A Study of the Relationship between Health and Subjective Well-Being in Parkinson's Disease Patients

Abstract

Objectives: In light of the apparent disconnect between traditional measures of societal well-being such as GDP and reported levels of happiness, governments globally are turning their attention to alternative subjective measures of well-being (SWB) to aid policy decisions. In the context of health, there is therefore growing interest in understanding how measures of health-related quality of life (HRQoL), widely used in health technology appraisal, relates to SWB, and whether SWB could provide a sound basis for resource allocation decisions in health and other sectors in the future. This study investigates the relationship between HRQoL, as measured by EQ-5D, and SWB in Parkinson’s disease (PD) and the extent to which patients’ self-reported health can explain (part of) their SWB.

Methods: A paper questionnaire included the EQ-5D, four key SWB questions taken from the Office for National Statistics Integrated Household Survey in England and other demographic details. It distributed to patients with PD in the UK. Responses were used to estimate multiple regression models explaining SWB using each of the EQ-5D Index (UK weights), EQ-5D dimensions and EQ-VAS and patient socio-demographic characteristics.

Results: 276 questionnaires were distributed and 183 responses received. The EQ-5D Index was a moderate predictor of SWB (adjusted R2 range 0.19-0.38 in OLS models), but EQ-VAS performed better (adjusted R2 range 0.32-0.49). Combining EQ-VAS and EQ-5D dimensions, especially anxiety/depression and mobility, and household status in some cases, yielded the best-fitting models (adjusted R2 range 0.40-0.52).

Conclusions: The findings imply that EQ-VAS and some dimensions of the EQ-5D, together with key demographic data, could potentially be used to predict SWB,e.g. via mapping. However, further empirical research into the relationship between SWB and EQ-5D longitudinally, and in different disease areas, is required to corroborate these findings, and further standardisation of SWB measures is recommended.