Risks Associated with Antiretroviral Treatment for Human Immunodeficiency Virus (HIV): Qualitative Analysis of Social Media Data and Health State Utility Valuation

Louis S. Matza; Karen C. Chung; Katherine J. Kim; Trena M. Paulus; Evan W. Davies; Katie D. Stewart; Grace A. McComsey; Marshall W. Fordyce

doi:10.1007/s11136-017-1519-3

Risks Associated with Antiretroviral Treatment for Human Immunodeficiency Virus (HIV): Qualitative Analysis of Social Media Data and Health State Utility Valuation

Louis S. Matza, Karen C. Chung, Katherine J. Kim, Trena M. Paulus, Evan W. Davies, Katie D. Stewart, Grace A. McComsey, Marshall W. Fordyce

Research output: Contribution to journal › Article › peer-review

Abstract

   Purpose 
 Despite benefts of antiretroviral therapies (ART), people with HIV infection have increased risk of cardiovascular disease, kidney disease, and low bone mineral density. Some ARTs increase risk of these events. The purpose of this study was to examine patients’ perspectives of these risks and estimate health state utilities associated with these risks for use in cost-utility models.
 
   Methods 
 Qualitative thematic analysis was conducted to examine messages posted to the POZ/AIDSmeds Internet community forums, focusing on bone, kidney, and cardiovascular side efects and risks of HIV/AIDS medications. Then, health state vignettes were drafted based on this qualitative analysis, literature review, and clinician interviews. The health states (representing HIV, plus treatmentrelated risks) were valued in time trade-of interviews with general population participants in the UK.
 
   Results 
 Qualitative analysis of the Internet forums documented patient concerns about ART risks, as well as treatment decisions made because of these risks. A total of 208 participants completed utility interviews (51.4% female; mean age 44.6 years). The mean utility of the HIV healthstate (virologically suppressed, treated with ART) was 0.86. Adding a description of risk resulted in statistically signifcant disutility (i.e., utility decreases): renal risk (disutility=−0.02), bone risk (−0.03), and myocardial infarction risk (−0.05).
 
   Conclusions 
 Patient concerns and treatment decisions were documented via qualitative analysis of Internet forum discussions, and the impact of these concerns was quantifed in terms of health state utilities. The resulting disutilities may be useful for diferentiating among ARTs in economic modeling of treatment for patients with HIV

Original language	American English
Journal	Quality of Life Research
Volume	26
DOIs	https://doi.org/10.1007/s11136-017-1519-3
State	Published - Jul 1 2017
Externally published	Yes

Keywords

acquired immune deficiency syndrome
antiretroviral
human immunodeficiency virus
time trade-off
treatment risk
utility

Disciplines

Educational Assessment, Evaluation, and Research
Medicine and Health Sciences
Physical Therapy
Social Media

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Cite this

@article{f313cce60d5c4805ae90ca4be710646e,

title = "Risks Associated with Antiretroviral Treatment for Human Immunodeficiency Virus (HIV): Qualitative Analysis of Social Media Data and Health State Utility Valuation",

abstract = " Purpose Despite benefts of antiretroviral therapies (ART), people with HIV infection have increased risk of cardiovascular disease, kidney disease, and low bone mineral density. Some ARTs increase risk of these events. The purpose of this study was to examine patients{\textquoteright} perspectives of these risks and estimate health state utilities associated with these risks for use in cost-utility models. Methods Qualitative thematic analysis was conducted to examine messages posted to the POZ/AIDSmeds Internet community forums, focusing on bone, kidney, and cardiovascular side efects and risks of HIV/AIDS medications. Then, health state vignettes were drafted based on this qualitative analysis, literature review, and clinician interviews. The health states (representing HIV, plus treatmentrelated risks) were valued in time trade-of interviews with general population participants in the UK. Results Qualitative analysis of the Internet forums documented patient concerns about ART risks, as well as treatment decisions made because of these risks. A total of 208 participants completed utility interviews (51.4\% female; mean age 44.6 years). The mean utility of the HIV healthstate (virologically suppressed, treated with ART) was 0.86. Adding a description of risk resulted in statistically signifcant disutility (i.e., utility decreases): renal risk (disutility=−0.02), bone risk (−0.03), and myocardial infarction risk (−0.05). Conclusions Patient concerns and treatment decisions were documented via qualitative analysis of Internet forum discussions, and the impact of these concerns was quantifed in terms of health state utilities. The resulting disutilities may be useful for diferentiating among ARTs in economic modeling of treatment for patients with HIV",

keywords = "acquired immune deficiency syndrome, antiretroviral, human immunodeficiency virus, time trade-off, treatment risk, utility",

author = "Matza, \{Louis S.\} and Chung, \{Karen C.\} and Kim, \{Katherine J.\} and Paulus, \{Trena M.\} and Davies, \{Evan W.\} and Stewart, \{Katie D.\} and McComsey, \{Grace A.\} and Fordyce, \{Marshall W.\}",

year = "2017",

month = jul,

day = "1",

doi = "10.1007/s11136-017-1519-3",

language = "American English",

volume = "26",

journal = "Quality of Life Research",

}

TY - JOUR

T1 - Risks Associated with Antiretroviral Treatment for Human Immunodeficiency Virus (HIV): Qualitative Analysis of Social Media Data and Health State Utility Valuation

AU - Matza, Louis S.

AU - Chung, Karen C.

AU - Kim, Katherine J.

AU - Paulus, Trena M.

AU - Davies, Evan W.

AU - Stewart, Katie D.

AU - McComsey, Grace A.

AU - Fordyce, Marshall W.

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Purpose Despite benefts of antiretroviral therapies (ART), people with HIV infection have increased risk of cardiovascular disease, kidney disease, and low bone mineral density. Some ARTs increase risk of these events. The purpose of this study was to examine patients’ perspectives of these risks and estimate health state utilities associated with these risks for use in cost-utility models. Methods Qualitative thematic analysis was conducted to examine messages posted to the POZ/AIDSmeds Internet community forums, focusing on bone, kidney, and cardiovascular side efects and risks of HIV/AIDS medications. Then, health state vignettes were drafted based on this qualitative analysis, literature review, and clinician interviews. The health states (representing HIV, plus treatmentrelated risks) were valued in time trade-of interviews with general population participants in the UK. Results Qualitative analysis of the Internet forums documented patient concerns about ART risks, as well as treatment decisions made because of these risks. A total of 208 participants completed utility interviews (51.4% female; mean age 44.6 years). The mean utility of the HIV healthstate (virologically suppressed, treated with ART) was 0.86. Adding a description of risk resulted in statistically signifcant disutility (i.e., utility decreases): renal risk (disutility=−0.02), bone risk (−0.03), and myocardial infarction risk (−0.05). Conclusions Patient concerns and treatment decisions were documented via qualitative analysis of Internet forum discussions, and the impact of these concerns was quantifed in terms of health state utilities. The resulting disutilities may be useful for diferentiating among ARTs in economic modeling of treatment for patients with HIV

AB - Purpose Despite benefts of antiretroviral therapies (ART), people with HIV infection have increased risk of cardiovascular disease, kidney disease, and low bone mineral density. Some ARTs increase risk of these events. The purpose of this study was to examine patients’ perspectives of these risks and estimate health state utilities associated with these risks for use in cost-utility models. Methods Qualitative thematic analysis was conducted to examine messages posted to the POZ/AIDSmeds Internet community forums, focusing on bone, kidney, and cardiovascular side efects and risks of HIV/AIDS medications. Then, health state vignettes were drafted based on this qualitative analysis, literature review, and clinician interviews. The health states (representing HIV, plus treatmentrelated risks) were valued in time trade-of interviews with general population participants in the UK. Results Qualitative analysis of the Internet forums documented patient concerns about ART risks, as well as treatment decisions made because of these risks. A total of 208 participants completed utility interviews (51.4% female; mean age 44.6 years). The mean utility of the HIV healthstate (virologically suppressed, treated with ART) was 0.86. Adding a description of risk resulted in statistically signifcant disutility (i.e., utility decreases): renal risk (disutility=−0.02), bone risk (−0.03), and myocardial infarction risk (−0.05). Conclusions Patient concerns and treatment decisions were documented via qualitative analysis of Internet forum discussions, and the impact of these concerns was quantifed in terms of health state utilities. The resulting disutilities may be useful for diferentiating among ARTs in economic modeling of treatment for patients with HIV

KW - acquired immune deficiency syndrome

KW - antiretroviral

KW - human immunodeficiency virus

KW - time trade-off

KW - treatment risk

KW - utility

U2 - 10.1007/s11136-017-1519-3

DO - 10.1007/s11136-017-1519-3

M3 - Article

VL - 26

JO - Quality of Life Research

JF - Quality of Life Research

ER -