Assessing quality of life in patients with hard-to-heal ulcers using the EQ-5D questionnaire

OBJECTIVE: To assess health-related quality of life (HRQoL) in an unselected patient population with hard-to-heal ulcers from baseline through healing and at follow-up 6 months after healing. METHOD: Fifty patients were recruited and the sex and age of the patient and the ulcer aetiology, duration, and size were recorded. The generic instrument EQ-5D was used for two purposes. The first was to investigate the feasibility of this instrument for assessing HRQoL in this patient group. The second was to see if the EQ-5D results would add information to the Swedish Registry of Ulcer Treatment (RUT), a national quality registry which includes variables for pain, disturbed sleep, and mobility. RESULTS: We found a significant difference in HRQoL between patients with an open ulcer and those with a healed ulcer (p=0.02), but no significant difference between patients with a just-healed ulcer and patients at follow-up six months after ulcer healing (p=0.08). Sex, age, and length of ulcer duration at inclusion did not influence HRQoL (p=0.55, p=0.4, and p=0.9, respectively). Ulcer size seemed to influence HRQoL, though not significantly (p=0.07). CONCLUSION: This study confirms that HRQoL was improved after ulcer healing. Pain, as one of the five constructs measured by the EQ-5D, was significantly associated with open ulcers. The results from the EQ-5D questionnaire were hard to interpret in terms of capturing HRQoL in this unselected patient population. Despite some limitations, we consider that the simplicity of EQ-5D could make it feasible to use in the clinical setting. However, the results from EQ-5D did not add consistent information to RUT; therefore, this questionnaire will not be included in the registry.