Abstract P62: Feasibility of Routine Quality of Life Assessment in Ambulatory Heart Failure Patients

Abstract

Background: Assessment of quality of life (QOL) may be helpful in management of heart failure (HF) patients in ambulatory practice and is considered a performance measure. Little is known about the feasibility of routine assessment of QOL in clinical management of HF. The objectives of this study were to a) evaluate ability to serially measure QOL in clinical practice and b) determine patient characteristics that influence change in QOL scores. Methods: Patients presenting to the ambulatory HF clinic were routinely administered (prior to physician encounter) a 2-page questionnaire to assess QOL and concerns to be addressed during the visit. Visual analog scales (VAS) were used to assess a) overall QOL, b) dyspnea, and c) fatigue with scores ranging from 0 to 100 (higher scores representing better health status). Patients were asked if their QOL was affected more by their HF or another medical condition. Data was analyzed with ANOVA and Chi-square tests. Results: Of 1069 patients who completed baseline questionnaires, 557 (52%) had QOL assessed at subsequent visit (mean time between visits 225±142 days, 58% male, mean age 57 ± 15, LVEF 40±16%). Health status was impaired at baseline (VAS QOL 63±29, dyspnea 68±32, and fatigue 65±25). Of patients with paired data, 411 (74%) answered (at baseline) questions on the contribution of HF to their QOL (Table). HF affected QOL most in 48% of these patients, 23% felt HF and other medical conditions affected them equally, and 29% felt other medical conditions were more important. Patients affected more by HF had greater improvements in VAS scores despite trend of more hospitalizations. Patients with other medical problems had better QOL at baseline, but noted declines in VAS scores. Conclusions: QOL can be routinely monitored in HF clinics. Strategies to improve QOL should be developed to meet the individual patient's needs as other co-morbidities often affect QOL equally or more. Future studies should evaluate more comprehensive QOL tools. Patient characteristics that influence change in QOL scores