Living long but living well? Health-related Quality of Life Tools for Singapore's Integrated Care Sector

In Singapore, the national integrated care effort is focused on elderly care services delivered in the intermediate and long term care (ILTC) sector. The elderly often have chronic diseases, multiple comorbidities, and varying levels of social support. The vision of Singapore’s integrated care effort is to enable the elderly to live well and age gracefully in the community. Therefore, good quality of life (QoL) is one of the key targets for such effort. Health related quality of life (HR-QoL) is often assessed in various settings. While a wide range of HR-QoL tools are available, care providers often have difficulty in choosing appropriate ones for the specific setting (e.g. nursing home) or target population (e.g. dementia patient). The QoL literature, although rich, does not specify HRQoL tools appropriate for the ILTC sector. This study aims to fill such a void by conducting a systematic literature review on HR-QoL tools that can be used in Singapore’s integrated care sector. A systematic review of the literature published in English was performed by electronically searching sources such as MEDLINE, PubMed, Web of Science, EBSCO, Cochrane Library and Google Scholar. Main keywords are HR-QoL, tool/measurement, elderly, and integrated care/long term care. CASP (Critical Appraisal Skills Programme) appraisal tools were used to assess the applicability, reliability and validity of the studies. We expect to develop a taxonomy of HR-QoL tools for clients utilizing integrated care services in Singapore. Specifically, we will identify appropriate HR-QoL tools and classify them according to type of services, type of clients, and type of assessors. The taxonomy will contribute to the QoL literature by focusing on integrated care settings such as residential-based, center-based and home-based care. It will enable care providers to select suitable tools to assess their clients’ QoL, cross-sectionally or longitudinally, so as to inform their service planning, delivery and enhancement. One limitation of this study is that the recommended HR-QoL tools might need to be validated before wide application in Singapore. Further research can validate tools in specific settings.