Patients’ Journey's In Living with Heart Failure - Its A Bumpy Road

Abstract

Introduction Patients (pts) have unique perspectives and journeys about living with chronic heart failure that may not be captured by heart failure-related quality of life scores. Purpose To examine predictors of the patients' journey in heart failure after controlling for demographic, heart failure and medical history factors. Methods Using a prospective, cross-sectional design, patients completed a valid and reliable 45-item Patients' Journey in Living with Heart Failure survey of 9 themes (provider-patient symptoms communication; provider-patient communication; self-care/symptom abilities; shared decision-making; receiving heart failure knowledge; feelings related to heart failure; caregiver support; worsening heart failure and advanced care planning /palliative care) and patients' demographic, heart failure and medical history factors. In univariate analyses, factors associated with patient journey total scores (p Results Of 293 adults, 60.1% were female, mean (SD) age was 61.9 (13.8) years, 65.5% were married/living w someone, 42.3% had heart failure for 5 or more years, 49.8% had poor/fair heath status, 51.9% had New York Heart Association- Functional Class III and 92.5% had a cardiologist provider (non specialist or specialist). Total mean (SD) pt journey standardized score (higher score reflected a more favorable journey) was 75.4 (15.3). By theme, highest scores were for provider-patient communication, 90.1 (18.0) and shared decision-making, 87.3 (15.5); lowest scores were for feelings related to heart failure, 59.0 (24.7) and advanced care planning/palliative care, 56.7 (30.8). Of 14 factors assessed in the total score multivariable model, 5 were retained after backward elimination (Table). Conclusion Patients’ heart failure journeys were enhanced by time, social support, higher socioeconomic status, HF specialty provider and higher self-rated health.