Health-related quality of life in patients with alcohol use disorder: comparing instruments and mapping from clinical measures to preference-based measures.

Background and objectives: The impact of alcohol use disorder (AUD) on quality of life can be quantified by generic and specific measures. This study's aims are to compare different preference-based instruments to measure health-related quality of life (HRQoL) in patients with AUD and to examine their relationship with alcohol-specific measures used in the clinical setting.

Methods: A sample of 259 patients with AUD were recruited from a Spanish alcoholism unit. We administered EuroQoL-5Dimension -5levels (EQ-5D), ShortForm-6Dimension (SF-6D), AlcoholQuality-of-life-4Dimension (AlcQ-4D), Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and Alcohol Use Disorders Identification Test (AUDIT) instruments at the beginning of treatment and 12 months thereafter. Differences in HRQoL instruments scores were estimated and their capacity to discriminate among known clinical severity groups was analysed. Several mapping functions were tested to transform scores from the clinical setting (AUDIT or DSM-5) into HRQoL scores (EQ-5D, SF-6D or AlcQ-4D).

Results: HRQoL scores are sensitive to the instrument used. Mean scores are always highest using EQ-5D, followed by SF-6D and AlcQ-4D. All HRQoL instruments discriminate among clinical severity groups defined using DSM-5 or AUDIT. Although several mapping functions were estimated, those using the total score of the clinical instruments were selected.

Conclusion: The results suggest that clinical measures used in the field of AUD could be adapted for use in economic evaluation. However, the incremental cost-utility ratio of AUD programs, and hence the policy decisions derived from it, may depend on the HRQoL instrument used.