Evidence of disagreement between patient-perceived change and conventional longitudinal evaluation of change in health-related quality of life among older adults.
OBJECTIVE
To identify agreement levels between conventional longitudinal evaluation of change (post-pre) and patient-perceived change (post-then test) in health-related quality of life.


METHODS
A prospective cohort investigation with two assessment points (baseline and six-month follow-up) was implemented.


METHODS
Community rehabilitation setting.


METHODS
Frail older adults accessing community-based rehabilitation services.


METHODS
Nil as part of this investigation.


METHODS
Conventional longitudinal change in health-related quality of life was considered the difference between standard EQ-5D assessments completed at baseline and follow-up. To evaluate patient-perceived change a 'then test' was also completed at the follow-up assessment. This required participants to report (from their current perspective) how they believe their health-related quality of life was at baseline (using the EQ-5D). Patient-perceived change was considered the difference between 'then test' and standard follow-up EQ-5D assessments.


RESULTS
The mean (SD) age of participants was 78.8 (7.3). Of the 70 participants 62 (89%) of data sets were complete and included in analysis. Agreement between conventional (post-pre) and patient-perceived (post-then test) change was low to moderate (EQ-5D utility intraclass correlation coefficient (ICC) = 0.41, EQ-5D visual analogue scale (VAS) ICC = 0.21). Neither approach inferred greater change than the other (utility P =0.925, VAS P =0.506). Mean (95% confidence interval (CI)) conventional change in EQ-5D utility and VAS were 0.140 (0.045,0.236) and 8.8 (3.3,14.3) respectively, while patient-perceived change was 0.147 (0.055,0.238) and 6.4 (1.7,11.1) respectively.


CONCLUSIONS
Substantial disagreement exists between conventional longitudinal evaluation of change in health-related quality of life and patient-perceived change in health-related quality of life (as measured using a then test) within individuals.
McPhail
Steven
S
Centre for Functioning, Disability and Health Research, Queensland Health, School of Health and Rehabilitation Sciences, The University of Queensland, Australia. steven_mcphail@health.qld.gov.au
Comans
Tracy
T
Haines
Terry
T
D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D015331:Cohort Studies; D003153:Community Health Services; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D006305:Health Status Indicators; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012046:Rehabilitation / Q000379:methods*; D018434:Sickness Impact Profile