Using patient-reported outcome measures for primary percutaneous coronary intervention

Abstract

IntroductionRoutine measurement of the outcome of myocardial infarction is usually limited to immediate morbidity and mortality. Our aim was to determine the response to patient-reported outcome measures (PROMs) 3 months later, identify response bias and explore the feasibility of comparing outcome with their recalled view of their prior health state.MethodsPatients admitted with ST-segment-elevation myocardial infarction (STEMI) to five percutaneous coronary intervention centres were invited to complete a retrospective questionnaire containing the EQ-5D-3L and short form Seattle Angina Questionnaire (SAQ-7). Response rate for a 3-month mailed follow-up questionnaire and potential response biases were assessed. Patients’ outcomes were compared with their baseline using χ2 and paired t-test to assess for differences.ResultsOf 392 patients contacted, 260 (66.3%) responded. Responders were more likely to be older, female, more affluent and have a higher EQ-5D at baseline. Three months after surgery, patients’ SAQ-7 and angina symptom subscale returned to their baseline score. The physical limitation subscale score was worse than at baseline (79.9 vs 73.2, p=0.002), whereas the quality-of-life subscale was better (66.6 vs 73.9; p<0.001). The EQ-5D-3L index score was similar at 3 months to baseline (0.82 vs 0.79). Evidence of bias arising from responders being in better general health at baseline needs further investigation and, if confirmed, needs to be taken into account in interpreting PROMs data.ConclusionIt is feasible to use PROMs routinely to assess the impact of emergency admissions of patients with STEMI. A larger demonstration project with more sites is needed to confirm these findings.

Does sex predict quality of life after acute coronary syndromes: an Australian, state-wide, multicentre prospective cohort study

“…This is important as various aspects of female gender can be associated with poorer outcomes and QoL after an ACS, including restricted access to healthcare and increased anxiety 20 24. Our registry does not routinely capture socioeconomic data such as marital status and income; this would be useful as the literature has identified that respondents of surveys tend to be female, older and more affluent,4 and that socioeconomic factors independently influence QoL measurements 22. However, its strengths lie in the recruitment of consecutive patents undergoing PCI for ACS with all patients approached for QoL assessment.…”

“…This has prompted investigation into social factors such as sex differences in access to care and patient-centred outcomes including symptoms, functional status or health-related quality of life (QoL) 3–5. Among these patient-centred outcome data, women have been observed to report lower health-related QoL, compared with men,6–9 and also experience greater angina frequency 10.…”

Assessment of utility values and QALYs after primary PCI with DP-Xience and BP-Biomatrix stents

“…QoL (patient reported outcomes) was assessed in patients of primary PCI after three months of procedure using Seattle angina questionnaire and EQ-5D-3L. EQ-5D-3L index score at baseline vs. at 3 months was 0.79 vs 0.82, and was not much different at follow-up [ 29 ]. There are very few studies comparing QoL of cardiac stents after PCI and PPCI, and no published study has been found comparing utility values or QALYs of Biomatrix and Xience DES.…”

Cost-effectiveness analysis of apixaban versus vitamin K antagonists for antithrombotic therapy in patients with atrial fibrillation after acute coronary syndrome or percutaneous coronary intervention in Spain

“…Hence, the United Kingdom (UK) preferences were mostly used. Inputs for acute and long-term (acute and post-acute period) events were derived from various published studies [42][43][44][45] (Table 2). The baseline utility for the modelled cohort was derived from the general population equation provided by Ara and Brazier [46], with the baseline cohort utility decreasing over time due to aging.…”

“…o Adult patients with first ever ICH. https://doi.org/10.1371/journal.pone.0259251.t001 Mean utility (standard error) 0.808 (0.014) [42] 0.837 (0.001) [42] 0.826 (0.007) [42] 0.836 (0.002) [42] 0.690 (0.011) [43] 0.805 (0.081) i [43] 0.640 (0.016) [44] 0.830 (0.012) [44] 0.560 (0.077) [44] 0.830 (0.012) [44] 0.780 (0.016) [45] 0.800 (0.012) [45] 0.730 (0.014) [44] 0.830 (0.012) [44] Event: control ratio h 0.965 [42] 0.988 [42] 0.857 [43] 0.771 [44] 0.675 [44] 0.975 [45] 0.879 [44] Post-acute period Mean utility (standard error) 0.829 (0.083) [42] 0.837 (0.001) [42] --0.702 (0.006) [43] 0.799 (0.080) i [43] 0.685 (0.008) [44] 0.830 (0.012) [44] 0.705 (0.044) [44] 0.830 (0.012) [44] ----Event: control ratio 0.990 [42] -0.878 [43] 0.825 [44] 0.849 [44] -- Treatment dosages were derived from the AUGUSTUS trial [20] and EMA labels (Clopidogrel: https://www.ema.europa.eu/en/documents/product-information/ plavix-epar-product-information_en.pdf; Prasugrel: https://www.ema.europa.eu/en/documents/product-information/efient-epar-product-information_en.pdf;…”