Using the Health Utilities Index in Routine Clinical Care: Process, Feasibility, and Acceptability: A Randomized Controlled Trial

Background and objective: Using measures of health-related quality of life (HR-QOL) in routine clinical practice has the potential to improve the quality of healthcare and outcomes. The Health Utilities Index (HUI) is a generic, preference-based measure of HR-QOL. The aim of this study was to describe the process, feasibility and acceptability of use of the HUI in routine clinical care. Methods: The study was conducted at the outpatient Heart and Lung Transplant Clinic, University of Alberta Hospital, Edmonton, Alberta, Canada. Before seeing the clinician, patients attending the clinic completed the HUI on a touch-screen computer at each visit. This information was graphically represented on the HUI score card and presented to the clinicians during the visit. Patients completed a battery of questionnaires at baseline and at the end of the study. Training in the interpretation of the results was provided on a regular basis to the clinicians. The use of HUI in clinical practice was assessed from the perspectives of clinicians and patients. Clinicians completed two questionnaires, at baseline (on expectations) and at the end of the study (an evaluation), regarding the usefulness of the HUI measure in routine clinical care. Patients completed an evaluation form at the end of the study. Results: Of 151 patients, 135 were happy to use the touch-screen computer and 138 patients confirmed that the questionnaire was easy to complete. Only 10 of 151 patients were unwilling to complete the questionnaires. Clinicians agreed that the results from the HUI helped to improve patient-clinician communication. Members of the team indicated that the HUI score card was clinically relevant and confirmed their diagnoses. Conclusions: Patients quickly learned how to complete the HUI questionnaire on the computer. Clinicians found that the information provided was valuable and have subsequently incorporated the use of the HUI in the routine clinical care of their patients.