Abstract
Introduction A principal goal in treating patients with heart failure with reduced ejection fraction (HFrEF) is to minimize their symptoms, improve their function and optimize their quality of life. Patient-reported outcome measures, such as the Kansas City Cardiomyopathy Questionnaire (KCCQ), have been proposed to measure healthcare quality. In previous research, we found substantial variation in mean KCCQ scores across practices. We now explore whether medication adjustments are associated with changes in KCCQ scores over time. Methods Using data from CHAMP-HF, a multicenter observational study of outpatients with HFrEF (LVEF Results Among 3313 patients from 140 practices, we observed marked changes and variability in patients' KCCQ scores at 3 months (Figure). Overall, 23.8% of patients' KCCQ scores worsened and 46.4% improved. At least 1 medication was adjusted in 727 (22%) patients. Adjustment in patients' HF medications was associated with significantly greater improvement in patients' KCCQ scores compared with no adjustment to any HF medications [+7.3 (IQR: -3.1, 20.8) vs + 3.1 (IQR: -4.7, 12.5) points; p Conclusion The health status of patients with HFrEF varies over time and is associated with treatment adjustments recommended by clinicians. Measuring patients' health status may encourage providers to adjust therapy to improve the symptoms, function and quality of life of patients' with HFrEF.
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