Assessment of Quality of Life for Home Enteral Nutrition

NutriQoL Questionnaire

Questionnaire developed by Nestle Health Science

Intended to be used by HCPs

Healthcare worker providing support to elderly woman on sofa

What

NutriQoL® is the first self-administered questionnaire developed by NHSC for all patients using Home Enteral Nutrition (HEN), regardless of their underlying condition or the method of nutritional formula administration. It is suitable for patients with various medical conditions who depend on enteral nutrition.

Why

The NutriQoL® questionnaire is used to assess the effectiveness of HEN, identify areas needing intervention and track changes in patient health status over time. This type of feedback is important for continuously improving treatment strategies, thereby enhancing their overall care and quality of life.

How often

The NutriQoL® questionnaire is typically administered 1-2 weeks after the initiation of HEN to allow patients to adapt to their new dietary regimen.

Subsequently, it is recommended to administer the questionnaire every 3 months for patients undergoing changes in HEN and every 6 months for those in stable conditions.

The NutriQol^® questionnaire comprises 17 items grouped into two dimensions:

Physical functioning and daily life activities
Aspects of social life

Items 1-9 are positive, while 10-17 are negative

Moreover, the NutriQoL^® questionnaire also includes a 0 to 100 visual analogue scale to evaluate patients’ overall health status.

Part A: Frequency with which patients perceive specific situations related to home enteral nutrition (3 response options: never, sometimes or always).
Part B: Importance that patients attach to the situations in part A (3 response options: not important at all, somewhat important or very important).

Instructions: 1. Select the option that best applies to each question.

2. All the questions are mandatory.

References:

De la Cuerda C, et al. Cuestionario NutriQoL^®: desarrollo de un cuestionario específico de Calidad de Vida Relacionada con la Salud para pacientes con Nutrición Enteral Domiciliaria. 28th National Congress of the Spanish Society of Parenteral and Enteral Nutrition (SENPE). 2013. Nutrición Hospitalaria. 2013;28(3).
Apezetxea A, et al. Health-related quality of life in patients with home enteral nutrition in Spain assessed by a specific questionnaire: NutriQoL^®. ISPOR 17th Annual European Congress. 2014. Value Health. 2014;17(7):A518-0.
De la Cuerda C, et al. Criterion validity analysis of a specific Health-Related Quality of Life questionnaire for Home Enteral Nutrition: The NutriQoL^® questionnaire. 35th European Society for Clinical Nutrition and Metabolism Congress (ESPEN). 2013. Clin Nutr. 2013;32(1):5217.
Apezetxea A, et al. Reliability of a specific health related quality of life (HRQoL) questionnaire for home enteral nutrition (HEN) (NutriQoL^® questionnaire). 36th European Society for Clinical Nutrition and Metabolism Congress (ESPEN). 2014. Clin Nutr. 2014;33(1):5228.
De la Cuerda C, et al. Inter-observer reliability of a specific health related quality of life (HRQoL) questionnaire for home enteral nutrition (HEN) (NutriQoL^® questionnaire). 36th European Society for Clinical Nutrition and Metabolism Congress (ESPEN). 2014. Clin Nutr. 2014;33(1):5230.
De la Cuerda C, et al. Responsiveness and minimal clinically important difference of a specific health related quality of life (HRQoL) questionnaire for home enteral nutrition (HEN) patients; NutriQoL^® questionnaire. Value Health. 2014;17(7):A575.
Joyce CRB, et al. A theory-based method for the evaluation of individual quality of life: the SEIQoL. Qual Life Res. 2003;12(3):275-280.
Cuerda MC, et al. Development and validation of a specific questionnaire to assess health-related quality of life in patients with home enteral nutrition: NutriQoL^® development. Patient Prefer Adherence. 2016;10:2289-2296.
Apezetxea A, et al. The NutriQoL^® questionnaire for assessing health-related quality of life (HRQoL) in patients with home enteral nutrition (HEN): validation and first results. Nutr Hosp. 2016;33(6):1260-1267.
Cuerda C, et al. Reliability and Responsiveness of NutriQoL^® questionnaire. Adv Ther. 2016;33(10):1728-1739.
Apezetxea A, et al. Rasch analysis in the development of the NutriQoL^® questionnaire, a specific health-related quality of life instrument for home enteral nutrition. J Patient Rep Outcomes. 2017;2(1):25.
Schneider SM, et al. P211: Linguistic and cultural adaptation of the NutriQoL^® questionnaire in France using ISPOR Guidelines. Clin Nutr ESPEN. 2023;54:463-726.
Cereda E, et al. P140: Linguistic and cultural adaptation of the NutriQoL^® questionnaire in Italy. Clin Nutr ESPEN. 2023;54:463-726.

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Interpreting the Results

The NutriQoL^® questionnaire results are scored on a scale from 0 to 100, with higher scores indicating better HRQoL.

Each category helps healthcare providers understand the patient’s current quality of life and determine the necessary actions to improve or maintain it.

Initial Assessment and Follow-up Evaluations

For patients scoring in the poor or very poor categories, a detailed analysis of each item in the questionnaire should be conducted to identify areas needing improvement.

When the assessment is acceptable, good or very good, the professional should conduct follow-up visits. During these visits, changes in HRQoL scores are compared to previous assessments.

A change of ±4 points indicates a significant variation in the patient’s health status, prompting further clinical interviews and potential adjustments to the treatment plan.

If the change produced is + 4 points, the result indicates that the patient’s HRQoL has improved with respect to the previous measurement.
If the change is - 4 points, the result indicates that the professional should review the therapeutic guideline.
If there has been no change in the questionnaire score, the professional should analyse the patient’s previous score and, according to his or her clinical judgment, determine the actions to be taken.

Reference: 1. De la Cuerda C et al. Cuestionario NutriQoL®: desarrollo de un cuestionario específico de Calidad de Vida Relacionada con la Salud para pacientes con Nutrición Enteral Domiciliaria. 28th National Congress of the Spanish Society of Parenteral and Enteral Nutrition (SENPE). 2013. Nutrición Hospitalaria. 2013; 28(3). 2. Apezetxea A et al. Health Related Quality of Life in patients with home enteral nutrition in Spain assessed by a specific questionnaire: NutriQoL®. ISPOR 17th Annual European Congress. 2014. Value Health.2014; 17(7):A518-0. 3. De la Cuerda C et al. Criterion validity analysis of a specific Health-Related Quality of Life questionnaire for Home Enteral Nutrition: The NutriQoL® questionnaire. 35th European Society for Clinical Nutrition and Metabolism Congress (ESPEN). 2013. Clin Nutr. 2013; 32(1):S217. 4. Apezetxea A et al. Reliability of a specific health related quality of life (HRQoL) questionnaire for home enteral nutrition (HEN) (NutriQoL® questionnaire). 36th European Society for Clinical Nutrition and Metabolism Congress (ESPEN). 2014. Clin Nutr. 2014; 33(1):S228. 5. De la Cuerda C et al. Inter-observer reliability of a specific health related quality of life (HRQoL) questionnaire for home enteral nutrition (HEN) (NutriQoL® questionnaire). 36th European Society for Clinical Nutrition and Metabolism Congress (ESPEN). 2014. Clin Nutr. 2014; 33(1):S230. 6. De la Cuerda C et al. Responsiveness and minimal clinically important difference of a specific health related quality of life (HRQoL) questionnaire for home enteral nutrition (HEN) patients; NutriQoL® questionnaire. ISPOR 17th Annual European Congress. 2014.Value Health. 2014; 17(7):A575. 7. Joyce CRB, Hickey A, McGee HM, O’Boyle CA. A theory based method for the evaluation of individual quality of life: the SEIQoL. Quality of life Research. 2003;12:275-280