An empirical comparison of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U in a post-hospitalisation population of frail older people living in residential aged care

Journal article


Ratcliffe, Julie, Flint, Thomas, Easton, Tiffany, Killington, Maggie, Cameron, Ian, Davies, Owen, Whitehead, Craig, Kurrle, Susan, Miller, Michelle D., Liu, Enwu and Crotty, Maria 2017. An empirical comparison of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U in a post-hospitalisation population of frail older people living in residential aged care. Applied Health Economics and Health Policy. 15 (3), pp. 399 - 412. https://doi.org/10.1007/s40258-016-0293-7
AuthorsRatcliffe, Julie, Flint, Thomas, Easton, Tiffany, Killington, Maggie, Cameron, Ian, Davies, Owen, Whitehead, Craig, Kurrle, Susan, Miller, Michelle D., Liu, Enwu and Crotty, Maria
Abstract

Objective
To empirically compare the measurement properties of the DEMQOL-U and DEMQOL-Proxy-U instruments to the EQ-5D-5L and its proxy version (CEQ-5D-5L) in a population of frail older people living in residential aged care in the post-hospitalisation period following a hip fracture.
Methods
A battery of instruments to measure health-related quality of life (HRQoL), cognition, and clinical indicators of depression, pain and functioning were administered at baseline and repeated at 4 weeks’ follow-up. Descriptive summary statistics were produced and psychometric analyses were conducted to assess the levels of agreement, convergent validity and known group validity between clinical indicators and HRQoL measures.
Results
There was a large divergence in mean (SD) utility scores at baseline for the EQ-5D-5L and DEMQOL-U [EQ-5D-5L mean 0.21 (0.19); DEMQOL-U mean 0.79 (0.14)]. At 4 weeks’ follow-up, there was a marked improvement in EQ-5D-5L scores whereas DEMQOL-U scores had deteriorated. [EQ-5D-5L mean 0.45 (0.38); DEMQOL-U mean 0.58 (0.38)]. The EQ-5D and CEQ-5D-5L were more responsive to the physical recovery trajectory experienced by frail older people following surgery to repair a fractured hip, whereas the DEMQOL-U and DEMQOL-Proxy-U appeared more responsive to the changes in delirium and dementia symptoms often experienced by frail older people in this period.
Conclusions
This study presents important insights into the HRQoL of a relatively under-researched population of post-hospitalisation frail older people in residential care. Further research should investigate the implications for economic evaluation of self-complete versus proxy assessment of HRQoL and the choice of preference-based instrument for the measurement and valuation of HRQoL in older people exhibiting cognitive decline, dementia and other co-morbidities.

KeywordsDementia; Residential Care; Utility Score; Residential Aged Care; Economic Evaluation Study
Year2017
JournalApplied Health Economics and Health Policy
Journal citation15 (3), pp. 399 - 412
PublisherAdis International Ltd.
ISSN1175-5652
Digital Object Identifier (DOI)https://doi.org/10.1007/s40258-016-0293-7
Scopus EID2-s2.0-85027879079
Page range399 - 412
Research GroupMary MacKillop Institute for Health Research
Place of publicationNew Zealand
EditorsT. Wrightson
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