Abstract 19601: Differential Patient Perceptions of Limitations to Quality of Life in a Large Ambulatory Heart Failure Population

Abstract

Introduction: Clinical assessment of quality of life (QOL) is being increasingly adopted in the ambulatory management of heart failure (HF). Little is known about the impact of other conditions on QOL in clinical practice. Methods: Patients routinely presenting to the HF clinic completed a self-administered 1-page questionnaire prior to the visit that assessed QOL, functional status, and degree to which their HF, as well as other conditions, affected their QOL. Visual analog scales (VAS) were used to assess a) overall QOL, b) ease of breathing, and c) energy > fatigue. Scores ranged from 0 to 100 (higher scores representing better health status). Patients were asked if their QOL was affected more, equally, or less by their HF compared to other medical conditions. Data was analyzed with Pearson’s correlation coefficients, ANOVA and Chi-square tests. Results: A total of 1069 patients completed baseline QOL (mean age 57±16 years, 56% left ventricular ejection fraction [LVEF] ≥40%, 41% female). Mean QOL score was 63±28. Only 48% of patients felt that HF affected their QOL most while 20% felt HF was equal to other illnesses, 18% cited other medical problems and 14% non-medical problems as most important for their QOL. Patients reporting HF as the primary factor influencing QOL had significantly lower scores on all 3 VAS measures, the highest proportion of patients with low LVEF and the strongest correlation between QOL and VAS Breathing (R=0.68) (Table). Conclusions: Patients describing HF as their major limitation had the lowest QOL score and were most affected by dyspnea and fatigue. However, over half of ambulatory HF patients rate other medical and/or non-medical factors as equal or greater limitations to their QOL, suggesting this important clinical outcome will be difficult to impact by therapies targeted at HF alone, particularly in those with LVEF ≥40%.