A Validation Study of the EQ-5D-5L and ICEpop Capability Measure for Older People Among Older Individuals With Depressive Symptoms in Brazil

Carina Akemi Nakamura*, Paul M Mitchell, TJ Peters, Darío Moreno-Agostino , Ricardo Araya, Marcia Scazufca , William Hollingworth

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

Objectives
This study aimed to assess the known-groups validity of the EQ-5D-5L and the ICECAP-O, two outcome measures used in economic evaluation, among older adults with depressive symptoms in socio-economically deprived areas of Brazil. We also explored the role of education and income on responses to these measures.

Methods
This cross-sectional study used baseline data from PROACTIVE, a cluster randomised controlled trial to evaluate a psychosocial intervention for late life depression among older adults. Participants aged 60 years or over with a Patient Health Questionnaire (PHQ-9) score≥10 were recruited from 20 primary healthcare clinics. Ordered logistic regression models assessed the association between depression severity, income and education and dimension level responses on the EQ-5D-5L and ICECAP-O. Multivariable regression models investigated the ability of EQ-5D-5L and ICECAP-O scores to discriminate between depression severity levels and other characteristics, including education level and household income.

Results
715 participants were included in the study. Depression severity was associated with all EQ-5D-5L and ICECAP-O dimensions, except the ICECAP-O enjoyment attribute. Household income, on the other hand, was only associated with the ICECAP-O security attribute. Higher severity of depressive symptoms (PHQ-9 scores) were also strongly associated with lower (i.e. worse) scores on both measures in all models. Education level and household income showed no association with either EQ-5D-5L or ICECAP-O scores.

Conclusions
This is the first study that investigated the validity of these two measures among older adults in Brazil. Both EQ-5D-5L and ICECAP-O showed evidence of validity in differentiating depressive symptom severity.
Original languageEnglish
Pages (from-to)91-99
Number of pages9
JournalValue in Health
Volume30
Early online date21 Mar 2022
DOIs
Publication statusE-pub ahead of print - 21 Mar 2022

Bibliographical note

Funding Information:
Funding/Support: This study was supported by São Paulo Research Foundation (process number 17/50094-2) and the Joint Global Health Trials initiative jointly funded by Medical Research Council , Wellcome Trust , and the UK Department for International Development (MRC, process number MR/R006229/1). Dr Nakamura is supported by a fellowship from São Paulo Research Foundation (2018/19343-0). Dr Mitchell’s time on this study was supported by the Wellcome Trust (205384/Z/16/Z). Dr Scazufca is supported by the CNPq-Brazil (307579/2-19-0). For the purpose of open access, the authors have applied a Creative Commons by public copyright license to any author accepted manuscript version arising from this submission.

Publisher Copyright:
© 2022 International Society for Health Economics and Outcomes Research

Structured keywords

  • HEB

Keywords

  • EQ-5D-5L
  • ICECAP-O
  • low- and middle-income countries
  • mental health
  • older adults

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