Danchenko, N.

Davis, K.

DiBenedetti, D.B.

François, C.

Lançon, C.

Lewis, S.

Elsevier - Publisher Connector 

increasing time between injections. Untreated schizophrenia was rated as very
poor health-related quality of life with a mean (median) utility of 0.27 (0.20). The
treated health states were rated at much higher utilities and were statistically
significantly different (p0.001) from each other: (1) 2-weekly: mean (median) util-
ity  0.61 (0.65); (2) 4-weekly: mean (median) utility  0.65 (0.70); (3) 3-monthly:
mean (median) utility 0.70 (0.75). CONCLUSIONS: This study has provided robust
data indicating that approximately a 0.05 utility difference exists between treat-
ment options, with the highest utility assigned to 3-monthly injections.
PMH51
BASELINE RESULTS FROM BEAT THE BLUES
Pizzi LT1, Jutkowitz E1, Gitlin L1, Suh DC2, Dennis M1
1Thomas Jefferson University, Philadelphia, PA, USA, 2School of Pharmacy, Rutgers University,
Piscataway, NJ, USA
OBJECTIVES: Depression exerts significant morbidity in homebound elders. While
antidepressant medications are effective, little data exist on non-pharmacological
support programs. Beat the Blues (BTB) is a non-pharmacological intervention de-
signed to teach community dwelling depressed African Americans elders coping
skills. BTB was tested in an 8-month randomized two-group experimental design
(treatment vs. wait list control). This analysis examines relationships between
health utility and baseline characteristics of participants.METHODS: Patientswere
enrolled in 2009 and 2010 and eligible if they had depressive symptoms (i.e., PHQ-9
score 5), were African American, 55 years, English speaking, and cognitively
intact (MMSE 24). Data included demographics, co-morbidities, functionality
(ADL, IADL, and mobility), and health utility which were converted from EQ-5D
scores using US scoring algorithm. Regression analyses were conducted to assess
the relationship between health utility and relevant variables with focus on the
relative impact of depression score, with and without adjusting for the study
variables. RESULTS: In the sample (n86), the average age was 68, most were
female (77%), unmarried (92%), non-working (89%), had an average of 6.5 health
conditions (range 1-15), and taking at least onemedication for depression, anxiety,
sleep, or pain. The mean EQ-5D utility index score was 0.56 (SD 0.2); mean PHQ-9
scorewas 12.6 (moderate depression; SD 4.9). EQ-5D index scoreswere significantly
related to PHQ9 score, gender, diabetes, asthma, stroke,multiple sclerosis,memory
problems (p.05) and highly related to functionality (IADL, mobility), foot prob-
lems, number of comorbidities (p.005). After adjusting for patients’ age, educa-
tion, and gender, EQ-5D utility score was significantly decreased as patients had
mobility difficulty, high PHQ9 score, or more comorbidities. CONCLUSIONS: BTB
serves as a unique sample for examination of contributors to health utility in
depressed homebound African American elders. Mobility, depression severity,
and number of comorbidities were significant predictors of health utility in this
population.
PMH52
PATIENT AND PHYSICIAN PREFERENCES AND SATISFACTION WITH ORAL AND
LONG-ACTING INJECTABLE LONG-TERM ANTIPSYCHOTIC TREATMENT FOR
PSHYCHOTIC DISORDERS
Prûtz C1, Andersson-Ljungberg G2, Hintikka J3, Opjordsmoen S4, Nielsen J5, Hansson F6
1Janssen Cilag AB, Sollentuna, Sweden, 2University Hospital of Gothenburg, Göteborg, Sweden,
3Kuopio University Hospital of Psychiatry, Kuopio, Finland, 4Oslo University Hospital, Oslo,
Norway, 5Aalborg University Hospital, Aalborg, Denmark, 6Commitum, Lund, Sweden
OBJECTIVES: Compliance to treatment in schizophrenia is important to avoid re-
lapse and hospitalization. There is evidence that satisfaction to treatment is posi-
tively associatedwith adherence.We studied patient and physician preference and
satisfaction for different forms of administration of antipsychotic treatment and
drivers behind. METHODS: A non-interventional study including adult patients
diagnosed with schizophrenia and other schizoaffective disorders using long-term
therapy with either atypical orals, atypical LAI (long acting injectables) or other
typical LAI were included. One face-to-facemeetingwas conductedwere a number
of questionnaires were answered by the patient and the physician, MSQ (Medical
Satisfaction Questionnaire), CGI-Severity, DAI (Drug Attitude Inventory) as well as
current and previous medication, adherence, adverse reactions and other back-
ground variables. The hypothesis was that non-.inferiority in MSQ scale between
Atypical LAIs and Atypical oral treatment exist. Statistical method was analysis of
variance with a 95% confidence interval. RESULTS: A total of 265 patients in Swe-
den, Finland, Norway and Denmark with a stable disease during the last three
months were included. Significant differences were observed between oral treat-
ment and injectables in age and time to diagnosis, and were therefore adjusted for
in our analysis. Non-inferiority could be established in theMSQ (primary objective).
The hypothesis of superiority was confirmed in DAI scale, were both Atypical Oral
and Atypical LAI where significant better (p0.0001 and p0.0003) compared to
Typical LAI. Patient own assessment of adherence showed that patients on LAI
were more adherent than patients on Atypical oral treatment, while no difference
between the two LAI existed. CONCLUSIONS: These results suggest that patient
satisfaction with their drug therapy is not determined by the administration form.
Physicians need to have a good understanding of patients preferences and satis-
faction to therapy when initiating drug therapy.
PMH53
ASSESSING THE IMPACT OF MAJOR DEPRESSIVE DISORDER (MDD) ON FAMILY
FUNCTIONING: DEVELOPMENT OF THE DEPRESSION AND FAMILY
FUNCTIONING SCALE
Lançon C1, DiBenedetti DB2, Lewis S2, Davis K2, Danchenko N3, François C3
1Hopital Sainte-Marguerite CHU, Marseille, France, 2RTI Health Solutions, Research Triangle
Park, NC, USA, 3Lundbeck SAS, Issy-les-Moulineaux, France
OBJECTIVES: To assess family functioning from patients’ and partners’ perspec-
tives to better understand the impact of depression on family functioning; To de-
velop and test patient and partner versions of a new self-reported measure, the
Depression and Family Functioning Scale (DFFS), for use in clinical trials.
METHODS: First, 32 in-depth interviews were conducted separately with adults
withmoderate-to-severeMDDand their respective partners to 1) gather qualitative
data describing the impact of depression on family functioning, and 2) identify
constructs relevant to measuring this impact. Next, based on the interview results
and a targeted literature review conducted to supplement these results, 26 items
were drafted to address each aspect of family functioning likely to be affected by
depression. Questionnaire items were then tested and refined through two itera-
tive sets of cognitive interviews with a total of 15 MDD patients and 15 partners of
MDDpatients to allow for enhanced comprehension of questionnaire items, aswell
as optimization of the recall period and response scales used in the final DFFS.
RESULTS: Depression negatively affects family functioning, most notably through
poorer communication, increased conflicts, decreased family interaction, and de-
creased intimacy. Family functioning constructsmost commonly referenced in the
literature review included communication, satisfaction, and cohesion. Draft DFFS
items generally tested well and only minor modifications were made to the items
after the second set of interviews to further facilitate comprehension and accurate
responses. Both patients and partners found the final 15 DFFS items important and
relevant. CONCLUSIONS: Depression negatively affects family functioning in mul-
tiple ways. The DFFS is a brief scale designed to evaluate depression’s impact on
family functioning in patients with MDD and their partners. The DFFS has the
potential to provide unique and important information facilitating more compre-
hensive evaluation of new treatments in clinical trial settings.
PMH54
CAREGIVER BURDEN IN SCHIZOPHRENIA - A SYSTEMATIC REVIEW
Shah D1, Kamal KM2
1Duquesne University Mylan School of Pharmacy, Pittsburgh, PA, USA, 2Duquesne University,
Pittsburgh, PA, USA
OBJECTIVES: Caregivers of people with schizophrenia experience economic and
humanistic burden which not only affects their quality of life (QoL) and function-
ing, but also compromises the continuity of care to the patients. The goal is to
provide a comprehensive reviewof studies that have assessed the caregiver burden
and to identify instruments that measure caregiver burden in schizophrenia.
METHODS: A systematic literature review was conducted from January 2000 -
December 2010 using a number of medical databases. Studies assessing care-
giver burden were identified after applying the inclusion/exclusion criteria. In
addition, the review also identified instruments along with their psychometric
evaluation. Clinical and review studies were excluded from the systematic
review. RESULTS: The review yielded 22 studies that focused on psychoeduca-
tional interventions designed for caregivers, predictors, mediators and conse-
quences of caregiver burden, and cultural/ethnic differences in caregiving. The
most important predictors of caregiver burden were contact time with the patient,
cohabitationwith the patient, and coping styles of the caregiver. The consequences
of caregiver burdenweremostly psychosocial in nature. The review also yielded 13
instruments (1 generic, 12 condition-specific). The most common domains in-
cluded impact on daily life/household tasks, social life, psychological well-being,
economic burden, time constraints imposed and relationship with healthcare pro-
fessionals. A review of the psychometric properties of these instruments indicated
good reliability (Cronbach’s alpha 0.6 – 0.94). However, responsiveness of the in-
struments was not discussed. CONCLUSIONS: Caregivers play a crucial role in the
management of schizophrenia and with the increasing recognition of caregiver
burden, it is important for healthcare professionals to consider the health and
well-being of caregivers. Understanding the nature and extent of caregiver burden
will facilitate the development of appropriate interventions that can help improve
caregivers’ quality of life (QoL) and functioning.
PMH55
THE BURDEN OF DIAGNOSED DEPRESSION AND SLEEP DIFFICULTIES ON
QUALITY OF LIFE, WORK PRODUCTIVITY, AND RESOURCE USE
Gupta S1, Goren A2, Gabriel S3, Kim E3, Dupclay L3
1Kantar Health, Princeton, NJ, USA, 2Kantar Health, New York, NY, USA, 3Novartis
Pharmaceuticals Corporation, East Hanover, NJ, USA
OBJECTIVES: To compare quality of life, work productivity loss, and resource use
between respondents diagnosed or not diagnosed with depression and/or experi-
encing sleep difficulties.METHODS:Datawere analyzed fromKantar Health’s 2010
US National Health andWellness Survey, a nationwide survey of adults (18 years
old). Outcome variables were components of the SF-12v2 HRQoL instrument: men-
tal and physical component summary scores (MCS and PCS) and SF6D health util-
ities (measuring health status).Work productivity loss (employed individuals only)
and activity impairment were assessed using the Work Productivity and Activity
Impairment questionnaire. Resource use was measured by the number of tradi-
tional health care provider visits, ER visits and hospitalizations. Linear regressions
and negative binomial regressions, controlling for patient demographics and co-
morbidities, were applied as appropriate. RESULTS: A total of 75,000 respondents
completed the survey, including those diagnosed with depression and experienc-
ing sleep difficulties (n  10,119), depressed without sleep difficulties (n  1,717),
not depressed with sleep difficulties (n  33,341), and not depressed with no sleep
difficulties (n  29,823). Compared with the other groups, those with both depres-
sion and sleep difficulties had poorer PCS, MCS and health utility scores; greater
lost work productivity and activity impairment; and significantly more traditional
healthcare provider visits, ER visits and hospitalizations (all p-values0.05). De-
A195V A L U E I N H E A L T H 1 4 ( 2 0 1 1 ) A 1 – A 2 1 4


PMH53 ASSESSING THE IMPACT OF MAJOR DEPRESSIVE DISORDER (MDD) ON FAMILY FUNCTIONING: DEVELOPMENT OF THE DEPRESSION AND FAMILY FUNCTIONING SCALE 

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PMH53 ASSESSING THE IMPACT OF MAJOR DEPRESSIVE DISORDER (MDD) ON FAMILY FUNCTIONING: DEVELOPMENT OF THE DEPRESSION AND FAMILY FUNCTIONING SCALE

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