Can urban methadone patients complete health utility assessments?

Overview

OBJECTIVE: To assess the ability of methadone maintenance treatment (MMT) patients to use two standardized health assessment tools to value health states related to chronic hepatitis C virus (HCV) infection and HCV treatment-associated side effects. An estimated 65-90% of MMT patients are chronically infected with HCV. METHODS: We employed qualitative methods to explore how patients completed computerized rating scale assessments and standard gamble utility assessments by (1) having them discuss their responses in a think-aloud interview immediately after each health state assessment, and (2) allowing them the opportunity to recalibrate prior responses after considering subsequent health states. RESULTS: MMT patients used the rating scale boundaries appropriately and used the standard gamble to rank the health states in an a priori logical order. A guided assessment approach that allowed recalibration provided additional insight into values assigned to the health states presented. CONCLUSION: MMT patients are able to perform the tasks associated with rating scale assessments and standard gamble utility assessments of HCV health states. PRACTICE IMPLICATIONS: These assessment methods should be considered as a means to elicit MMT patients' values for HCV treatment, since the treatment outcome is uncertain but it is likely that side effects will adversely affect current health.