Quality of life among hazardous and harmful drinkers: EQ-5D over a 1-year follow-up period Holly N. Essex • Ian R. White • Zarnie Khadjesari • Stuart Linke • Jim McCambridge • Elizabeth Murray • Steve Parrott • Christine Godfrey Accepted: 2 September 2013 Ó Springer Science+Business Media Dordrecht 2013 Abstract Purpose To investigate the ability of the EQ-5D to dis- criminate between levels of alcohol risk in a large sample of hazardous and harmful drinkers, and to explore the relationship between transitions between alcohol risk levels and changes in EQ-5D up to 12 months. Methods This is a web-based randomised controlled trial evaluating a novel intervention for hazardous and harmful alcohol consumption. EQ-5D scores were compared among groups of drinkers at baseline (low/medium/high risk according to self-reported past week alcohol consumption), and changes in EQ-5D scores were estimated as a function of changes in alcohol consumption level. Results Baseline EQ-5D scores were dominated by problems with anxiety/depression, which increased with alcohol risk level, whilst high-risk drinkers also experi- enced more problems with physical HRQoL dimensions. However, the tool demonstrated a considerable ceiling effect. At follow-up, despite considerable reductions in alcohol consumption across the sample, significant changes in aggregated EQ-5D index scores were only observed for high-risk drinkers at baseline who reduced their drinking, with small improvements (0.04–0.06) compared to those who did not reduce. Conclusions Our results suggest that the three-option EQ- 5D may not be an optimal primary end point for measuring clinical and cost-effectiveness in randomised controlled trials of interventions among hazardous and harmful alco- hol users, although further testing of the sensitivity of the tool in these populations is needed. Keywords EQ-5D Á EuroQoL Á Quality of life Á Alcohol Á Hazardous drinking Á Harmful drinking Á Internet Introduction With healthcare resources under pressure in many coun- tries, decision-makers are increasingly looking to evidence from economic evaluations. Alcohol consumption is a major contributor to the global burden of disease and car- ries with it a substantial economic burden [1, 2]. Although brief interventions for high-risk drinkers can be effective [2], and cost-effective compared to no intervention [3], their ability to compete with other healthcare interventions may be limited by the choice of suitable primary end points to measure both effectiveness and cost-effectiveness. Consumption end points allow for thorough evaluation of alcohol programmes [4] and are widely used. However, consumption itself is not a direct cost [4] and there is considerable variability in consumption measures used [5]. Consequently, standardised alcohol measures are recom- mended [6, 7]; however, these do not facilitate decisions H. N. Essex (&) Á S. Parrott Á C. Godfrey Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York YO10 5DD, UK e-mail: holly.essex@york.ac.uk I. R. White MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 0SR, UK Z. Khadjesari Á S. Linke Á E. Murray Research Department of Primary Care and Population Health, e-Health Unit, Royal Free Hospital, University College London, Upper 3rd Floor, Rowland Hill Street, London NW3 2PF, UK J. McCambridge Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK 123 Qual Life Res DOI 10.1007/s11136-013-0521-7