Trajectory of health-related quality of life during and after hospitalisation due to worsening of heart failure.
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| Title: | Trajectory of health-related quality of life during and after hospitalisation due to worsening of heart failure. |
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| Authors: | Kuan, Wai Chee (AUTHOR), Lim, Ka Keat (AUTHOR), Chee, Kok Han (AUTHOR), Kasim, Sazzli (AUTHOR), Dujaili, Juman Abdulelah (AUTHOR), Lee, Kenneth Kwing-Chin (AUTHOR), Teoh, Siew Li (AUTHOR) |
| Source: | Quality of Life Research. Feb2025, Vol. 34 Issue 2, p471-484. 14p. |
| Subjects: | Quality of life, Heart failure, Quality of life measurement, Malaysians, Treatment effectiveness, Patient reported outcome measures, Hospital care |
| Geographic Terms: | Malaysia |
| Abstract: | Purpose: This study aimed to examine the trajectory in health-related quality of life (HRQoL) during and after hospitalisation for worsening of heart failure (HF) in Malaysia. Methods: 200 patients with heart failure and reduced ejection fraction (HFrEF) admitted into two hospitals in Malaysia due to worsening of HF were surveyed using the EQ-5D-5 L questionnaire. The primary outcomes were utility values at admission, discharge and 1-month post-discharge (1MPD). Secondary outcomes included the visual analogue scores (VAS) and the proportion of patients reporting each EQ-5D-5 L dimension levels. Missing data were imputed using multiple imputation, and generalised linear mixed models were fitted. Results: At admission, the unadjusted mean utility values and VAS scores for HFrEF patients in Malaysia were as low as 0.150 ± 0.393 and 38.2 ± 20.8, respectively. After a median hospital stay of 4 days, there was a significant improvement in utility values and VAS scores by 0.510 (95% CI: 0.455–0.564) and 28.8 (95% CI: 25.5–32.1), respectively. The utility value and VAS score at 1-month post-discharge were not significantly different from discharge. The proportion of HFrEF patients reporting problems and severe problems in mobility, self-care, usual activities, and anxiety/depression, pain/discomfort reduced at varying degree from admission to discharge and 1MPD. Conclusion: HF is a progressive condition with substantial variation in HRQoL during the disease trajectory. During hospitalisation due to worsening of HF, HFrEF population has unfavourable HRQoL. Rapid and significant HRQoL improvement was observed at discharge, which sustained over one month. The study findings can inform future cost-effectiveness analyses and policies. Plain english summary: Heart failure is a progressive disease. Health-related quality of life of heart failure patients dynamically changes over time. Upon worsening of symptoms requiring hospital admission, the average level of health-related quality of life among people living with heart failure was low, approximately one-third of their perfect health. From the perspective of general public, this is equivalent to a health state that is near to being dead. Majority of patients had problems in mobility, self-care, usual activities, anxiety/depression and pain/discomfort. After receiving treatments in hospitals, most patients reported less problem in mobility, are able to take care of themselves and perform usual activities, feeling less pain/discomfort, and feeling less anxious/depressed. At discharge, their health state improved significantly by a large amount (equivalent to gaining half a year in perfect health), and this gain was sustained at 1-month post-discharge. This study provides policy makers insights on heart failure patients' disease experiences and quantifies their health-related quality of life during and after hospital admissions based on patients' disease experiences and general public's preference. In this way, both patients and public were involved in the policy-making process. Highlights: HF is a progressive condition with substantial variation in HRQoL during the disease trajectory. During hospitalisation due to worsening of heart failure, people living with heart failure and reduced ejection fraction have unfavourable health-related quality of life. After receiving treatments in hospitals, there was a rapid and significant improvement in health-related quality of life and the improvement sustained at 1-month after discharge. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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