Comparison of Instrumental Activities of Daily Living assessment by in-person or phone interviews: A randomized, crossover trial

Abstract

Background The functional autonomy assessment is essential to manage patients with a neurodegenerative disease, but is therefore not always possible during consultation. To optimize ambulatory autonomy assessment, the Lawton IADL questionnaire assessment between phone and in-person interviews was compared.Methods A randomized, crossover trial was carried-out in patients in memory clinic. The IADL questionnaire was collected for patients during phone and in-person interviews between nurses and patients’caregivers. The agreement between the two methods was measured with the proportion of participants giving the same response, the Cohen’s kappa, the intraclass correlation (ICC) coefficient and Bland and Altman’s method. The associations between patients’characteristics, events occurring between the two measures and agreement were assessed.Results Among the 292 patients with two IADL measures, the agreement rate between the two modes ranged from 75% to 92% depending the IADL items, and from 84% to 97% depending of the level of autonomy. Kappa score was 0.3 for total score and ranged from 0.5 to 0.8 for the analysis by item or level of IADL. ICC score was 0.91 for total IADL score. Overall, 96.9% of measures lied within the 95% limits of agreement. The occurrence of fall was less likely associated with the probability to lie within the 95% limits of agreement (OR=0.07 [0.02-0.27], p<0.0001).Conclusions The administration of IADL by phone with the caregiver appears as an acceptable way of assessment for patients followed by MC compared to in-person interview. The events which could occur in a time close to the evaluation should be reported.