Table 2 Secondary outcome measures for assessment of process and performance
Outcome | Measure or source | Details of measure | Scoring |
|---|---|---|---|
Quality of life | Short-Form Health Survey (SF36-V1) | • Eight domains: role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health | 0 to 100, with higher scores = higher quality of life |
• Five domains with 5-point scales: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression • Overall health rated on scale from 0–100 (“worst imaginable health” to “best imaginable health”) | The Canadian Index was used: -0.148 to 0.949, with higher scores = high quality of life | ||
World Health Organization Disability Assessment Schedule 2.0 (WHODAS) [53] | • Thirty-six items to assess health and disability across all diseases and is useful for multimorbidity • Six domains of functioning rated as 0–4 (none, mild, moderate, severe, extreme): including cognition, mobility, self-care, getting along, life activities, and participation | Summed the first 36 items 0 to 144, with higher scores representing higher disability | |
Psychological distress | Kessler Psychological Distress Scale [54] | • Ten items that produce a global measure of distress based on questions about anxiety and depressive symptoms experienced in last 4 weeks • 5-point scale (all of the time, most of the time, some of the time, a little of the time, and none of the time) | Did not include the question “during the last 30 days, how often did you feel worthless?” Scores for 9 items range 9 to 45, with higher values representing higher psychological distress |
Cognition | • Eleven items for 5 domains of cognitive function: orientation, registration, attention, calculation, recall, and language | Overall score ranges 0 to 30 Severe impairment = 0 to 9 Moderate impairment = 10 to 19 Mild impairment = 20–25 Potentially normal = 26–30 [57] | |
Mobility-related fatigue | Avlund Mobility-Tiredness Scale [58] | • Indicated whether participant experiences fatigue performing 6 activities (yes = 1 or no = 0) | 0 to 6, with higher scores representing greater fatigue |
Mobility | MANTY (64) | • Three items: level of difficulty walking 2 km, walking 0.5 km, and climbing 1 flight of stairs • Participants indicate the following: manage without great difficulty, some difficulty, a great deal of difficulty, with the help of another person or unable to manage even with help | Descriptive |
Nutritional status | Mini Nutritional Assessment Short-Form [59] | • Six items: identifies elderly patients who are malnourished or at risk of being malnourished • Has been used to measure decline in nutritional status due to polypharmacy (63) | 0 to 14, with higher scores indicating a better nutritional status |
Sleep | Pittsburgh Sleep Quality Index (65) | • Assesses 1-month period • Nineteen items grouped into 7 components which are weighted equally on a scale of 0–3 | 0 to 21, with higher scores indicating poorer sleep quality |
Patient enablement | Patient Enablement Instrument (66) | • Six items about patient understanding of and coping with health issues as a result of a consultation with a healthcare provider • We changed the stem, “As a result of your visit to the doctor today” to “After a usual visit with your family doctor” | 0 to 12, with higher scores indicating a stronger patient enablement |
Grip strength | With a JAMAR hand dynamometer | • Done with a supported forearm (67) but alternating between right and left hands to prevent fatigue • Three trials per hand | Average of three trials Measured in kilograms |
Number of falls | Electronic Medical Record | • The number of falls and those requiring medical attention • The number of health care providers seen by the patient • The number of visits to the providers related to each fall incident | Descriptive |
Healthcare utilization | Electronic medical record Custom self-report form | • Number of hospitalizations, emergency room visits, or urgent care visits • Number of long-term care admissions • Number of family doctor or specialist visits • Medication use • Home care services • Professional care services • Support equipment use • Caregiver support • Home care visits | Descriptive |