Does the HoNOS 65+ meet the criteria for a clinical outcome indicator for mental health services for older people?
BACKGROUND
A clinical indicator should demonstrate clinically meaningful change, be relevant, allow comparisons between services, be acceptable to clinicians, and have acceptable validity, reliability and sensitivity to change. The HoNOS 65+ has been suggested as a clinical outcome indicator. The sensitivity to change of the HoNOS 65+ is not known.


METHODS
This is a prospective study using routine clinical data. A pilot cohort (n = 42) was used to measure the concurrent validity of the HoNOS 65+ with the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15) and Brief Agitation Rating Scale (BARS). The main cohort of 245 consecutive referrals to a community mental health service for older adults was used to assess sensitivity to change against the CIBIC+.


RESULTS
The HoNOS 65+ was acceptable to case managers, most HoNOS 65+ items had excellent interrater reliability and the HoNOS 65+ had good concurrent validity. Changes in the HoNOS 65+ scores between assessment and discharge had a moderate, but significant correlation with CIBIC+ scores.


CONCLUSIONS
The HoNOS 65+ meets the criteria for a clinical outcome indicator for community mental health services for older people. The HoNOS 65+ is sensitive to change.
Spear
Jon
J
Peel and Rockingham-Kwinana Mental Health Service for Older People, PO Box 288, Goddard Street, Rockingham, Perth, Western Australia 6169, Australia. jon.spear@health.wa.gov.au
Chawla
Sudarshan
S
O'Reilly
Maria
M
Rock
Daniel
D
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D009313:National Health Programs / Q000706:statistics & numerical data*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D015588:Observer Variation; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D015203:Reproducibility of Results; D014904:Western Australia