Feasibility, reliability and validity of a questionnaire on healthcare consumption and productivity loss in patients with a psychiatric disorder (TiC-P)

Clazien Bouwmans, Kim De Jong, Reinier Timman, Moniek Zijlstra-Vlasveld, Christina Van der Feltz-Cornelis, Siok Tan Swan, Leona Hakkaart-van Roijen, Clazien Bouwmans, Kim De Jong, Reinier Timman, Moniek Zijlstra-Vlasveld, Christina Van der Feltz-Cornelis, Siok Tan Swan, Leona Hakkaart-van Roijen

Abstract

Background: Patient self-report allows collecting comprehensive data for the purpose of performing economic evaluations. The aim of the current study was to assess the feasibility, reliability and a part of the construct validity of a commonly applied questionnaire on healthcare utilization and productivity losses in patients with a psychiatric disorder (TiC-P).

Methods: Data were derived alongside two clinical trials performed in the Netherlands in patients with mental health problems. The response rate, average time of filling out the questionnaire and proportions of missing values were used as indicators of feasibility of the questionnaire. Test-retest analyses were performed including Cohen's kappa and intra class correlation coefficients to assess reliability of the data. The construct validity was assessed by comparing patient reported data on contacts with psychotherapists and reported data on long-term absence from work with data derived from registries.

Results: The response rate was 72%. The mean time needed for filling out the first TiC-P was 9.4 minutes. The time needed for filling out the questionnaire was 2.3 minutes less for follow up measurements. Proportions of missing values were limited (< 2.4%) except for medication for which in 10% of the cases costs could not be calculated. Cohen's kappa was satisfactory to almost perfect for most items related to healthcare consumption and satisfactory for items on absence from work and presenteeism. Comparable results were shown by the ICCs on variables measuring volumes of medical consumption and productivity losses indicating good reliability of the questionnaire.Absolute agreement between patient-reported data and data derived from medical registrations of the psychotherapists was satisfactory. Accepting a margin of +/- seven days, the agreement on reported and registered data on long-term absence from work was satisfactory. The validity of self-reported data using the TiC-P is promising.

Conclusions: The results indicate that the TiC-P is a feasible and reliable instrument for collecting data on medical consumption and productivity losses in patients with mild to moderate mental health problems. Additionally, the construct validity of questions related to contacts with psychotherapist and long-term absence from work was satisfactory.

Figures

Figure 1
Figure 1
Example of an item on medical resource use.
Figure 2
Figure 2
Questions related to absence from work.
Figure 3
Figure 3
Questions related to reduced efficiency during work.

References

    1. Jonsson B. Ten arguments for a societal perspective in the economic evaluation of medical innovations. Eur J Health Econ. 2009;10(4):357–359. doi: 10.1007/s10198-009-0173-2.
    1. Knies S, Severens JL, Ament AJ, Evers SM. The transferability of valuing lost productivity across jurisdictions. Differences between national pharmacoeconomic guidelines. Value Health. 2010;13(5):519–527. doi: 10.1111/j.1524-4733.2010.00699.x.
    1. Hjelmgren J, Berggren F, Andersson F. Health economic guidelines–similarities, differences and some implications. Value Health. 2001;4(3):225–250. doi: 10.1046/j.1524-4733.2001.43040.x.
    1. Tan SS, Bouwmans CAM, Rutten FF, Hakkaart-van Roijen L. Update of the Dutch Manual for Costing in Economic Evaluations. Int J Technol Assess Health Care. 2012;28(2):152–158. doi: 10.1017/S0266462312000062.
    1. Drummond MF, Sculpher MJ, Torrence GW, O’Brien BJ, Stoddart GL. Methods for the Economic Evaluation of health Care Programmes: third ed. Oxford: Oxford University Press; 2005.
    1. Riley GF. Administrative and claims records as sources of health care cost data. Med Care. 2009;47(7 Suppl 1):S51–S55.
    1. Sevilla-Dedieu C, Kovess-Masfety V, Angermeyer M, Bruffaerts R, Fernandez A, Girolamo GD, De Graaf R, Haro JM, Konig HH. The ESEMED/MHEDEA 2000 Investigators. Measuring use of services for mental health problems in epidemiological surveys. Int J Methods Psychiatr Res. 2011;20(3):182–191.
    1. Wang PS, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bromet EJ, Bruffaerts R, De Girolamo G, De Graaf R, Gureje O, Haro JM, Karam EG, Kessler RC, Kovess V, Lane MC, Lee S, Levinson D, Ono Y, Petukhova M, Posada-Villa J, Seedat S, Wells JE. Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. Lancet. 2007;370(9590):841–850. doi: 10.1016/S0140-6736(07)61414-7.
    1. Van den Brink M, Van den Hout WB, Stiggelbout AM, Putter H, Van de Velde CJ, Kievit J. Self-reports of health-care utilization: diary or questionnaire? Int J Technol Assess Health Care. 2005;21(3):298–304.
    1. Goossens ME, Rutten-van Molken MP, Vlaeyen JW, Van der Linden SM. The cost diary: a method to measure direct and indirect costs in cost-effectiveness research. J Clin Epidemiol. 2000;53(7):688–695. doi: 10.1016/S0895-4356(99)00177-8.
    1. Hakkaart-van Roijen L, Van Straten A, Al M, Rutten F, Donker M. Cost-utility of brief psychological treatment for depression and anxiety. Br J Psychiatry. 2006;188:323–329. doi: 10.1192/bjp.188.4.323.
    1. Polak AR, Witteveen AB, Visser RS, Opmeer BC, Vulink N, Figee M, Denys D, Olff M. Comparison of the effectiveness of trauma-focused cognitive behavioral therapy and paroxetine treatment in PTSD patients: design of a randomized controlled trial. BMC Psychiatry. 2012;12:166. doi: 10.1186/1471-244X-12-166.
    1. Berghout CC, Zevalkink J, Hakkaart-Van Roijen L. The effects of long-term psychoanalytic treatment on healthcare utilization and work impairment and their associated costs. J Psychiatr Pract. 2010;16(4):209–216. doi: 10.1097/01.pra.0000386907.99536.75.
    1. Horn EK, Van Benthem TB, Hakkaart-van Roijen L, Van Marwijk HW, Beekman AT, Rutten FF, Van der Feltz-Cornelis CM. Cost-effectiveness of collaborative care for chronically ill patients with comorbid depressive disorder in the general hospital setting, a randomised controlled trial. BMC Health Serv Res. 2007;7:28. doi: 10.1186/1472-6963-7-28.
    1. Institute for Medical Technology Assessment. Questionnaire Healthcare consumption, illness and work (TIC-P) .
    1. Hakkaart-Van Roijen L. Manual. Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness (TiC-P adults) 2010. .
    1. Roijen VL, Essink-Bot M, Koopmanschap M, Bonsel G, Rutten F. Labor and health status in economic evaluation of health care. The Health and Labor Questionnaire. Int J Technol Assess Health Care. 1996;12(3):405–415. doi: 10.1017/S0266462300009764.
    1. De Jong K. A chance for change: building an outcome monitoring feedback system for outpatient mental health care. PhD thesis.Leiden University, Department of Clinical Health and Neuropsychology; 2012.
    1. Vlasveld MC, Van der Feltz-Cornelis CM, Ader HJ, Anema JR, Hoedeman R, Van Mechelen W, Beekman AT. Collaborative care for major depressive disorder in an occupational healthcare setting. Br J Psychiatry. 2012;200(6):510–511. doi: 10.1192/bjp.bp.111.095687.
    1. Altman D. Practical statistics for medical research. London: Chapman & Hall; 1991.
    1. Al Mahdy H, Seymour DG. How much can elderly patients tell us about their medications? Postgrad Med J. 1990;66(772):116–121. doi: 10.1136/pgmj.66.772.116.
    1. Pinto D, Robertson MC, Hansen P, Abbott JH. Good agreement between questionnaire and administrative databases for health care use and costs in patients with osteoarthritis. BMC Med Res Methodol. 2011;11:45. doi: 10.1186/1471-2288-11-45.
    1. Severens J, Mulder J, Laheij R, AL AV. Precision and accuracy in measuring absence from work as a basis for calculating productivity costs in The Netherlands. Soc Sci Med. 2000;51(2):243–249. doi: 10.1016/S0277-9536(99)00452-9.
    1. Van Poppel MN, De Vet HC, Koes BW, Smid T, Bouter LM. Measuring sick leave: a comparison of self-reported data on sick leave and data from company records. Occup Med (Lond) 2002;52(8):485–490. doi: 10.1093/occmed/52.8.485.
    1. Ferrie JE, Kivimaki M, Head J, Shipley MJ, Vahtera J, Marmot MG. A comparison of self-reported sickness absence with absences recorded in employers’ registers: evidence from the Whitehall II study. Occup Environ Med. 2005;62(2):74–79. doi: 10.1136/oem.2004.013896.

Source: PubMed

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