The relationship between patient engagement and health-related quality of life in patients: a cross-sectional study in general outpatient clinic in Hong Kong SAR, China

Introduction: Patient engagement (PE) helps healthcare professionals to collaborate with patients to work together to improve health outcomes. However, the studies of PE and its relationship with health-related quality of life (HRQoL) is very rare in Hong Kong (HK) and China. The aim of this study was to assess the PE level and its association with HRQoL in the general outpatient clinic (GOPC) in Hong Kong.

Methods: A cross-sectional survey was conducted in a GOPC in 2017. Patient engagement index (PEI) was used as a valid and reliable instrument to assess the PE level in the primary care setting. EQ-5D-5L HK Chinese version was used to evaluate the patients' HRQoL. ANOVA, ANCOVA and robust linear regression were used to analyse the data.

Results: 686 patients successfully completed the survey (response rate =64%). The mean utility of EQ-5D (0~1.0) was 0.92. Male, highly educated and younger respondents got higher utility. For PEI (0~100), the mean score was 37.02, whereas female (38.03), highly educated and younger respondents performed better. The regression model indicated that there is a positive relationship between PE and HRQoL (beta =2.66, SE =5.11, p<0.05). However, after adjusting a series of socio-economic characteristics, the relationship was weakened (beta =1.77, SE =4.64, p<0.05) and even insignificant.

Conclusion: This is the first study in HK to assess the PE level and its relationship with HRQoL in the primary care setting. The result indicated that improve PE could bring a positive influence on the HRQoL. However, the PE-HRQoL relationship might be deeply influenced by an individual's physical, psychological or social characteristics.