Assessing health‐related quality of life in heart failure patients attending an outpatient clinic: a pragmatic approach

Gallagher, Angela; Lucas, Rebecca; Cowie, Martin R.

doi:10.1002/ehf2.12363

Cited by 72 publications

(70 citation statements)

References 24 publications

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“…Aged 60 and above years had worse mental state, physical health, social relation and environmental health. This nding is lined with previous studies conducted in different research setting (31,32). Based on the knowledge that CHF incidence increases with age, researchers would anticipate that older patients who experience several limitations such as cognitive impairment, loss of personal autonomy, or anxiety and depression may have poor quality of life (31).…”

Section: Discussionsupporting

confidence: 84%

Health Related Quality of Life Among Heart Failure Patients Attending an Outpatient Clinic at University of Gondar Comprehensive Specialized Hospital Northwest Ethiopia 2020: Structural Equation Modeling Approach

Tarekegn

Gezie

Birhan

2020

Preprint

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Background: Chronic heart failure (CHF) is one of the most important public health concerns in the industrialized and developing world having increasing incidence and prevalence. Measuring quality of life using rigorous statistical method may be helpful to provide input for decision makers, policy makers and development of guidelines for the Ethiopia. The aim of this study was to determine health-related quality of life and its associated factors among heart failure patients attending University of Gondar comprehensive specialized hospital.Methods: A cross-sectional study design was employed to select 469 heart failure patients who has follow up at the University of Gondar comprehensive specialized hospital consecutively from March 1 to 30, 2020. Data were entered to Epi-info7 and exported to STATA 14 and Amos for further analysis. The four Quality of life domains were measured with Standardized World Health Organization Quality of Life BREF. Structural equation modeling was employed to estimate the relationships among exogenous, mediating, and endogenous variables simultaneously. Results: Chronic heart failure patients had a significant lower mean score in all domains of health-related quality of life (p-value< 0.0001). Age had a direct positive effect on all domains of health-related quality of life and a positive total effect on overall health related quality of life. Residency also had a direct negative effect on both physical and environmental health related quality of life domain. Duration of chronic heart failure had a direct negative effect on psychological health. There was strong correlation among the four domains of health-related quality of life.ConclusionPoor health related quality of life in the physical dimension, moderately poor overall health related quality of life and a moderate health related quality of life in the psychological health domain. Developing and providing intervention programs to enhance social support can lead to improved quality of life for patients, because of the long-term and chronic illness of the patient.

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Section: Discussionsupporting

confidence: 84%

Health Related Quality of Life Among Heart Failure Patients Attending an Outpatient Clinic at University of Gondar Comprehensive Specialized Hospital Northwest Ethiopia 2020: Structural Equation Modeling Approach

Tarekegn

Gezie

Birhan

2020

Preprint

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“…Using the cut-off KCCQ-12 of <29, Campbell et al (26) identified 27% of patients with SC needs, while we identified 9%. Compared to our HF patient population, the patient cohort in the Campbell et al study was older and had more co-morbidities, and generally involved a sicker in-patient population (26, 36, 37).…”

Section: Discussionmentioning

confidence: 91%

Screening and Initiating Supportive Care in Patients With Heart Failure

Nguyen

Wang

Nikhanj

et al. 2019

Front. Cardiovasc. Med.

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Background: Patients with heart failure (HF) experience a major symptom burden and an overall reduction of quality of life. However, supportive care (SC) remains an under-utilized resource for these patients. Among the many existing barriers to integrating SC into routine care, identifying patients with SC needs remains challenging. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is an important predictor of SC needs in patients with HF.Methods and Results: We used the shortened version KCCQ-12 as a screening tool for SC need in our ambulatory HF patient population using a KCCQ-12 summary score of <29 as the cut-off. Of the 456 patients who completed the KCCQ-12, 41 (9%) were predicted to have SC needs. Demographics, medical history, biochemical parameters, echocardiographic assessment and medical treatment were similar between the two groups of patients. However, patients with KCCQ-12 <29 were more symptomatic based on both New York Heart Association (NYHA) classification and American Heart Association (AHA) staging with a higher prevalence of depression. We established a multidisciplinary SC clinic and the profile and outcomes of patients with SC needs that were referred and followed at our SC clinic were also evaluated. Twenty-three patients were referred to our SC clinic: 2 died before being seen, 1 refused SC and 20 received SC. Of these 20 patients, 11 died and 9 are currently being followed. Median survival after starting the SC clinic is 3 months. In the original SC cohort of 23, 17 patients had available KCCQ-12 summary scores. However, only 6 out of 17 (35%) had KCCQ-12 scores <29, indicating the need for additional assessment tools in this patient population.Conclusions: The magnitude of unmet supportive care needs in patients with HF is significant. While the KCCQ-12 questionnaire is a useful tool to identify patients with SC, serial clinical evaluation, establishment of a SC clinic and prompt referral are essential for patients needing supportive care.

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“…HF patients are often symptomatic and have a poor QoL. 5,25 Improving QoL is acknowledged as a fundamental goal of HF management in the guidelines. 26,27 Heart failure-specific QoL in our study at baseline was moderate (median score 37) and independent of LVEF, which is, for example, comparable with findings in the CHARM programme with a mean MLHFQ summary score of 41.…”

Section: Discussionmentioning

confidence: 99%

The impact of pharmacist/physician care on quality of life in elderly heart failure patients: results of the PHARM‐CHF randomized controlled trial

et al. 2020

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Aims Patients with heart failure (HF) have impaired quality of life (QoL). The randomized controlled trial PHARM-CHF investigated whether an interdisciplinary intervention consisting of regular contacts with the community pharmacy and weekly dosing aids improves medication adherence in patients with HF. It is unknown how an intervention involving frequent structured pharmacy visits affects QoL. Our aim was to explore adherence to the intervention and effects on QoL. Methods and results Among 237 patients, n = 110 were randomized to pharmacy care and n = 127 to usual care. The pharmacy care group received a medication review followed by (bi-)weekly dose dispensing and counselling. The median follow-up was 2.0 years [inter-quartile range (IQR) 1.2-2.7]. Median interval between pharmacy visits was 8.4 days (IQR 8.0-10.3) and the visits lasted in median 14 min (IQR 10-15). Median adherence to the intervention was 96% (IQR 84-100). QoL at 365 days was predefined as a main secondary and at 730 days as another secondary endpoint in PHARM-CHF. QoL was measured by the Minnesota Living with Heart Failure Questionnaire; and for 111 patients (n = 47 in the pharmacy care group and n = 64 in the usual care group), data were available at baseline, and after 365 and 730 days (mean age 74 years; 41% female). Improvement in QoL was numerically higher in the pharmacy care group after 365 days and was significantly better after 730 days (difference in total scores À7.7 points [À14.5 to À1.0]; P = 0.026) compared to the usual care group. In all subgroups examined, this treatment effect was preserved. Improvements in the physical and emotional dimensions were numerically higher in the pharmacy care group after 365 days and were significantly better after 730 days: À4.0 points [À6.9 to À1.2]; P = 0.006, and À1.9 points [À3.7 to À0.1]; P = 0.039, respectively. Conclusions A pharmacy-based interdisciplinary intervention was well received by the patients and suggests clinically important improvements in QoL.

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Assessing health‐related quality of life in heart failure patients attending an outpatient clinic: a pragmatic approach

Cited by 72 publications

References 24 publications

Health Related Quality of Life Among Heart Failure Patients Attending an Outpatient Clinic at University of Gondar Comprehensive Specialized Hospital Northwest Ethiopia 2020: Structural Equation Modeling Approach

Health Related Quality of Life Among Heart Failure Patients Attending an Outpatient Clinic at University of Gondar Comprehensive Specialized Hospital Northwest Ethiopia 2020: Structural Equation Modeling Approach

Screening and Initiating Supportive Care in Patients With Heart Failure

The impact of pharmacist/physician care on quality of life in elderly heart failure patients: results of the PHARM‐CHF randomized controlled trial

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