Changes in health-related quality of life during outpatient rehabilitation: a prospective observational cohort study in four patient groups

Purpose: To evaluate changes in health-related quality of life (HRQoL) of different patient groups, as measured using the EuroQoL (EQ5D) during outpatient multidisciplinary rehabilitation. Methods: Patients with acquired brain injury, chronic pain, neurodegenerative diseases or oncological diagnoses, who received outpatient multidisciplinary rehabilitation, were included in a multi-center prospective observational cohort study. They completed the EQ5D, consisting of an index and a Visual Analogue Scale (VAS), at the start of outpatient rehabilitation (T0) and 6 months thereafter (T1), and two perceived change questions (about quality of life and about general health) at T1. Results: Both EQ5D index and VAS improved for the total sample (n = 419, 68.8% females, mean age 54.5 years) and for each patient group, with the exception of the EQ5D VAS in patients with neurodegenerative diseases. The latter group showed less improvement, as measured on the EQ5D index, than patients with chronic pain (p = 0.004), and less on VAS compared to the other patient groups (all p < 0.05). At an individual level, 76.8% (304/396) of all patients reported improvement on the perceived change question about quality of life and 279/419 (66.6%) on the perceived change question about general health. Again, patients with neurodegenerative diseases had the lowest percentages (49/83 (59.0%) and 39/85 (47.0%), respectively). Conclusion: All patient groups improved on HRQoL during outpatient multidisciplinary rehabilitation, both at group and individual level. However, patients with neurodegenerative diseases showed slightly less improvement than other patient groups, which may reflect the progressive nature of their disease rather than lower rehabilitation effectiveness.