Impact of Chorea on Self-care Activity, Employment, and Health-care Resource Use in Patients with Huntington’s Disease
**Background:** Chorea is recognized as a prototypic motor feature of Huntington’s disease (HD), but its effect on health-related quality of life (HRQoL) has not been fully explored. This study describes the impact of chorea on HRQoL in patients with HD. **Objective:** To determine the impact of HD...
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| Format: | Article |
| Language: | English |
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Columbia Data Analytics, LLC
2021-06-01
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| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/001c.24620 |
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| author | Daniel O. Claassen Jonathan DeCourcy Jennifer Mellor Charlotte Johnston Ravi G. Iyer |
| author_facet | Daniel O. Claassen Jonathan DeCourcy Jennifer Mellor Charlotte Johnston Ravi G. Iyer |
| author_sort | Daniel O. Claassen |
| collection | DOAJ |
| description | **Background:** Chorea is recognized as a prototypic motor feature of Huntington’s disease (HD), but its effect on health-related quality of life (HRQoL) has not been fully explored. This study describes the impact of chorea on HRQoL in patients with HD.
**Objective:** To determine the impact of HD-related chorea on employment, self-care activities, activities of daily living, and health-care resource utilization (HCRU).
**Methods:** Data were drawn from the Adelphi HD Disease Specific Programme, a real-world point-in-time survey of 144 neurologists and 427 patients in the United States between July and October 2017. HD patients with and without chorea were identified and examined for differences in employment status, reasons for employment changes, self-care activities, and modifications to cope with involuntary movements. Bivariate tests and inverse probability weighted regression adjustment methods were used to determine differences in outcomes between patients with and without chorea.
**Results:** HD patients with (n=287) and without (n=140) chorea were identified. Patients with chorea were less likely to be employed full-time (16.7% vs 25.7%; _P_<0.04) and more likely to be on long-term sick leave (17.4% vs 5.0%; _P_<0.01). The onset of motor symptoms in HD-related chorea patients coincided with a change in employment status (42.7% vs 20.8%; _P_<0.01). Among those still working (n=145), more than two-fifths of patients with chorea required changes to their workplace and required these changes more frequently (45% vs 17%; _P_<0.001). HD patients with chorea required aid to help them get around significantly more frequently than those without chorea (55% vs 34%; _P_<0.001).
**Discussion:** These results demonstrate that HD patients with chorea experienced greater negative impact to employment, self-care activities, and HCRU than patients without chorea experienced. These patients were more likely to stop working due to motor, cognitive, and behavioral symptoms; require modifications in the home and workplace; and need more assistance from caregivers than patients without chorea.
**Conclusions:** Patients with HD-related chorea have greater detriments to emotional, interpersonal, and professional functioning that could be improved by reducing chorea. |
| format | Article |
| id | doaj-art-9fe27d7151d24a509692598a52be7816 |
| institution | Kabale University |
| issn | 2327-2236 |
| language | English |
| publishDate | 2021-06-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj-art-9fe27d7151d24a509692598a52be78162025-02-10T16:13:18ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362021-06-0181Impact of Chorea on Self-care Activity, Employment, and Health-care Resource Use in Patients with Huntington’s DiseaseDaniel O. ClaassenJonathan DeCourcyJennifer MellorCharlotte JohnstonRavi G. Iyer**Background:** Chorea is recognized as a prototypic motor feature of Huntington’s disease (HD), but its effect on health-related quality of life (HRQoL) has not been fully explored. This study describes the impact of chorea on HRQoL in patients with HD. **Objective:** To determine the impact of HD-related chorea on employment, self-care activities, activities of daily living, and health-care resource utilization (HCRU). **Methods:** Data were drawn from the Adelphi HD Disease Specific Programme, a real-world point-in-time survey of 144 neurologists and 427 patients in the United States between July and October 2017. HD patients with and without chorea were identified and examined for differences in employment status, reasons for employment changes, self-care activities, and modifications to cope with involuntary movements. Bivariate tests and inverse probability weighted regression adjustment methods were used to determine differences in outcomes between patients with and without chorea. **Results:** HD patients with (n=287) and without (n=140) chorea were identified. Patients with chorea were less likely to be employed full-time (16.7% vs 25.7%; _P_<0.04) and more likely to be on long-term sick leave (17.4% vs 5.0%; _P_<0.01). The onset of motor symptoms in HD-related chorea patients coincided with a change in employment status (42.7% vs 20.8%; _P_<0.01). Among those still working (n=145), more than two-fifths of patients with chorea required changes to their workplace and required these changes more frequently (45% vs 17%; _P_<0.001). HD patients with chorea required aid to help them get around significantly more frequently than those without chorea (55% vs 34%; _P_<0.001). **Discussion:** These results demonstrate that HD patients with chorea experienced greater negative impact to employment, self-care activities, and HCRU than patients without chorea experienced. These patients were more likely to stop working due to motor, cognitive, and behavioral symptoms; require modifications in the home and workplace; and need more assistance from caregivers than patients without chorea. **Conclusions:** Patients with HD-related chorea have greater detriments to emotional, interpersonal, and professional functioning that could be improved by reducing chorea.https://doi.org/10.36469/001c.24620 |
| spellingShingle | Daniel O. Claassen Jonathan DeCourcy Jennifer Mellor Charlotte Johnston Ravi G. Iyer Impact of Chorea on Self-care Activity, Employment, and Health-care Resource Use in Patients with Huntington’s Disease Journal of Health Economics and Outcomes Research |
| title | Impact of Chorea on Self-care Activity, Employment, and Health-care Resource Use in Patients with Huntington’s Disease |
| title_full | Impact of Chorea on Self-care Activity, Employment, and Health-care Resource Use in Patients with Huntington’s Disease |
| title_fullStr | Impact of Chorea on Self-care Activity, Employment, and Health-care Resource Use in Patients with Huntington’s Disease |
| title_full_unstemmed | Impact of Chorea on Self-care Activity, Employment, and Health-care Resource Use in Patients with Huntington’s Disease |
| title_short | Impact of Chorea on Self-care Activity, Employment, and Health-care Resource Use in Patients with Huntington’s Disease |
| title_sort | impact of chorea on self care activity employment and health care resource use in patients with huntington s disease |
| url | https://doi.org/10.36469/001c.24620 |
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