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Comparison and correlates of three preference-based health-related quality-of-life measures among overweight and obese women with urinary incontinence

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Abstract

Purpose

To compare three preference-based health-related quality-of-life (HRQL) measures and examine independent correlates of HRQL among overweight and obese women with urinary incontinence (UI) enrolled in a weight loss intervention trial.

Methods

Participants completed baseline questionnaires, which included the Health Utilities Index 3 (HUI3) and Medical Outcomes Study Short Form-36 (SF-36). The SF-36 was used to derive SF-6D and estimated Quality of Well-Being (eQWB) scores. Height, weight, medical history, incontinence measures, and level of physical activity also were assessed. The intraclass correlation coefficient (ICC) was computed, and differences in mean scores across HRQL measures were examined. Potential correlates of HUI3, SF-6D, and eQWB scores were evaluated using multivariable generalized linear models.

Results

Mean ± SD scores for the HUI3, SF-6D, and eQWB were 0.81 ± 0.18, 0.75 ± 0.10, and 0.71 ± 0.06, respectively. Significant differences were observed across measures (P < 0.0001), and the overall ICC was 0.36. In multivariable analyses, BMI was negatively associated with HUI3 (P = 0.003) and eQWB (P < 0.001), and UI episode frequency was negatively associated with eQWB (P = 0.015) and SF-6D (P < 0.001).

Conclusions

Significant differences in mean utilities across the HUI3, SF-6D, and eQWB indicate that these measures do not assess identical dimensions of HRQL. Both BMI and UI episode frequency were related to HRQL in this cohort; however, the magnitude of the relationship depended on the preference-based measure used. These findings highlight the need to consider the method used to generate HRQL values for calculating quality-adjusted life-years in cost-utility analyses, since choice of method may have a substantial impact on the outcome of the analysis.

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Acknowledgments

The authors wish to acknowledge the contribution made by PRIDE investigators, staff, consultants, sponsor and Data and Safety Monitoring Board: The University of Alabama, Birmingham—Frank Franklin, MD, PhD (Principal Investigator), Holly Richter, PhD, MD (Co-Investigator), Leslie Abdo, BSN, RN, CCRC, Charlotte Bragg, MS, RD, LD, Kathy Burgio, PhD (Investigator), Kathy Carter,RN, BSN, Juan Dunlap, Stacey Gilbert, MPH, Sara Hannum, Anne Hubbell, MS, RD, LD, Karen Marshall, Lisa Pair, CRNP, Penny Pierce, RN, BSN, Clara Smith, MS, RD, Sue Thompson, RN, Janet Turman, Audrey Wrenn, MAEd. The Miriam Hospital—Rena Wing, PhD (Principal Investigator), Amy Gorin, PhD (Co-Investigator), Deborah Myers, MD (Co-Investigator), Tammy Monk, MS, Rheanna Ata, Megan Butryn, PhD, Pamela Coward, MEd, RD, Linda Gay, MS, RD, CDE, Jacki Hecht, MSN, RN, Anita Lepore-Ally, RN, Heather Niemeier, PhD, Yael Nillni, Angela Pinto, PhD, Deborah Ranslow-Robles, Phlebotomist/MedAsst, Natalie Robinson, MS, RD, Deborah Sepinwall, PhD, Margaret E. Hahn, MSN, RNP, Vivian W. Sung, MD, MPH, Victoria Winn, Nicole Zobel. The University of Arkansas for Medical Sciences—Delia West, PhD (Investigator). The University of Pennsylvania—Gary Foster, PhD (Consultant). The University of California, San Francisco (Coordinating Center)—Deborah Grady, MD, MPH (Principal Investigator), Leslee Subak, MD (Co-PI), Judith Macer, Ann Chang, Jennifer Creasman, MSPH, Judy Quan, PhD, Eric Vittinghoff, PhD, Jennifer Yang. Supported by grants #U01 DK067860, U01 DK067861 and U01 DK067862 from The National Institute of Diabetes and Digestive and Kidney Diseases—John W. Kusek, PhD, Leroy M. Nyberg, MD, PhD (Project Officers). Preparation of this manuscript was supported by 5K23DK075645 from the National Institute of Diabetes and Digestive and Kidney Diseases. Data and Safety Monitoring Board. The University of Utah Health Sciences Center—Ingrid Nygaard, MD (DSMB Chairperson). The Children’s Hospital Boston—Leslie Kalish, ScD. The University of California, San Diego—Charles Nager, MD. The Medical University of South Carolina—Patrick M. O’Neil, PhD. The Johns Hopkins School of Medicine—Cynthia S. Rand, PhD. The University of Virginia Health Systems—William D. Steers, MD.

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Authors and Affiliations

  1. Department of Psychology, Baruch College, CUNY, 55 Lexington Avenue, B8-215, New York, NY, 10010, USA

    Angela Marinilli Pinto

  2. Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA

    Miriam Kuppermann, Sanae Nakagawa & Leslee L. Subak

  3. Department of Epidemiology & Biostatistics, UCSF, San Francisco, CA, USA

    Miriam Kuppermann, Eric Vittinghoff & Leslee L. Subak

  4. Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA

    Rena R. Wing

  5. National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA

    John W. Kusek

  6. Department of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, MI, USA

    William H. Herman

  7. Department of Urology, UCSF, San Francisco, CA, USA

    Leslee L. Subak

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  1. Angela Marinilli Pinto
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  2. Miriam Kuppermann
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  3. Sanae Nakagawa
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  4. Eric Vittinghoff
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  5. Rena R. Wing
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  6. John W. Kusek
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  7. William H. Herman
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  8. Leslee L. Subak
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Corresponding author

Correspondence to Angela Marinilli Pinto.

Additional information

For the Program to Reduce Incontinence by Diet and Exercise (PRIDE). Clinical Trial Registration for “PRIDE” is NCT00091988 in www.clinicaltrials.gov

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Pinto, A.M., Kuppermann, M., Nakagawa, S. et al. Comparison and correlates of three preference-based health-related quality-of-life measures among overweight and obese women with urinary incontinence. Qual Life Res 20, 1655–1662 (2011). https://doi.org/10.1007/s11136-011-9896-5

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