OBJECTIVES: The terms “health-related quality of life” (HRQoL) and “quality of life” (QoL) are used in the patient-centered outcomes (PCO) field to describe the impact of diseases on patients’ lives. However, these terms are not well defined and are used interchangeably in the literature, product labels, clinical trial endpoints, and PCO research. The social ecological model (SEM) can be used to distinguish these terms when classifying impact concepts reported by patients in qualitative interviews. The SEM is a theoretical framework that can be used to understand how a disease affects an individual’s interaction with their outside environment, and conversely how an individual’s environment may impact their experience of a disease.

METHODS: The SEM was modified to demonstrate the differences between the terms “HRQoL” and “QoL” and how they can be distinguished. A review of 103 impact concepts reported during qualitative interviews by patients (N=28) with a serious infection was conducted. These concepts were evaluated against the terms “HRQoL” and “QoL” using the parameters of the modified SEM.

RESULTS: Review of the impact concepts within the SEM framework illustrated the differences between the terms “HRQoL” and “QoL.” In this model, impact concepts that are directly attributable to one’s disease are “HRQoL” impacts, whereas impact concepts that are considered social determinants of health or attributable to conditions within one’s environment are “QoL” impacts.

CONCLUSIONS: The terms “HRQoL” and “QoL” are used interchangeably within the PCO field to describe impact concepts reported by patients; however, use of the SEM supports in distinguishing these terms. Results reveal that “HRQoL” impacts are more relevant to clinical trial endpoints and product labels and may be more appropriate for use within the PCO field.