Purpose <p>Peripherally Inserted Central Catheter (PICC)-associated complications, such as infections and thrombosis, impact significantly upon patients’ experiences and outcomes of care. The purpose of this study was to assess the utility of a patient-reported outcome measure (EuroQol Five Dimension Five Level (EQ5D-5L)), and patient-reported experience measure (Australian Hospital Patient Experience Question Set (AHPEQS)), to discriminate incidence of PICC failure among adults.</p> Methods <p>A secondary analysis was undertaken of two large randomised controlled trials, conducted in two adult tertiary hospitals in Queensland, Australia. The EQ5D-5L and AHPEQS instruments were assessed against incidence of three clinical outcomes likely to impact upon self-reported outcomes and experiences: Central Line Associated Bloodstream Infection (CLABSI), venous thrombosis, and all-cause PICC complication. Partial proportional odds, multinomial logistic, linear regression and generalised linear regression models were used to assess instrument performance.</p> Results <p>Overall, 984 participants provided baseline EQ5D-5L responses. Subsequently, n=628 completed an EQ5D-5L at study end; n=552 further completed the AHPEQS. EQ5D-5L demonstrated poor discrimination of individual complications (CLABSI, thrombosis), however, there was a significant association (<i>p</i>=&lt;0.05) between all-cause PICC complication and: utility (− 0.1, Confidence Interval (CI) − 0.1 to − 0.1); disutility (0.4, CI 0.2–0.7); and self-reported health (– 4.3, CI − 7.8 to − 0.9). AHPEQS demonstrated poor discrimination; one item (‘both physical and emotional harm’) was significantly associated with all-cause PICC complication (1.0, 95%CI 0.1–1.9); CLABSI (2.4, 95%CI 0.7–4.2); and thrombosis (2.0, 95%CI 0.7–3.4).</p> Conclusion <p>EQ5D-5L demonstrated moderate suitability for use among patients with PICCs; AHPEQS demonstrated little reliability.</p>

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Performance of EQ5D-5L and AHPEQS for measuring outcomes and experiences of patients with peripherally inserted central catheters: a secondary analysis

  • Emily N. Larsen,
  • Amanda J. Ullman,
  • Nicole Marsh,
  • Ruth Royle,
  • Mari Takashima,
  • Deanne August,
  • Penny Comans Inglis,
  • Nicole Gavin,
  • Amanda Corley,
  • Brighid Scanlon,
  • Doreen Tapsall,
  • Raymond J. Chan,
  • Claire M. Rickard,
  • Joshua Byrnes

摘要

Purpose

Peripherally Inserted Central Catheter (PICC)-associated complications, such as infections and thrombosis, impact significantly upon patients’ experiences and outcomes of care. The purpose of this study was to assess the utility of a patient-reported outcome measure (EuroQol Five Dimension Five Level (EQ5D-5L)), and patient-reported experience measure (Australian Hospital Patient Experience Question Set (AHPEQS)), to discriminate incidence of PICC failure among adults.

Methods

A secondary analysis was undertaken of two large randomised controlled trials, conducted in two adult tertiary hospitals in Queensland, Australia. The EQ5D-5L and AHPEQS instruments were assessed against incidence of three clinical outcomes likely to impact upon self-reported outcomes and experiences: Central Line Associated Bloodstream Infection (CLABSI), venous thrombosis, and all-cause PICC complication. Partial proportional odds, multinomial logistic, linear regression and generalised linear regression models were used to assess instrument performance.

Results

Overall, 984 participants provided baseline EQ5D-5L responses. Subsequently, n=628 completed an EQ5D-5L at study end; n=552 further completed the AHPEQS. EQ5D-5L demonstrated poor discrimination of individual complications (CLABSI, thrombosis), however, there was a significant association (p=<0.05) between all-cause PICC complication and: utility (− 0.1, Confidence Interval (CI) − 0.1 to − 0.1); disutility (0.4, CI 0.2–0.7); and self-reported health (– 4.3, CI − 7.8 to − 0.9). AHPEQS demonstrated poor discrimination; one item (‘both physical and emotional harm’) was significantly associated with all-cause PICC complication (1.0, 95%CI 0.1–1.9); CLABSI (2.4, 95%CI 0.7–4.2); and thrombosis (2.0, 95%CI 0.7–3.4).

Conclusion

EQ5D-5L demonstrated moderate suitability for use among patients with PICCs; AHPEQS demonstrated little reliability.