Comparing EQ-5D-5L and IPOS among residents with malignant tumors in a community home hospice: a longitudinal study

In community home hospices, limited medical staff and high workloads necessitate measurement models that objectively and effectively capture the needs of residents with malignant tumors. This study compares the measurement properties and feasibility of the EuroQol 5-Dimension 5-level (EQ-5D-5L) and Integrated Palliative care Outcome Scale (IPOS), primarily used in palliative care, as only few studies have compared their measurement properties and feasibility based on their actual application in home hospice care.

Two-wave longitudinal data were collected from 2021 to 2023 at a community home hospice in Japan from a sample of 120 residents diagnosed with malignant tumors. Residents completed both the EQ-5D-5L and IPOS upon admission. Data were collected at three main time points: the initial admission date, one week after admission, and when residents' conditions changed. This study evaluates the feasibility and measurement properties of EQ-5D-5L and IPOS, including ceiling and floor effects, correlations among domains, and responsiveness.

The EQ-5D-5L demonstrated high feasibility, whereas the IPOS had moderate feasibility with a higher missing data rate. Both scales had low ceiling and floor effects. The EQ-5D-5L showed low responsiveness, while the IPOS showed moderate responsiveness. Anxiety and the emotional domains of the IPOS or EQ-5D-5L scores were insignificantly correlated. Participants who did not complete the IPOS had significantly lower EQ-5D-5L scores.

The EQ-5D-5L may be slightly more suitable for the primary screening of needs in this setting owing to its higher feasibility. In contrast, the IPOS is an excellent tool when it is important to comprehensively and deeply capture the needs of individuals over time. We note that when selecting or using different measures, one must consider the specific characteristics of each measure.