Health-State Utilities in Liver Cirrhosis: A Cross-Sectional Study

Objectives: Liver cirrhosis is a serious disease which can change many aspects of life of the patients, and their family and also effects society. Health-related quality of life (HRQL) in patients with cirrhosis can be evaluated using utility assessment techniques. We aimed to study the utility of cirrhosis from the point of view of the patients, their family, and their caretakers to find appropriate interventions, and training and counselling programmes to support patients. Methods: In this cross-sectional study with a purposive sampling method, 66 subjects, consisting of 30 patients with decompensated cirrhosis (all of whom were on the liver transplant waiting list), 21 family caregivers, and 15 caretakers, were included. We administered data collection in face to face interviews and through paper-based questionnaires. We also elicited utilities using formal approaches; time trade-off (TTO), standard gamble (SG), rating scale (RS), and the willingness to pay (WTP). Results: There were statistically significant differences in utilities assigned by three groups in all preference-based measures (P < 0.05). The total utility score of patients was lower in comparison to their family members and caretakers. The Spearmanʹs correlation coefficient showed that the three methods of TTO, RS, and SG were convergent in the caretaker group and divergent in the patient group. The only significant correlations between utilities were between TTO and WTP in the patient group and between TTO and RS in family caregiver group (P < 0.05). Conclusions: utility assessments indicate that Health-related quality of life (HRQL) is compromised in patients with cirrhosis. These data can be the basis for cost-effectiveness analyses in studies of patients with chronic liver disease.