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Using the Health Utilities Index in Routine Clinical Care: Process, Feasibility, and Acceptability

A Randomized Controlled Trial

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Abstract

Background and objective: Using measures of health-related quality of life (HR-QOL) in routine clinical practice has the potential to improve the quality of healthcare and outcomes. The Health Utilities Index (HUI) is a generic, preference-based measure of HR-QOL. The aim of this study was to describe the process, feasibility and acceptability of use of the HUI in routine clinical care.

Methods: The study was conducted at the outpatient Heart and Lung Transplant Clinic, University of Alberta Hospital, Edmonton, Alberta, Canada. Before seeing the clinician, patients attending the clinic completed the HUI on a touch-screen computer at each visit. This information was graphically represented on the HUI score card and presented to the clinicians during the visit. Patients completed a battery of questionnaires at baseline and at the end of the study. Training in the interpretation of the results was provided on a regular basis to the clinicians. The use of HUI in clinical practice was assessed from the perspectives of clinicians and patients. Clinicians completed two questionnaires, at baseline (on expectations) and at the end of the study (an evaluation), regarding the usefulness of the HUI measure in routine clinical care. Patients completed an evaluation form at the end of the study.

Results: Of 151 patients, 135 were happy to use the touch-screen computer and 138 patients confirmed that the questionnaire was easy to complete. Only 10 of 151 patients were unwilling to complete the questionnaires. Clinicians agreed that the results from the HUI helped to improve patient-clinician communication. Members of the team indicated that the HUI score card was clinically relevant and confirmed their diagnoses.

Conclusions: Patients quickly learned how to complete the HUI questionnaire on the computer. Clinicians found that the information provided was valuable and have subsequently incorporated the use of the HUI in the routine clinical care of their patients.

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References

  1. Detmar SB, Muller MJ, Schornagel JH, et al. Health-related quality-of-life assessments and patient-physician communication: a randomized controlled trial. JAMA 2002; 288(23): 3027–34

    Article  PubMed  Google Scholar 

  2. Espallargues M, Valderas JM, Alonso J. Provision of feedback on perceived health status to health care professionals: a systematic review of its impact. Med Care 2000; 38: 175–86

    Article  PubMed  CAS  Google Scholar 

  3. Rao JK, Anderson LA, Inuit TS, et al. Communication interventions make a difference in conversations between physicians and patients: a systematic review of the evidence. Med Care 2007; 45(4): 340–9

    Article  PubMed  Google Scholar 

  4. Velikova G, Booth L, Smith A, et al. Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol 2004; 22(4): 714–24

    Article  PubMed  Google Scholar 

  5. Donaldson M. Use of patient-reported outcomes in clinical oncology practice: a nonvisit approach to patient care based on the IOM report. J Ambul Care Manage 2007; 30(4): 302–7

    PubMed  Google Scholar 

  6. Epstein RM, Street Jr RL. Patient-centered communication in cancer care: promoting healing and reducing suffering. Bethesda (MD): National Cancer Institute, 2007; NIH Publication No. 07-6225

    Google Scholar 

  7. Velikova G, Wright EP, Smith AB, et al. Automated collection of quality of life data: a comparison of paper and computer touch-screen questionnaires. J Clin Oncol 1999 Mar; 17(3): 998–1007

    PubMed  CAS  Google Scholar 

  8. Taenzer P, Bultz BD, Carlson LE, et al. Impact of computerized quality of life screening on physician behaviour and patient satisfaction in lung cancer outpatients. Psychooncology 2000; 9(3): 203–13

    Article  PubMed  CAS  Google Scholar 

  9. Torrance GW, Feeny DH, Furlong WJ, et al. Multiattribute utility function for a comprehensive health status classification system health utilities index mark 2. Med Care 1996; 34(7): 702–22

    Article  PubMed  CAS  Google Scholar 

  10. Feeny D, Furlong W, Torrance GW, et al. Multiattribute and single-attribute utility functions for the Health Utilities Index Mark 3 system. Med Care 2002; 40(2): 113–28

    Article  PubMed  Google Scholar 

  11. Horsman J, Furlong W, Feeny D, et al. The Health Utilities Index (HUI®): concepts, measurement properties and applications [online]. Available from URL: http://www.hqlo.com/content/1/1/54 [Accessed 2009 Jun 15]

  12. Ware JE, Sherbourne C. The MOS 36-Item Short Form Health Survey (SF-36). Med Care 1992; 30(6): 473–83

    Article  PubMed  Google Scholar 

  13. Nelson EC, Wasson J, Kirk J, et al. Assessment of function in routine clinical practice: description of the COOP Chart method and preliminary findings. J Chronic Dis 1987; 40Suppl. 1:55–63

    Article  Google Scholar 

  14. Pratheepawanit N, Salek MS, Finlay IG. Quality of life assessment in routine clinical practice: lesson learned from a two-year study. PRO Newsletter 2006; 36: 25–8 [online]. Available from URL: http://www.pro-newsletter.com/images/PDF/pron36.pdf [Accessed 2009 Aug 3]

    Google Scholar 

  15. Wagner AK, Ehrenberg BL, Tran TA, et al. Patient-based health status measurement in clinical practice: a study of its impact on epilepsy patients’ care. Qual Life Res 1997; 6: 329–41

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

The authors appreciate the financial support of the Institute of Health Economics (IHE) which did not, however, review or approve this article. David Feeny owns stock in Health Utilities Inc., Dundas, Ontario, Canada, which distributes copyrighted Health Utilities Index (HUI) materials and provides methodological advice on the use of HUI. Maria-Jose Santana has no conflicts of interest that are directly relevant to the content of this study. The authors are extremely grateful to the patients for their willingness to participate in the study. The authors also thank the lung and heart transplant teams at the outpatient clinics of the University of Alberta Hospital, Edmonton, Alberta, Canada. The authors would also like to thank T. Chan, S. Tymchuk, and M. Jackson, who assisted in this study; Dr Darrell Tomkins, who edited the photographs; and Dr George Torrance and William Furlong, who provided constructive comments on an earlier draft of the article.

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Correspondence to Maria-Jose Santana.

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Santana, MJ., Feeny, D.H. Using the Health Utilities Index in Routine Clinical Care: Process, Feasibility, and Acceptability. Patient-Patient-Centered-Outcome-Res 2, 159–167 (2009). https://doi.org/10.2165/11313620-000000000-00000

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