PID22: AN APPRAISAL OF HEALTH-RELATED QUALITY OF LIFE INSTRUMENTS FOR USE IN PATIENTS DIAGNOSED WITH HUMAN IMMUNODEFICIENCY VIRUS (HIV) DISEASE

Abstract

OBJECTIVES: The increasing effectiveness of medical treatments for HIV (Human Immunodeficiency Virus) has increased survival time of patients infected with the virus. Because of the high incidence of side effects and the burden of complex medication regimens, an increased emphasis has been placed on the assessment of health-related quality of life (HRQL) in HIV patients. The purpose of this study is to review and compare instruments used for measuring HRQL in HIV patients. METHODS: Clinical trials involving HIV patients were identified through the use of MEDLINE and AIDSLINE. The HRQL instruments used in these trials included: 1) generic instruments such as the Medical Outcomes Study (MOS) Short-Form (SF-36), Sickness Impact Profile, Nottingham Health Profile; 2) utility-based measures such as the Quality of Well-Being Scale and the Q-TWIST (Quality adjusted Time Without Symptoms of disease and Toxicity); and 3) disease-specific instruments such as the Multidimensional Quality of Life questionnaire for HIV (MQoL-HIV), Functional Assessment of HIV Infection (FAHI) scale, HIV/AIDS-Targeted Quality of Life Instrument (HAT-QoL), HIV Overview of Problem/Evaluation System (HOPES) instrument, HIV Patient Reported Status and Experience (HIV-PARSE) scale, and the MOS-HIV scale. Criteria for evaluating the instruments included: comprehensiveness, respondent burden, internal consistency of scales, test-retest reliability, clinical validity, and responsiveness to change. RESULTS: No instrument was found to be completely devoid of ceiling effects. Although none of the instruments demonstrated perfect psychometric properties, overall, the MOS-HIV instrument fared better than all its counterparts. The instrument has minimal respondent burden and has shown evidence of internal consistency, test-retest reliability, validity, and is responsive to changes over time. The instrument has been widely used in clinical trials and has been translated into 14 other languages, and translated forms have been validated. CONCLUSIONS: The MOS-HIV scale appears to be most optimal for HRQL measurement in clinical trials involving HIV patients.