Application and subjective benefit of Crataegus extracts in patients with incipient heart failure with regard to performance and quality of life—A qualitative study

Abstract

Background Heart failure is one of the most common and most expensive chronic diseases in western industrial countries. And it is increasing because of the demographic development. While the effect of standardized Crataegus extracts for heart failure NYHA I-II is well proven [1] , these results do not allow detailed conclusions about how the use of Crataegus extract influences quality of life and everyday life of patients with heart failure in an early state and how its personal benefit is estimated from a patient's point of view [2] . Methods Descriptive interview study with 3 groups of patients with heart failure in an early stage and with vs. without intake of a standardized Crataegus extract for at least 90 days. In total 40 patients were randomised from a patients’ file of a general practitioner and in order to maximize the variance of the probability distribution another 20 patients with the same requirements were acquired by advertisement. The severity of heart failure was estimated by screenings (history, Goldman's Specific Activity Scale and NYHA criteria), pattern of utilisation and concepts of usefulness were collected by a semi-structured interview guide. Additionally the general and heart specific quality of life was evaluated by SF-36 and Kansas City Cardiomyopathy Questionaire (KCCQ) and the comorbid depression by PHQ-D. Results The qualitative content analysis suggests that in the analysed sample CAM is applied non-specifically as well as specifically with different concepts of usefulness. Patients who take Crataegus extracts have a better general and heart-related quality of life. The complete data will be demonstrated at the congress. Discussion Pattern of utilisation of CAM in general and of Crataegus extracts in particular are only superficially analysed. Our data show, that patients who take Crataegus extracts, have a better quality of life, which seems to be the benefit of Crataegus. This effect seems to apply all the more, as the costs for these remedies must be born from the patients themselves and so patients who suffer a lot prefer to invest in their health. Conclusion Patients with heart failure in an early stage can estimate the benefit and the absence of side effects of Crataegus extracts. In most cases they agree to bear the costs for the medicine.