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Spillover Effects on Caregivers’ and Family Members’ Utility: A Systematic Review of the Literature

Author

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  • Eve Wittenberg

    (Harvard TH Chan School of Public Health)

  • Lyndon P. James

    (Harvard TH Chan School of Public Health)

  • Lisa A. Prosser

    (University of Michigan Medical School)

Abstract

Background A growing body of research has identified health-related quality-of-life effects for caregivers and family members of ill patients (i.e. ‘spillover effects’), yet these are rarely considered in cost-effectiveness analyses (CEAs). Objective The objective of this study was to catalog spillover-related health utilities to facilitate their consideration in CEAs. Methods We systematically reviewed the medical and economic literatures (MEDLINE, EMBASE, and EconLit, from inception through 3 April 2018) to identify articles that reported preference-based measures of spillover effects. We used keywords for utility measures combined with caregivers, family members, and burden. Results Of 3695 articles identified, 80 remained after screening: 8 (10%) reported spillover utility per se, as utility or disutility (i.e. utility loss); 25 (30%) reported a comparison group, either population values (n = 9) or matched, non-caregiver/family member or unaffected individuals’ utilities (n = 16; 3 reported both spillover and a comparison group); and 50 (63%) reported caregiver/family member utilities only. Alzheimer’s disease/dementia was the most commonly studied disease/condition, and the EQ-5D was the most commonly used measurement instrument. Conclusions This comprehensive catalog of utilities showcases the spectrum of diseases and conditions for which caregiver and family members’ spillover effects have been measured, and the variation in measurement methods used. In general, utilities indicated a loss in quality of life associated with being a caregiver or family member of an ill relative. Most studies reported caregiver/family member utility without any comparator, limiting the ability to infer spillover effects. Nevertheless, these values provide a starting point for considering spillover effects in the context of CEA, opening the door for more comprehensive analyses.

Suggested Citation

  • Eve Wittenberg & Lyndon P. James & Lisa A. Prosser, 2019. "Spillover Effects on Caregivers’ and Family Members’ Utility: A Systematic Review of the Literature," PharmacoEconomics, Springer, vol. 37(4), pages 475-499, April.
    • Handle: RePEc:spr:pharme:v:37:y:2019:i:4:d:10.1007_s40273-019-00768-7
    DOI: 10.1007/s40273-019-00768-7
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    4. María J. Mendoza-Jiménez & Job Exel & Werner Brouwer, 2024. "On spillovers in economic evaluations: definition, mapping review and research agenda," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(7), pages 1239-1260, September.
    5. Nishit Dhanji & Werner Brouwer & Cam Donaldson & Eve Wittenberg & Hareth Al‐Janabi, 2021. "Estimating an exchange‐rate between care‐related and health‐related quality of life outcomes for economic evaluation: An application of the wellbeing valuation method," Health Economics, John Wiley & Sons, Ltd., vol. 30(11), pages 2847-2857, November.
    6. Al-Janabi, Hareth & Wittenberg, Eve & Donaldson, Cam & Brouwer, Werner, 2022. "The relative value of carer and patient quality of life: A person trade-off (PTO) study," Social Science & Medicine, Elsevier, vol. 292(C).
    7. Henry, Edward & Cullinan, John, 2021. "Mental health spillovers from serious family illness: Doubly robust estimation using EQ-5D-5L population normative data," Social Science & Medicine, Elsevier, vol. 279(C).
    8. Johanna Katharina Hohls & Hans-Helmut König & Eleanor Quirke & André Hajek, 2021. "Anxiety, Depression and Quality of Life—A Systematic Review of Evidence from Longitudinal Observational Studies," IJERPH, MDPI, vol. 18(22), pages 1-26, November.
    9. Edward J. D. Webb & John O’Dwyer & David Meads & Paul Kind & Penny Wright, 2020. "Transforming discrete choice experiment latent scale values for EQ-5D-3L using the visual analogue scale," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(5), pages 787-800, July.
    10. Lisa A. Prosser & Eve Wittenberg, 2019. "Advances in Methods and Novel Applications for Measuring Family Spillover Effects of Illness," PharmacoEconomics, Springer, vol. 37(4), pages 447-450, April.
    11. Siok Swan Tan & Marta M Pisano & An LD Boone & Graham Baker & Yves-Marie Pers & Alberto Pilotto & Verushka Valsecchi & Sabrina Zora & Xuxi Zhang & Irene Fierloos & Hein Raat, 2019. "Evaluation Design of EFFICHRONIC: The Chronic Disease Self-Management Programme (CDSMP) Intervention for Citizens with a Low Socioeconomic Position," IJERPH, MDPI, vol. 16(11), pages 1-10, May.
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