Abstract
BackgroundPatients with coronary heart disease (CHD) commonly present with more than one comorbid condition, contributing to poorer health-related quality of life (HRQoL). The aim of our study was to identify the associations between HRQoL and patient characteristics, vascular comorbidities and anxiety/depression disorders.MethodsThis observational study was conducted in 36 family medicine practices selected by random stratified sampling from all regions of Slovenia. HRQoL was assessed using the European Quality of Life - 5 Dimensions (EQ-5D) questionnaire and EQ Visual Analogue Scale (EQ-VAS). The associations between HRQoL and patient characteristics stratified by demographics, vascular comorbidities, health services used, their assessment of chronic illness care, and anxiety/depression disorders were identified by ordinal logistic regression and linear regression models.ResultsThe final sample included 423 CHD patients with a mean age of 68.0 ± SD 10.8 years; 35.2% were female. Mean EQ-VAS score was 58.6 ± SD 19.9 (median: 60 with interquartile range of 45–75), and mean EQ-5D index was 0.60 ± SD 0.19 (median: 0.56 with interquartile range of 0.41–0.76). The statistically significant predictors of a lower EQ-VAS score were higher family physician visit frequency, heart failure (HF) and anxiety/depression disorders (R² 0.240; F = 17.368; p < 0.001). The statistically significant predictor of better HRQoL, according to EQ-5D was higher patient education, whereas higher family physician visit frequency, HF and peripheral artery disease (PAD) were predictors of poorer HRQoL (Nagelkerke R 2 = 0.298; χ 2 = 148.151; p < 0.001).ConclusionsResults of our study reveal that comorbid conditions (HF and PAD), family physician visit frequency and years in education are significant predictors of HRQoL in Slovenian CHD patients.
Highlights
Patients with coronary heart disease (CHD) commonly present with more than one comorbid condition, contributing to poorer health-related quality of life (HRQoL)
The aim of our study was to identify the associations between CHD patient characteristics, vascular comorbidities, anxiety/depression disorders and HRQoL in CHD patients
Despite the high volume of excluded data, there were no statistically significant differences between the excluded (n = 345) and analysed (n = 423) samples by mean age (68.7 ± SD 10.5 and 68.0 ± SD 10.8 respectively, p = 0.362), gender (64.3% of male patients excluded from the analysis and 64.8% of all male patients participating in the study, respectively, p = 0.939), and distribution of patients across practices (p = 0.443)
Summary
Patients with coronary heart disease (CHD) commonly present with more than one comorbid condition, contributing to poorer health-related quality of life (HRQoL). Coronary heart disease (CHD) is the most common and is, together with stroke, responsible for the largest number of premature cardiovascular diseases (CVDs) deaths. This number has been in decline for the last two decades, it has increased in low- and middle-income countries [1,2,3,4]. Patients with CVDs report significantly poorer health-related quality of life (HRQoL) as compared to the population without chronic diseases, Poorer HRQoL is associated with different factors, among which are patient characteristics and comorbid conditions. Heart failure (HF) and anxiety/depression disorders significantly affect not
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