Changes in health-related quality of life (EQ-5D) dimensions associated with community-based musculoskeletal physiotherapy: a multi-centre analysis

Caplan, Nick, Robson, H., Robson, A., Kelly, Michael and Wilkes, G. (2018) Changes in health-related quality of life (EQ-5D) dimensions associated with community-based musculoskeletal physiotherapy: a multi-centre analysis. Quality of Life Research, 27 (9). pp. 2373-2382. ISSN 0962-9343

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Official URL: http://dx.doi.org/10.1007/s11136-018-1883-7

Abstract

Purpose
To determine the changes in each of the five dimensions of the EuroQol 5-dimension index associated with community-based physiotherapy.

Methods
Four thousand one hundred and thirty-six patients that received community-based musculoskeletal physiotherapy across five NHS centres completed the EQ-5D on entry into the service and upon discharge. Patients were categorised on symptom location and response to treatment based on their EQ-5D index improving by at least 0.1 (“EQ-5D responders”). For each symptom location, and for responders and non-responders to treatment, the mean (± SD) were calculated for each dimension pre- and post-treatment as well as the size of effect.

Results
The mobility dimension improved (p < 0.05) in all symptom locations for EQ-5D responders (d = 0.26–1.58) and in ankle, knee, hip and lumbar symptoms for EQ-5D non-responders (d = 0.17–0.45). The self-care dimension improved (p < 0.05) in all symptom locations for EQ-5D responders (d = 0.49–1.16). The usual activities dimension improved (p < 0.05) across all symptom locations for EQ-5D responders (d = 1.00–1.75) and EQ-5D non-responders (d = 0.14–0.60). Despite the pain/discomfort dimension improving (p < 0.05) across all symptom locations for both EQ-5D responders (d = 1.07–1.43) and EQ-5D non-responders (d = 0.29–0.66), the anxiety/depression dimension improved (p < 0.05) from higher starting levels in EQ-5D responders (d = 0.76–1.05) with no change seen for EQ-5D non-responders (d = − 0.16 to 0.06).

Conclusions
Clinicians should not assume that a patient presenting with pain but expressing high anxiety/depression is unlikely to respond to treatment, as they may show the best HRQoL outcomes. For patients presenting with pain/discomfort and low levels of anxiety/depression, the EQ-5D index is perhaps not a suitable tool for sole use in patient management and service evaluation.

Item Type: Article
Uncontrolled Keywords: Rehabilitation, Intervention, Physical therapy, Quality of life, Musculoskeletal
Subjects: B900 Others in Subjects allied to Medicine
Department: Faculties > Health and Life Sciences > Sport, Exercise and Rehabilitation
Depositing User: Becky Skoyles
Date Deposited: 22 Nov 2018 12:15
Last Modified: 11 Dec 2018 08:31
URI: http://nrl.northumbria.ac.uk/id/eprint/36877

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