Long-Term Conditions Questionnaire (LTCQ)

The Long-Term Conditions Questionnaire (LTCQ) is a 20-item patient reported outcome measure (PRO measure or PROM).

The LTCQ was designed and developed to understand the impact of long-term health conditions on people’s lives, and to find out what support those people want or need. The LTCQ has been validated for use in both health and social care settings, including more recent applications in assessing mild cognitive impairment and early-stage dementia. It was developed through an extensive process of qualitative and cognitive interviews and can be used both in research (including clinical studies) and in clinical practice, with the potential to inform person-centered service provision.

The LTCQ comes in a short form version (LTCQ-8).

A companion measure for evaluating the effectiveness of carer support (LTCQ-Carer) is also available, which was validated in carers of people with mild cognitive impairment/dementia.

Background

A long-term condition (LTC) is any health issue that has lasted, or will last, for at least 12 months. LTCs include memory problems, depression and other mental health conditions as well as physical health conditions such as diabetes and heart disease. The LTCQ is a patient-reported outcome measure for assessing the overall impact of living with long-term health conditions, including multi-morbidity.

Design and development

The LTCQ was designed and developed by researchers at the Health Services Research Unit (HSRU) at the University of Oxford and the Personal Social Services Research Unit at the University of Kent, with support by the Department of Health (Policy Research Programme) and NIHR (CLAHRC Oxford).

An initial conceptual framework was developed through a review of the literature and in-depth interviews with professional stakeholders.

The 20 items of LTCQ were developed through in-depth patient interviews to generate content, and items were refined with lay and professional stakeholders. A translatability assessment was conducted to further refine the items.

A larger-scale validation study among primary care and social care recipients (n=1200+) in England demonstrated the LTCQ’s measurement reliability and validity of its broad construct, ‘living well with LTCs’. A second study validated the LTCQ in people with memory problems recruited through memory clinics.

The LTCQ encompasses traditional domains of PROMs (e.g. role functioning, social participation) as well as domains that have more recently emerged as important for living well with LTCs (e.g. treatment burden, confidence to self-manage illness).

Scoring system

Scoring the LTCQ is a very straightforward of the summation of individual item scores, with higher scores indicating higher health-related quality of life. Further guidance is available.

Delivery methods

The LTCQ is to date validated for pen and paper completion. Careful migration to a digital delivery format (for example screen based device) can be authorised. Please contact us for advice.

LTCQ-8

The LTCQ-8 is the short-form version of the Long-Term Conditions Questionnaire (LTCQ), a tool designed to measure the quality of life for people living with long-term health conditions. The short form consists of eight key items, providing a more concise way to assess the impact of long-term conditions on daily life and well-being, while still maintaining the reliability and validity of the original, longer questionnaire. It is particularly useful in settings where a quicker assessment is needed without sacrificing the depth of insight into patients’ experiences.

The LTCQ measures a unidimensional construct, and it is therefore acceptable to use a summed total score. The LTCQ-8 also met the assumption of unidimensionality and had comparable construct validity with the LTCQ. Additional validation is required in an independent sample.

LTCQ-Carer

Despite global policies aimed at supporting the health and wellbeing of informal (family) caregivers, there is no agreed-upon method for evaluating the effectiveness of carer support. To address this, the LTCQ-Carer has been developed and validated as a new quality-of-life measure specifically for carers. The tool assesses quality of life across broad health and social care domains, expanding the range of high-quality tools for evaluating carer support

When used concurrently with patient assessment, it could highlight carer needs and prompt appropriate family support at the earliest point in the clinical pathway.

Funding

The initial and ongoing research of the LTCQ is funded by NIHR as part of the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) – Oxford. The Oxford team collaborated with the Quality and Outcomes of person-centred care policy Research Unit (QORU) at the University of Kent.

National institute for health research

Research Team:

Prof. Ray Fitzpatrick

Prof. Michele Peters

Dr Caroline Potter

Dr Cheryl Hunter

Dr Laura Kelly

Elizabeth Gibbons

Dossier Extracts:

LTCQ Sample copy

Available Languages

Key References:

Hunter C, Fitzpatrick R, Jenkinson C, et al. Perspectives from health, social care and policy stakeholders on the value of a single self-report outcome measure across long-term conditions: a qualitative study. BMJ Open 2015;5:e006986. doi:10.1136/bmjopen-2014- 006986

Kelly L, Potter CM, Hunter C, Gibbons E, Fitzpatrick R, Jenkinson C, Peters M. Refinement of the Long-Term Conditions Questionnaire (LTCQ): patient and expert stakeholder opinion. Patient Relat Outcome Meas. 2016 Nov 16;7:183-193.

Peters M, Potter CM, Kelly L, Hunter C, Gibbons E, Jenkinson C, Coulter A, Forder J, Towers AM, A'Court C, Fitzpatrick R. The Long-Term Conditions Questionnaire: conceptual framework and item development. Patient Relat Outcome Meas. 2016 Aug 30;7:109-25.

Potter CM, Batchelder L, A'Court C, et al. Long-Term Conditions Questionnaire (LTCQ): initial validation survey among primary care patients and social care recipients in England. BMJ Open 2017;7:e019235. doi:10.1136/ bmjopen-2017-019235

Batchelder, L., Fox, D., Potter, C.M. et al. Rasch analysis of the long-term conditions questionnaire (LTCQ) and development of a short-form (LTCQ-8). Health Qual Life Outcomes 18, 375 (2020).

Tsiachristas, A., Potter, C.M., Rocks, S. et al. Estimating EQ-5D utilities based on the Short-Form Long Term Conditions Questionnaire (LTCQ-8). Health Qual Life Outcomes 18, 279 (2020).

Potter, C.M., Peters, M., Cundell, M. et al. Use of the Long-Term Conditions Questionnaire (LTCQ) for monitoring health-related quality of life in people affected by cognitive impairment including dementia: pilot study in UK memory clinic services. Qual Life Res 30, 1641–1652 (2021).

Potter, C.M., Peters, M., Cundell, M. et al. Living well while providing support: validation of LTCQ-Carer for assessing informal carers’ quality of life. Qual Life Res 32, 3507–3520 (2023).

Date Added:

29/10/2020

Therapeutic Area

Healthcare Management & Outcomes Research