Quality of life improvement in patents with osteoarthritis: the potential for office-based assessment

This study presents the initial findings from our evaluation of the Nottingham Health Profile, a short and simple quality of life instrument, to determine its ease and robustness as a routine office tool for evaluating changes in the quality of life for arthritis patients undergoing joint replacement.

Thirty-five patients awaiting total joint replacement surgery were asked to complete the Nottingham Health Profile at their pre-operative clinic. A post-joint replacement evaluation profile, with a self-addressed stamped envelope, was mailed to each participant 3-4 months post-surgery. The profile was self-administered on both occasions.

The follow-up response rate was 69%. The t-test for the paired difference of related populations was used to determine pre-test and post-test changes. Significant improvement was found in the profile's 6 subscales, with energy, pain, and physical mobility significant at the 0.001 level, emotion and social isolation significant at the 0.005 level, and sleep significant at the 0.05 level. The before and after comparison of the profile's global self-assessment of health was not significant.

Preliminary findings suggest that the Nottingham Health Profile is a useful office tool for the routine assessment of intervention-related changes in quality of life. The instrument was easy to self-administer and was associated with a mail return response rate consistent with other investigations using the profile. Even with a small sample size, the profile rendered data consistent with large-scale research evaluations of changes in quality of life for joint replacement patients. The finding that patients' global health status measures did not change despite improvements in quality of life subscales indicates that the instrument reliably netted out the quality of life benefits of the arthritis-related intervention from the patients' total burden of illness.