OBJECTIVES: The validity of generic health measures (e.g., the EQ-5D), has been questioned in mental health. The Recovering Quality-of-Life (ReQoL) is a mental health recovery-focused quality of life outcome. This study aimed to compare the use of the EQ-5D and ReQoL in a feasibility trial in adults with severe mental illness in secure forensic services.

METHODS: A cluster-randomized controlled feasibility trial compared multidisciplinary weight management intervention (Motiv8 plus treatment as usual) to treatment as usual. The health economic component aimed to collect preliminary data to inform economic evaluation methods for a definitive trial. The primary economic outcome measure for a definitive trial will be Quality-Adjusted Life Years (QALYs) derived from utility scores. The EQ-5D(-5L) and the ReQoL-10 were collected at baseline, week 10 and month 3. Published algorithms/mapping functions were used to generate utilities from the measures. Completeness and mean scores were compared. Patient and Public Involvement (PPI) group feedback was sought on the measures.

RESULTS: The trial met recruitment targets (n=29). Utility could be estimated using the EQ-5D for 55% of participants at all time points. The mean EQ-5D value at baseline was 0.732 (SD 0.243). Estimating utility from ReQoL data uses a selection of the items available. Complete ReQoL-UI data was available for 45% of participants at all time points. The mean ReQoL-UI value at baseline was 0.846 (SD 0.146). PPI feedback favored the ReQoL as it was easier to complete, was clearer what questions were asking, felt more meaningful and captured wellbeing.

CONCLUSIONS: Comparing the EQ-5D and ReQoL derived utilities for participants who had complete data for both at baseline, there is a notable difference. PPI feedback strongly supported the ReQoL and noted many issues with the EQ-5D. Further work is needed to validate the ReQoL-UI in similar populations prior to using it in a full-scale trial.