Quality of life in older adults following a hip fracture: an empirical comparison of the ICECAP-O and the EQ-5D-3 L instruments

Abstract

BackgroundThe purpose of this study was to empirically compare the performance of two generic preference based quality of life instruments, EQ-5D-3 L (with a health and physical function focus) and ICECAP-O (with a wellbeing and capability focus), in a population of older Australians following hip fracture.MethodsOlder adults or their family member proxies (in cases of severe cognitive impairment) following surgery to repair a fractured hip were invited to take part in this cross sectional study. Inclusion criteria included an age of 60 years or older, confirmed falls-related hip fracture and those receiving current palliative care or consented to other research studies were excluded. 87 participants completed the ICECAP-O and EQ-5D-3 L instruments between one and three weeks post-surgery.ResultsFor the hip fracture population, the mean ICECAP-O score was 0.639 (SD 0.206, n = 82) and the mean EQ-5D-3 L utility score was 0.545 (SD 0.251, n = 87). There was a statistically significant positive correlation between the ICECAP-O and EQ-5D-3 L scores (r = 0.529, p = < 0.001).ConclusionsStudy findings indicate significant impairments in quality of life post hip fracture. In multiple regression analyses, age and health-related QoL (measured by the EQ-5D) were significant determinants of ICECAP-O scores, while proxy respondent status, age, and capability-related QoL (measured by the ICECAP-O) were significant determinants of EQ-5D scores. Approaches to measuring and valuing quality of life in this sample, should consider the target domains of the intervention in their choice of instrument. Studies aiming to measure the impact of interventions targeting broader domains of wellbeing and QoL should consider including a broader measure of QoL in conjunction with a HRQoL measure.

Quality of life in elderly people after a hip fracture: a prospective study

“…Our study population is mainly composed of women over the age of 80, not institutionalized, which is in line with other studies [16,[28][29][30][31][32][33]. The length of hospitalisation was 5.3 days (±1.2), considerably less than what was reported in the Úbeda study.…”

ICECAP-O, the current state of play: a systematic review of studies reporting the psychometric properties and use of the instrument over the decade since its publication

“…One study included patients who had previously had a stroke [ 16 ] and one study included the carers of people with dementia [ 20 ]. Five studies focussed on patients undergoing joint surgery [ 17 – 19 , 24 , 42 ].…”

“…The majority of studies were undertaken in Europe with ten conducted in the UK [ 15 – 20 , 24 , 27 , 29 , 36 ], five in the Netherlands [ 21 , 26 , 30 , 34 , 39 ], and one each in Germany [ 33 ], Spain [ 35 ] and Sweden [ 23 ]. Of the remaining studies, four were carried out in Australia [ 28 , 31 , 40 – 42 ] and three in Canada [ 22 , 32 , 37 , 38 ].…”

Measuring capabilities in health and physical activity promotion: a systematic review.

“…Some questionnaires were further been checked regarding their reliability using test-retest analysis [23,33,34,41,42], or regarding their responsiveness via anchor-based analysis [34,37]. Moreover, the ICECAP-O and the Ox-CAP questionnaire were evaluated comparatively to the EQ-ED questionnaire by correlating their results [34,43,44].…”

“…The most detailed results were available for questionnaires of the ICECAP-family. Both the ICECAP-O and the ICECAP-A were reported to have good construct [35,[37][38][39]49], convergent, and discriminant validity [28][29][30]44] when compared to the EQ-5D instrument to measure generic health status [55]. The ICECAP-O and ICECAP-A further showed good test-retest reliability [41,42] and good internal consistency [30,35,36].…”