Changes over time in patient-reported outcomes in patients with heart failure.

Abstract

This paper describes the trajectory during 1year of four patient-reported outcomes (PROs), namely, sleep, depressive symptoms, health-related quality of life (HrQoL), and well-being, in patients with heart failure (HF), their relationshipand the patient characteristics associated with changes in these PROs. Data analyses of PROs from 603 patients (mean age 67years; 29% female, 60% NYHA II) enrolled in the HF-Wii study. On short term, between baseline and 3months, 16% of the patients experienced continuing poor sleep, 11% had sustained depressive symptoms, 13% had consistent poor HrQoL, and 13% consistent poor well-being. Across the entire 1-year period only 21% of the patients had good PRO scores at all timepoints (baseline, 3, 6, and 12months). All others had at least one low score in any of the PROs at some timepoint during the study. Over the 12months, 17% had consistently poor sleep, 17% had sustained symptoms of depression, 15% consistently rated a poor HrQoL, and 13% poor well-being. Different patient characteristics per PRO were associated with a poor outcomes across the 12months. Age, education, New York Heart Association, and length of disease were related to two PRO domains and submaximal exercise capacity (6min test), co-morbidity, and poor physical activity to one. In total, 79% of the patients with HF encountered problems related to sleep, depressive symptoms, HrQoL, and well-being at least once during a 1-year period. This underscores the need for continuous monitoring and follow-up of patients with HF and the need for dynamic adjustments in treatment and care regularly throughout the HF trajectory.