Evaluating the PROMIS-29 v2.0 for use among older adults with multiple chronic conditions
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The Patient-Reported Outcomes Measurement Information System 29-item profile (PROMIS-29 v2.0), which measures health-related quality of life (HRQoL), has had limited evaluation among older adults (age 65+) with multiple chronic conditions. Our purpose was to establish convergent validity for PROMIS-29 in this population.
We collected the PROMIS-29 v2.0 and the Veterans RAND 36 (VR-36) for 1359 primary care patients aged 65 + with at least 2 of 13 chronic conditions, oversampling those aged 80+. We conducted multiple analyses to examine score differences across subgroups, differential item functioning (DIF), and comparisons of PROMIS-29 v2.0 and VR-36 scores.
The mean age was 80.7, and all patients had at least 2 of 13 chronic conditions. Older age, female sex, Hispanic ethnicity, and more chronic conditions were associated with worse physical health scores (PHS) and mental health scores (MHS) on the PROMIS-29 v2.0—findings which are in the expected direction. None of the 700 pairs of items met criteria for DIF. PHS and MHS were highly intercorrelated (r = 0.74, p < 0.001 for this and all other findings). PHS was more highly correlated with the VR-36 Physical Component Score (PCS) than the Mental Component Score (MCS) (r = 0.85 and 0.32, respectively), while MHS was highly correlated with both (r = 0.70 and 0.64, respectively).
PROMIS-29 v2.0 demonstrates expected bivariate relationships with key person-level characteristics and does not show DIF. PROMIS-29 v2.0 scores are highly correlated with VR-36 scores. These results provide support for the validity of PROMIS-29 v2.0 as a measure of HRQoL among older adults with multiple chronic conditions.
KeywordsQuality of life PROMIS Geriatrics Comorbidity Chronic disease Elderly
Funded by the National Institute on Aging (contract #HHSN271201500064C NIH NIA, PI: Edelen). The funder had no role in data collection, data analysis, interpretation, manuscript drafting, manuscript revision, or decision to submit for publication.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no relevant conflicts of interest.
The authors declare that this study was conducted in accordance with appropriate ethical standards for research, including the Declaration of Helsinki. The study was approved by the RAND Human Subjects Research Protection Committee (Study #2015-0956-AM05), and by the Kaiser Permanente Colorado IRB (IRB Number CO-15-2199).
Participants provided informed consent, with a waiver of documentation of informed consent.
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