Are the Health of the nation outcome scales (HoNOS) useful for measuring outcomes in older people'smental health services?

Abstract

The Health of the Nation Outcome Scales (HoNOS) were developed to provide a single index in order to enable the government target 'to improve significantly the health and social functioning of mentally ill people' to be quantified. They were intended to be applicable to all adults (including older people), across a wide range of settings so that services in different localities could be compared and changes both within individuals and within services could be measured. In 1999 the HoNOS65+ was launched with a modified glossary for older people. The HoNOS has been formally adopted as the preferred outcome measure for adults of working age. There has been no such formal adoption of the HoNOS65+, or any other outcome measure, for mental health services for older people. This review summarises how the HoNOS was originally developed and validated. Studies with older people, which have used both the original definitions and those developed for the HoNOS65+ are reviewed focusing on data on the reliability and validity of the HoNOS and HoNOS65+ with older people. Finally the question of whether the HoNOS or HoNOS65+ is suitable as an outcome measure in routine clinical practice in services for older people is addressed.

A review of the psychometric properties of the Health of the Nation Outcome Scales (HoNOS) family of measures

“…Anecdotally, some clinicians question the psychometric soundness of the instruments, and argue that they do not have good clinical utility [ 7 ]. With the exception of a specific review of the applicability of the HoNOS and the HoNOS65+ for older people [ 8 ], there has been no comprehensive review of these instruments that can inform this debate. The current paper fills this gap, by appraising the psychometric properties of each.…”

Assessing depression outcome in patients with moderate dementia: Sensitivity of the HoNOS65+ scale

“…The HoNOS family of measures is most widely used in UK and Australia and the HoNOS65+ is considered as one of the six most commonly used assessment scales in old age psychiatry services providing key material results for shaping the provision of psychiatric services for older people [38]. Previous contributions showed that the HoNOS65+ is an acceptable clinical outcome measure for use in the evaluation of mental health services for elderly persons [15,37,39]. Moreover, earlier studies have pointed to the ability of the HoNOS65+ to discriminate between patients with dementia and those with functional psychiatric disorders [15,16].…”

De Health of the Nation Outcome Scale als effectmaat in de ouderenpsychiatrie

“…De HoNOS is het meest gebruikte beoordelingsinstrument in Engeland en Australië en blijkt gevoelig voor veranderingen in het toestandsbeeld bij de cliënten. 4 Vooral voor bepaalde doelgroepen (zoals mensen met een psychose, kinderen, ouderen), die misschien niet altijd goed in staat zijn de vragenlijst zelf in te vullen, is de HoNOS een ge-schikt instrument om in Routine Outcome Assessment te worden opgenomen. De HoNOS wordt ook in Nederland al veel gebruikt, vooral in de langdurende zorg.…”