Perceptions of heart failure symptoms, disease severity, treatment decision-making and side effects by patients and cardiologists: a multinational survey in a cardiology setting

Abstract

PurposeExplore the extent to which heart failure (HF) symptoms and side effects of HF treatment experienced by patients are recognized by cardiologists, and concordance between patient–cardiologist perceptions of HF severity and patients’ contributions to treatment decision-making.MethodsA multinational, cross-sectional survey of cardiologists and patients with HF was conducted. Patient-record forms (PRFs) were completed by cardiologists for consecutive consulting patients with HF, who completed a patient self-completion questionnaire (PSC). Responses from PRFs with an associated PSC were analyzed to compare patient- and cardiologist-reported occurrences of HF symptoms and treatment side effects, patient-perceived severity of HF and cardiologists’ perceived risk of death within 12 months, and patient input into treatment decisions. Concordance was calculated as the number of response agreements between PSCs and PRFs for total number of matched pairs. Over- or underreporting of symptoms and side effects by cardiologists relative to patient-reported occurrences were calculated.ResultsOverall, 2,454 patient–cardiologist pairs were identified. High levels of concordance between matched pairs were observed for the occurrence of reported HF symptoms (93%), side effects (77%–98%) and degree of patient input into treatment decisions (74%); for perceived HF severity, concordance was 54%. Most symptoms (except dyspnea when active and fatigue/weakness, experienced by >50% of patients) were underreported by cardiologists. Of patients reporting to have been informed by their cardiologist that their HF was mild, 28% were perceived by their cardiologist to have a moderate–high/very high risk of death within 12 months. Treatment choice was not discussed with almost a third of patients. When discussed, 94% of patients (n=1,540) reported the cardiologist made the final decision. Cardiologists more often under- than overreported the occurrence of side effects reported by patients.ConclusionImproved patient–cardiologist dialogue and shared decision-making is required for optimizing patient care and outcomes in HF.

Burden and Quality of Life Among Female and Male Patients with Heart Failure in Europe: A Real-World Cross-Sectional Study

“…The baseline characteristics and comorbidities were consistent with those of other surveys/cross-sectional studies on chronic HF patients from Europe, as well as with those of other DSP™ HF studies. [31][32][33][34][35] The occurrence of common and most troublesome symptoms was also in line with that in previous studies. 36 The five most troublesome symptoms reported by the patients correlated with the most frequently reported symptoms, with the exception of shortness of breath when at rest, which frequently bothered patients despite not being the most common symptom.…”

Cardiologists’ perceptions on multidisciplinary collaboration in heart failure care - a qualitative study

“…Although most cardiologists find a discussion of the prognosis in HF important, the majority is reluctant to broach the topic at the time of diagnosis [ 26 ]. In addition, a multicontinental cross-sectional survey of more than two thousand patient-cardiologist pairs indicated that they often understate the severity of HF and neglect to discuss treatment choice with almost a third of patients [ 27 ]. This reluctance to discuss the diagnosis and prognosis of HF with patients likely contributes to a notoriously low sensitivity of both self-reported HF and concordance of patient awareness with physicians’ assessment of disease severity [ 28 – 30 ].…”

Burden of Heart Failure on Patient Daily Life and Patient–Physician Discordance in Disease Management ― Results From a Cross-Sectional Survey in Japan ―

“…Data were collected from the Adelphi HF Disease Specific Programme TM (DSP), 14 a cross-sectional survey of physicians and their HF patients conducted in a real-world setting in Japan between February and July 2016. 15 The DSP comprises 3 main phases: a preparatory phase involving the development of survey materials and participant recruitment, a data-collection phase, and data analysis. Details of these 3 phases have been described previously.…”