Validity of the EQ-5D-5L for Routine Assessment in Residential Aged Care: Results From a Feasibility Study

Objectives To examine the psychometric performance of the EQ-5D-5L in residential aged care and to explore the measurement properties of the EQ-HWB(-S), Adult Social Care Outcomes Toolkit (ASCOT), and Quality-of-Life Aged Care Consumers (QoL-ACC) in a smaller subsample. Methods Residents were eligible if consent was provided for 1 of the following: (1) self-reported quality of life (QoL); (2) staff proxy-reported QoL; or (3) family proxy-reported QoL. The EQ-5D-5L was administered first, with a second measure randomly assigned from either the ASCOT, QoL-ACC, or the EQ-HWB. Feasibility, floor and ceiling effects, convergent validity, known-group validity, and interrater reliability were examined. Results We gathered cross-sectional QoL data from 103 consenting participants through self-report (N = 90), staff proxy report (N = 101), and family proxy report (N = 49). Missing values on the EQ-5D-5L ranged from 1% for staff to 14% for family members. No floor/ceiling effects were detected, and the EQ-5D-5L showed good convergent validity with the QoL-ACC (r = 0.62-0.82). Interrater reliability was good between residents and family (intraclass correlation = 0.84) and excellent between residents and staff (intraclass correlation = 0.96). Only staff-reported EQ-5D-5L scores could discriminate residents by cognitive impairment but all raters could discriminate by dependency levels. Other measures showed minimal missing data, no floor/ceiling effects, and moderate to good interrater reliability. Although most measures could discriminate by dependency level, some did not reach statistical significance. Conclusions The EQ-5D-5L showed promising performance and could serve as a potential candidate for implementation in residential aged care. Although this study also provided additional evidence for the EQ-HWB(-S), QoL-ACC, and ASCOT, further validation in larger samples are needed.