Predictors and outcomes of poor health-related quality of life in atrial fibrillation populations

Abstract

Health-related quality of life is a self-reported health scale that has increasingly been used in clinical and epidemiological research studies. Health-related quality of life measures help to quantify how symptoms are affecting quality of life and can serve as a benchmark in treatment guidelines for clinicians and healthcare providers when treating patients to help understand the efficacy of treatments. Health-related quality of life measures are particularly important for treating individuals living with chronic conditions where treatment and symptom management are the goals. Atrial fibrillation is an example of a chronic condition which can end in poor health-related quality of life. Poor health-related quality of life in atrial fibrillation is important to understand as it can result in serious consequences including stroke, unwanted bleeding events, and even death. In this dissertation, while the relationship between poor health-related quality of life and atrial fibrillation has been explored, I provide an in-depth examination of this relationship. In Chapter 2, I examine a range of geriatric variables, rarely evaluated together, as well as sociodemographic and clinical variables associated with atrial fibrillation and poor health-related quality of life. In Chapter 3, I utilize an established change method in health-related quality of life measures to develop a change threshold to understand which individuals had significant changes in health-related quality of life overtime, and identify sociodemographic, clinical, and geriatric variables associated with this established change threshold. Finally, in Chapter 4, I explore how health-related quality of life status impacts adverse clinical outcomes such as major bleeding events, strokes, and all-cause mortality over a two year period. Identifying sociodemographic, clinical geriatric variables related health-related quality of life within atrial fibrillation populations, while also incorporating measures of change, adds to the literature around atrial fibrillation and health-related quality of life. I argue that health-related quality of life is just as important to health outcomes as treatments and therapies and therefore is an important measure for understanding health inequities in this population.--Author's abstract