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Long-term QALY-weights among spouses of dependent and independent midlife stroke survivors.

Journal article
Authors Josefine Persson
Mattias Aronsson
Lukas Holmegaard
Petra Redfors
Kaj Stenlöf
Katarina Jood
Christina Jern
Christian Blomstrand
Gunilla Forsberg-Wärleby
Lars-Åke Levin
Published in Quality of Life Research
Volume 26
Issue 11
Pages 3059-3068
ISSN 0962-9343
Publication year 2017
Published at Institute of Neuroscience and Physiology
Institute of Biomedicine, Department of Pathology
Institute of Medicine
Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
Pages 3059-3068
Language en
Links 10.1007/s11136-017-1636-z
Keywords Health-related quality of Life, Quality adjusted life years, SF-36, SF-6D, Spouses, Stroke
Subject categories Neurosciences, Health Care Service and Management, Health Policy and Services and Health Economy


PURPOSE: The aim of this study was to investigate whether the dependency of midlife stroke survivors had any long-term impact on their spouses' QALY-weights. METHOD: Data on stroke survivors, controls, and spouses were collected from the 7-year follow-up of the Sahlgrenska Academy Study on Ischemic Stroke. Health-related quality of life was assessed by the SF-36, and the preference-based health state values were assessed with the SF-6D. Spouses of dependent and independent stroke survivors were categorized according to their scores on the modified Rankin Scale. An ordinary least squares regression analysis was used to evaluate whether the dependency of the stroke survivors had any impact on the spouses' QALY-weights. RESULT: Cohabitant dyads of 247 stroke survivors aged <70 at stroke onset and 245 dyads of controls were included in the study. Spouses of dependent stroke survivors (n = 50) reported a significant lower mean QALY-weight of 0.69 in comparison to spouses of independent stroke survivors (n = 197) and spouses of controls, (n = 245) who both reported a mean QALY-weight of 0.77. The results from the regression analysis showed that higher age of the spouse and dependency of the stroke survivor had a negative association with the spouses' QALY-weights. CONCLUSION: The QALY-weights for spouses of dependent midlife stroke survivors were significantly reduced compared to spouses of independent midlife stroke survivors. This indicates that the inclusion of spouses' QALYs in evaluations of early treatment and rehabilitation efforts to reduce stroke patients' dependency would capture more of the total effect in dyads of stroke survivors.

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