Valuing quality of life for residents of care homes
Valuing quality of life for residents of care homes
Theme 2: Measuring and Valuing Outcomes
Economic evaluation of health and social care interventions for people with older people, with conditions like severe dementia, faces challenges when assessing the value of improvements in health-related quality of life (HRQoL). Generic instruments used to assess HRQoL may not be fully appropriate in this setting, but alternative condition specific approaches have met with limited success. Decision makers require a consistent integrated approach.
The proposed work repurposes clinical trial data for secondary research, coupled with expertise in statistical methods for the analysis of quality-of-life data.
To establish the relationship between preference-based measures of health outcome, for use in economic evaluation, and measures of cognitive impairment, patient reported outcomes, frailty and disease specific quality of life assessments in care home residents with dementia.
To what extent does quality of life as measured by EQ5D-5L correlate with responses to Dementia Quality of Life (DEMQOL), Physical Activity Measure- Residential Care Homes (PAM-RC), Barthel Index for Activities of Daily Living, Cohen Mansfield Agitation Inventory, Quality of Life in Late Stage dementia, Clinical Frailty Score, and Quality of Life in Alzheimer’s Disease.
If there is evidence that EQ-5D-5L omits relevant aspects of quality of life, can the magnitude of its bias be quantified?
Monica Hernandez, Steve Pudney, Allan Wailoo,
Monica Hernandez monica.hernandez@sheffield.ac.uk
Background:
The goal of this research is to better understand how we evaluate the impact of health and social care interventions for older individuals, particularly those with severe dementia in care homes. It's challenging to measure improvements in their quality of life accurately. Common tools may not be the best fit, so we're trying to find a consistent way to assess this.
Aims and objectives:
1. Understand how people's health preferences relate to their overall well-being in care home residents with dementia.
2. Look into how one measure of quality of life very commonly used in economic studies to assess quality of life (the EQ5D-5L) compares to other indicators in people with dementia.
3. Find out if EQ-5D-5L misses important aspects of quality of life and measure how much it might affect the results.
Methods:
We plan to use data from clinical trials and apply statistical methods to analyse the quality of life for people with dementia living in care homes. Specifically, we want to know:
We're using data from the Virtual International Care Homes Trial Archive, which includes information from 6 trials conducted in UK care homes. We have over 12,000 observations from 339 care homes. We'll perform two types of analysis: mapping the relationship between EQ5D-5L and other measures, and assessing the agreement between EQ-5D-5L and other outcomes between individuals completing these assessments, including between specific question responses and when these responses are added together. This second task requires us to divide the different questions and groups of questions into those that clearly overlap with EQ5D and those that do not.
Policy relevance & dissemination:
This research is important for evaluating costs and benefits in various diseases affecting elderly individuals in care homes. It will also showcase new ways to measure quality of life in challenging populations.