Health-related quality of life and utility values among patients with anxiety and/or depression in a low-income tertiary care setting: a cross-sectional analysis

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OBJECTIVES: To describe the health-related quality of life (HRQoL), estimate the associated health state utility values (HSUVs) and explore factors associated with HRQoL of patients with anxiety and/or depression in a resource-limited hospital setting. METHODS: A cross-sectional survey involving 462 participants was conducted in a hospital setting. The Amharic version of the EQ-5D-5 L assessed HRQoL, while the GAD-7 and PHQ-9 measured severity of anxiety and depression symptoms respectively. HSUVs were analysed based on clinical and demographic profiles; mean differences were compared using t-tests and one-way ANOVA; Scheffe's post hoc comparisons and effect sizes (Cohen's d statistic) were used to assess the magnitude of group differences. Factors associated with HRQoL were explored using regression analysis. RESULTS: The mean HSUV was 0.87 (SD = 0.17) and the EQ VAS was 71.4 (SD = 19.1). Patients with both anxiety and depression scored significantly lower (HSUV = 0.83 [0.16], EQ VAS = 64.4 [17.9]) compared to those with either anxiety only (HSUV = 0.88 [0.17], EQ VAS = 75.3 [17.9]) or depression only (HSUV = 0.89 [0.18], EQ VAS 74.4 [19.7]). Males had slightly higher mean scores than females, while those aged 18-35 years demonstrated the highest scores on both the EQ-5D-5 L and EQ VAS. Older age (β=-0.002), higher PHQ-9 scores (β=-0.008) and comorbid hypertension (β=-0.07) associated with lower HSUVs. Lower EQ VAS scores were associated with being female (β=-4.4), having comorbid hypertension (β=-7.4) and higher PHQ-9 scores (β=-0.86), while a positive association was found with having 'more than enough' income (β = 11.8). CONCLUSIONS: Older age, severity or co-diagnosis of anxiety or depression and comorbid conditions were associated with lower HRQoL, highlighting the need for better interventions to improve the HRQoL of patients with anxiety and depression in Ethiopia.

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