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Riley AG, Mulé CM, Lerner D, Belter L, O'Toole CM, Kowal S, Fox D, Shapouri S, Vesel T, Lavelle TA. Assessing the impact of grief on quality of life, work productivity, and health outcomes for parents bereaved from SMA: A study protocol. Cost Eff Resour Alloc 2023; 21:55. [PMID: 37612702 PMCID: PMC10464285 DOI: 10.1186/s12962-023-00465-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/02/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND U.S. cost-effectiveness recommendations suggest that analyses should include all costs and effects relevant to the decision problem [1]. However, in many diseases, including spinal muscular atrophy (SMA), few studies have evaluated bereaved family outcomes after a child has died, neglecting potential impacts on their health-related quality of life (HRQoL), work productivity, and mental health. Additionally, grief-related outcomes are rarely included in economic evaluations. This manuscript outlines the protocol of a study that will estimate the HRQoL, work functioning, and mental health of bereaved parents of children with SMA type 1 to determine how outcomes vary based on parent's sex and the time since a child's death. METHODS This study will involve two phases. In Phase 1, we will conduct a literature review to identify prior research that has measured how parental grief impacts HRQoL, work productivity, and mental health. We will also interview four bereaved parents of children with SMA type 1, stratified by parent sex and time since their child's death, and analyze findings using a thematic analysis. In Phase 2, we will develop a survey draft based on Phase 1 findings. Parents bereaved from SMA type 1 will review our survey draft and we will revise the survey based on their feedback. We will send a cross-sectional survey to approximately 880 parents bereaved from SMA type 1. We will analyze findings from the survey to investigate whether the severity of grief symptoms is correlated with HRQoL, productivity, depression and anxiety symptom severity. We will also evaluate whether the mean scores of grief and each of the outcomes vary significantly when stratified by parent sex and the time since the child's death. DISCUSSION Our results will provide preliminary information on how parental grief can impact HRQoL, productivity, and mental health outcomes over time. Increasing the availability of family outcomes data will potentially assist organizations performing health economic evaluations, such as the Institute of Clinical and Economic Review (ICER) in the U.S. This research will also help to inform the development of future economic guidelines on this topic.
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Affiliation(s)
- Abigail G Riley
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Christina M Mulé
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Debra Lerner
- Program on Health, Work and Productivity, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine Department of Psychiatry, Boston, MA, USA
| | | | | | | | - David Fox
- Genentech, Inc, South San Francisco, CA, USA
| | | | - Tamara Vesel
- Division of Palliative Care, Department of Medicine, Tufts Medical Center, Boston, MA, USA
| | - Tara A Lavelle
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
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