Presentation (CTI)

OBJECTIVES: Whole Health is an emerging term that integrates longstanding health outcome concepts namely physical, social, and psychological functioning, along with signs and symptoms. Beyond these concepts, Whole Health also incorporates environmental, spiritual, and economic influences on health. Consistent with ISPOR’s 2030 Strategy, which includes Whole Health, this study aimed to identify how to measure Whole Health and which tools currently capture its sub-concepts.
METHODS: ISPOR’s Whole Health literature was used to establish a conceptual framework. Next, keyword searches were performed in PROQOLID’s “Domain” field, a clinical outcome assessment (COA) library, to identify instruments measuring at least two Whole Health sub-concepts. Considering the conventional conceptual scope of COAs, our search focused specifically on environmental, spiritual, and economic domains. Gap analysis then evaluated whether any COAs comprehensively measured Whole Health. Due to limited COAs measuring environmental factors, a supplemental search was conducted in Atlas, a digital health technology (DHT) repository, by reviewing DHTs listed within the “Environment” category of “Measures”.
RESULTS: After de-duplication, 129 COAs were identified with ten addressing all Whole Health components. Three targeted the general population (SigQOLM, SigQOLM-36, WHOQOL-100), four focused on mental health (CAN-M, Mayers’ LSQ (2), QLS-BC, QOL.BD), two on older adults (Mayers’ LSQ (3), OPQOL), and one on caregivers of people with terminal illnesses (QOLLTI-F). 290 DHTs covering 25 relevant environmental sub-concepts were identified in Atlas. Frequently used DHTs were Besi-C (n=7), ADXL362A (n=7), and Awair Omni (n=6). Common therapeutic indications included, diabetes (n=12), general population (n=12), and Parkinson’s disease (n=9).
CONCLUSIONS: Several COAs measure components of Whole Health, yet widespread applicability is limited by population specificity and respondent burden given the often-high number of items. Environmental measurement is underrepresented in COAs; however, we found numerous DHTs. Future research may consider integrating DHTs measuring environmental factors alongside COAs to support more comprehensive, holistic, and less burdensome Whole Health assessment.