Quality of Well-Being in Older People With
Osteoarthritis
ERIK J. GROESSL,
1
ROBERT M. KAPLAN,
1
AND TERRY A. CRONAN
2
Objective. To examine the sensitivity of the Quality of Well-Being Scale (QWB) as a measure of health-related quality of
life (HRQOL) in people with osteoarthritis (OA).
Methods. The QWB was administered, along with the Arthritis Impact Measurement Scale (AIMS) and other health
measures. Health care utilization data were also obtained.
Results. People with OA had a mean QWB score of 0.643. The QWB scores were significantly correlated with total AIMS
scores, self-rated health status, health care costs, depression scores, and most AIMS subscales. In addition, changes in
QWB scores after 1 year were significantly correlated with changes in total AIMS scores and some AIMS subscales.
Conclusion. The QWB appears to be a useful and sensitive generic, utility-based measure of HRQOL in people with OA.
KEY WORDS. Osteoarthritis; Quality of life; Quality of Well-Being Scale; Outcomes measurement; Health assessment.
INTRODUCTION
Arthritis is the most frequently occurring chronic condi-
tion among older Americans, affecting 49% of those older
than 65 years (1). Osteoarthritis (OA) has been shown to
affect the health status of older persons on 3 primary
dimensions: physical disability, psychological disability,
and pain (2). Social support and social activity are also
affected by arthritis (3,4).
The Arthritis Impact Measurement Scale (AIMS) is a
widely used, disease-specific measure that addresses the
multiple impacts of arthritis severity (5,6). The AIMS is
composed of 11 subscales relating to symptoms and func-
tional impairment associated with arthritis. Although the
AIMS may be a sensitive measure of arthritis symptom-
atology, it does not provide a scaled score that can be
easily used in cost-effectiveness analysis. Therefore, many
researchers recommend using both a generic and a disease-
specific measure (7,8).
The Quality of Well-Being Scale (QWB) is a comprehen-
sive, generic measure of health-related quality of life
(HRQOL) that combines information about symptoms and
functioning into a single-scaled score that is independent
of diagnosis. This independence is useful for comparing
quality of life across illnesses, treatments, and popula-
tions. The QWB is linked to the concept of quality-ad-
justed life years (QALYs). QALYs combine quality and
quantity of life into a single index that adjusts survival
time for reduced life quality. The cost of an intervention or
treatment can be divided by the number of QALYs lost to
a particular health condition or produced by an interven-
tion to estimate the cost/QALY. This value can then be
directly compared among different options that compete
for health care resources.
The present study examines the sensitivity of a generic
outcome measure (QWB) for assessing HRQOL in people
with OA. Although the QWB has been validated as a
general measure of HRQOL with several other specific
diseases, its sensitivity has not been validated in people
with OA. This article also provides an estimate of the
impact of OA on HRQOL.
SUBJECTS AND METHODS
Subjects. Members of a Southern California health
maintenance organization (HMO) agreed to participate in
an intervention testing the effects of social support and
education on health and health care utilization. The re-
sults of the intervention aspects of the study are reported
elsewhere (9 –12). To be eligible, HMO members needed a
diagnosis of OA, which was defined as self-reported
chronic pain and stiffness and being told by a physician
Supported by NIH grants AR-40423, AR-44020, and P60-
AR-40770 and AHCPR grant 5R01-HS-09170.
1
Erik J. Groessl, PhD, Robert M. Kaplan, PhD: University
of California, San Diego, La Jolla, California;
2
Terry A.
Cronan, PhD: San Diego State University, San Diego, Cali-
fornia.
Address correspondence to Erik J. Groessl, UCSD—
Health Outcomes Assessment Program, 9500 Gilman Drive,
Mail Code 0994, University of California, San Diego, La
Jolla, CA 92093-0994. E-mail: egroessl@popmail.ucsd.edu.
Submitted for publication April 17, 2001; accepted in
revised form March 23, 2002.
Arthritis & Rheumatism (Arthritis Care & Research)
Vol. 49, No. 1, February 15, 2003, pp 23–28
DOI 10.1002/art.10903
© 2003, American College of Rheumatology
ORIGINAL ARTICLE
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