OBJECTIVES:

While the individual domains of generic health state utility instruments (HSUIs) differ, items related to function in everyday activities are frequently included. Assessment of performance in everyday activities is the cornerstone of occupational therapy, which considers self-care, productivity, and leisure key aspects of occupational functioning. This study evaluated the inclusion of occupational functioning aspects in HSUIs.

METHODS:

Six generic HSUIs were selected: QWB scale; 15D; HUI; EQ-5D; SF-6D, and AQoL. Items within each HSUI were reviewed against the Canadian Occupational Performance Measure’s categorization of occupational functioning: self-care (personal care, functional mobility, community mobility), productivity (work, household management, school) and leisure (recreation and socialization). Coverage was classified as direct (item(s) assessed an aspect) or indirect (item(s) could potentially assess an aspect); and specific (item(s) assessed one aspect) or broad (item(s) assessed two or three aspects grouped together).

RESULTS:

Only two HSUIs (QWB, AQoL) had direct specific coverage of all self-care aspects. While all HSUIs had direct specific coverage of personal care, functional and community mobility were less frequently covered. The HUI had direct specific coverage of functional mobility, and the SF-6D had direct broad coverage of both (“other activities”). One (QWB) had direct specific coverage for productivity and leisure, and three (EQ-5D, 15D, SF-6D) had direct broad coverage (“usual”, “other” activities). Two (SF-6D, AQoL) included specific direct items for socialization. Additionally, the AQoL had direct specific coverage for household management. The HUI did not have direct coverage of any productivity or leisure aspects.

CONCLUSIONS:

Only the QWB scale has direct specific coverage for self-care, productivity, and leisure. Other HSUIs do not holistically capture all aspects. HSUIs with broad coverage are unable to identify which specific aspect is impacted. These findings may help inform the choice of HSUI for upcoming research in health conditions where accurately classifying impact on performance in everyday activities is critical.