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lenert, Leslie A.</creatorcontrib><creatorcontrib>Ziegler, Jennifer</creatorcontrib><creatorcontrib>Lee, Tina</creatorcontrib><creatorcontrib>Sommi, Roger</creatorcontrib><creatorcontrib>Mahmoud, Ramy</creatorcontrib><title>Differences in Health Values among Patients, Family Members, and Providers for Outcomes in Schizophrenia</title><title>Medical care</title><addtitle>Med Care</addtitle><description>Objective. The objectives of this study were to determine whether there are important differences in how patients, family members, and health care providers (HCPs) value health outcomes in schizophrenia and to assess the degree to which such differences, if they exist, could adversely affect clinical and policy decision making. Methods. Participants viewed videotaped depictions of simulated patients with mild and moderate symptoms of schizophrenia, with and without a common adverse drug effect (pseudoparkinsonism), and then provided standard gamble and visual analog scale ratings of desirability of these states. Subjects. A convenience sample of unrelated patients (n = 148), family members of patients (n = 91), and HCPs (nurses, psychologists, doctors of pharmacy, and doctors of medicine; n = 99) was drawn from geographically and clinically diverse environments. Results. Patients' and family members' utilities for health states averaged 0.1 to 0.15 units higher than those of HCPs (P &lt;0.002 for differences between groups, ANOVA for multiple observations). The disutility of adverse drug effects was less for health professionals than patients and family members (P = 0.008). Health professionals tended to prefer states with mild symptoms with extrapyramidal side effects to states with moderate symptoms. Patients and family members found these states equally preferable (P &lt;0.007 for differences between groups). Conclusions. There are systematic differences in values for health outcomes between patients and HCPs with regard to states with adverse effects of antipsychotic drugs. Family members of patients in general had values that were more similar to those of patients than were those of health professionals. The results emphasize the importance of participation by patients (or family member proxies) in clinical decision making and guideline development.</description><subject>Adult</subject><subject>Adverse effects</subject><subject>Analysis of Variance</subject><subject>Antipsychotic agents</subject><subject>Antipsychotic Agents - adverse effects</subject><subject>Antipsychotic Agents - therapeutic use</subject><subject>Attitude of Health Personnel</subject><subject>Attitude to Health</subject><subject>Consumer Behavior</subject><subject>Cross-Sectional Studies</subject><subject>Drug effects</subject><subject>Family</subject><subject>Family members</subject><subject>Female</subject><subject>Gold standard</subject><subject>Humans</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Mental health outcomes</subject><subject>Odds Ratio</subject><subject>Parkinson Disease, Secondary - etiology</subject><subject>Patient Simulation</subject><subject>Quality of Life</subject><subject>Schizophrenia</subject><subject>Schizophrenia - drug therapy</subject><subject>Schizophrenic Psychology</subject><subject>Symptoms</subject><subject>Treatment Outcome</subject><subject>United States</subject><issn>0025-7079</issn><issn>1537-1948</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><recordid>eNp1UUtOwzAUtBCIlsINEPIBCNhOHMdLVChFKmolPtvISV6ISz6VnVCV0-M2pazw5nlGMyN7HkKYkhtKpLgl7vCQE4-5C90ib0cdoSHlvvCoDKJjNCSEcU8QIQfozNqlkwqfs1M0oJQwGopgiIp7nedgoE7BYl3jKaiyLfC7KjtHqKqpP_BCtRrq1l7jiap0ucHPUCVgHFZ1hhem-dKZgzhvDJ53bdpUfdZLWujvZlW4dK3O0UmuSgsX-zlCb5OH1_HUm80fn8Z3My_1heBeLinLgDLJIKQKBCRcuVeDUlGYECllICnkIFOfMp5yqkTIWCDygCuRRI4eoajPTU1jrYE8XhldKbOJKYm35cW_5cWH8nrKWa9666pLKsj-jPu2nCDoBeumbN2PP8tuDSYudp3F_y3F2S5729K2jTnE-iIUMgr8H_WKgxQ</recordid><startdate>200010</startdate><enddate>200010</enddate><creator>Lenert, Leslie A.</creator><creator>Ziegler, Jennifer</creator><creator>Lee, Tina</creator><creator>Sommi, Roger</creator><creator>Mahmoud, Ramy</creator><general>J. B. Lippincott Williams and Wilkins Inc</general><general>Lippincott Williams &amp; Wilkins, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>200010</creationdate><title>Differences in Health Values among Patients, Family Members, and Providers for Outcomes in Schizophrenia</title><author>Lenert, Leslie A. ; Ziegler, Jennifer ; Lee, Tina ; Sommi, Roger ; Mahmoud, Ramy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3775-f912de1292e61ae7eb5a173eaa86b0999491efe9c3125c51a762247f45a7b89c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Adverse effects</topic><topic>Analysis of Variance</topic><topic>Antipsychotic agents</topic><topic>Antipsychotic Agents - adverse effects</topic><topic>Antipsychotic Agents - therapeutic use</topic><topic>Attitude of Health Personnel</topic><topic>Attitude to Health</topic><topic>Consumer Behavior</topic><topic>Cross-Sectional Studies</topic><topic>Drug effects</topic><topic>Family</topic><topic>Family members</topic><topic>Female</topic><topic>Gold standard</topic><topic>Humans</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Mental health outcomes</topic><topic>Odds Ratio</topic><topic>Parkinson Disease, Secondary - etiology</topic><topic>Patient Simulation</topic><topic>Quality of Life</topic><topic>Schizophrenia</topic><topic>Schizophrenia - drug therapy</topic><topic>Schizophrenic Psychology</topic><topic>Symptoms</topic><topic>Treatment Outcome</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lenert, Leslie A.</creatorcontrib><creatorcontrib>Ziegler, Jennifer</creatorcontrib><creatorcontrib>Lee, Tina</creatorcontrib><creatorcontrib>Sommi, Roger</creatorcontrib><creatorcontrib>Mahmoud, Ramy</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Medical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lenert, Leslie A.</au><au>Ziegler, Jennifer</au><au>Lee, Tina</au><au>Sommi, Roger</au><au>Mahmoud, Ramy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differences in Health Values among Patients, Family Members, and Providers for Outcomes in Schizophrenia</atitle><jtitle>Medical care</jtitle><addtitle>Med Care</addtitle><date>2000-10</date><risdate>2000</risdate><volume>38</volume><issue>10</issue><spage>1011</spage><epage>1021</epage><pages>1011-1021</pages><issn>0025-7079</issn><eissn>1537-1948</eissn><abstract>Objective. The objectives of this study were to determine whether there are important differences in how patients, family members, and health care providers (HCPs) value health outcomes in schizophrenia and to assess the degree to which such differences, if they exist, could adversely affect clinical and policy decision making. Methods. Participants viewed videotaped depictions of simulated patients with mild and moderate symptoms of schizophrenia, with and without a common adverse drug effect (pseudoparkinsonism), and then provided standard gamble and visual analog scale ratings of desirability of these states. Subjects. A convenience sample of unrelated patients (n = 148), family members of patients (n = 91), and HCPs (nurses, psychologists, doctors of pharmacy, and doctors of medicine; n = 99) was drawn from geographically and clinically diverse environments. Results. Patients' and family members' utilities for health states averaged 0.1 to 0.15 units higher than those of HCPs (P &lt;0.002 for differences between groups, ANOVA for multiple observations). The disutility of adverse drug effects was less for health professionals than patients and family members (P = 0.008). Health professionals tended to prefer states with mild symptoms with extrapyramidal side effects to states with moderate symptoms. Patients and family members found these states equally preferable (P &lt;0.007 for differences between groups). Conclusions. There are systematic differences in values for health outcomes between patients and HCPs with regard to states with adverse effects of antipsychotic drugs. Family members of patients in general had values that were more similar to those of patients than were those of health professionals. The results emphasize the importance of participation by patients (or family member proxies) in clinical decision making and guideline development.</abstract><cop>United States</cop><pub>J. B. Lippincott Williams and Wilkins Inc</pub><pmid>11021674</pmid><doi>10.1097/00005650-200010000-00005</doi><tpages>11</tpages></addata></record>
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ispartof Medical care, 2000-10, Vol.38 (10), p.1011-1021
issn 0025-7079
1537-1948
language eng
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source JSTOR Archival Journals and Primary Sources Collection
subjects Adult
Adverse effects
Analysis of Variance
Antipsychotic agents
Antipsychotic Agents - adverse effects
Antipsychotic Agents - therapeutic use
Attitude of Health Personnel
Attitude to Health
Consumer Behavior
Cross-Sectional Studies
Drug effects
Family
Family members
Female
Gold standard
Humans
Male
Medical personnel
Mental health outcomes
Odds Ratio
Parkinson Disease, Secondary - etiology
Patient Simulation
Quality of Life
Schizophrenia
Schizophrenia - drug therapy
Schizophrenic Psychology
Symptoms
Treatment Outcome
United States
title Differences in Health Values among Patients, Family Members, and Providers for Outcomes in Schizophrenia
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