Health-related quality of life and its associated factors among patients with angina in Jordan

Determinants of Health-Related Quality of Life in Outpatients with Myocardial Infarction

Background

The health-related quality of life (HRQOL) of patients with myocardial infarction (MI) is suboptimal because of the disease's life-threatening nature, the requirement for long-term lifestyle modifications, and the treatment regimens following MI. This study aimed to evaluate HRQOL and its associated factors in MI patients.

Material and Methods

This study was conducted on patients with MI who attended the outpatient cardiology clinic at a major teaching hospital in Jordan. The EQ-5D-3L questionnaire was used to assess HRQOL of the study participants. Quantile regression analysis was conducted to identify the variables associated with HRQOL.

Results

The study included 333 patients with a history of MI, with a median age of 58 (57-60). The median of the total EQ-5D score was 0.65 (0.216-0.805). Regression results revealed that male patients (Coefficient= 0.110, 95%Cl (0.022-0.197), P=0.014) and not being diagnosed with diabetes (Coefficient= 0.154, 95%Cl (0.042-0.266), P=0.007) were associated with increased HRQOL. On the other hand, low income (Coefficient= -0.115, 95%Cl (-0.203 - -0.026), P=0.011), not receiving DPP-4 (Dipeptidyl Peptidase -4) inhibitors (Coefficient= -0.321 95%Cl (-0.462 - -0.180), P<0.001), and having low (Coefficient= -0.271, 95%Cl (-0.395 - -0.147), P<0.001) or moderate (Coefficient= -0.123, 95%Cl (-0.202 - -0.044), P=0.002) medication adherence was associated with decreased HRQOL.

Conclusion

The current study demonstrated diminished HRQOL among patients with MI, highlighting the necessity of tailoring interventions to tackle medication adherence barriers in this population. Personalized interventions such as educational programs, counseling, and reminders that consider each patient's needs and circumstances can greatly enhance medication adherence and, thus, the HRQOL of MI patients. Individuals with lower income levels, female patients, and those with diabetes should be the specific targets of these interventions.

Health-Related Quality of Life and Its Influencing Factors in Patients with Coronary Heart Disease in China

PURPOSE

This study aimed to comprehensively evaluate Chinese coronary heart disease (CHD) patients' health-related quality of life (HRQoL) using various measures and explore influencing factors associated with HRQoL.

METHODS

A cross-sectional study was conducted from April to September 2019 in the General Hospital of Tianjin Medical University. A convenience sampling framework was used to successively recruit 316 inpatients with CHD. Two generic preference-based instruments (EQ-5D-5L and 15D), a disease-specific instrument (Seattle Angina Questionnaire, SAQ), and the WHO-5 well-being index (WHO-5) were administered. Tobit regression model and multiple linear regression were used for data analyses.

RESULTS

A total of 305 patients (mean age was 62.9) with CHD participated in this study. The mean health state utility (HSU) scores of EQ-5D-5L and 15D were 0.85 (SD=0.14) and 0.89 (SD=0.07), respectively. For EQ-5D-5L, pain/discomfort was the most frequently reported, followed by anxiety/depression. As for 15D, discomfort and symptoms was the most severely impaired dimension. For SAQ, more limitations were found in the domains of angina stability and disease perception. For WHO-5, the mean score was 16.93. Marital status, disease state and comorbidity were influencing factors associated with HRQoL, patient's subjective well-being had a positive impact on HRQoL.

CONCLUSION

To improve the HRQoL of CHD patients in China, more attention needs to be paid to unmarried and relapsed patients, especially those with comorbidity of hypertension. Additionally, more social support and psychological counseling should be provided to patients.

Variables associated with poor health-related quality of life among patients with dyslipidemia in Jordan

PURPOSE

The study aim was to evaluate HRQOL and to explore the variables associated with poor HRQOL among patients with dyslipidemia in Jordan.

METHODS

The present study utilized the EQ-5D questionnaire which evaluates HRQOL in terms of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Responses to the five dimensions were presented using the value set, which ranges from 1 for full health to - 0.594 for severe problems in all five dimensions. Multiple linear regression analysis was implemented to identify the variables that best predicted the total EQ-5D score and hence HRQOL in the study population.

RESULTS

The mean age of the 228 participants was 60.23 (SD = 10.64). The mean of the total EQ-5D score was 0.675 (SD = 0.14). Regression analysis identified necessity for dyslipidemia medication (B = 0.18, P < 0.01) and patients with controlled lipid profile (B = 0.28, P < 0.01) were positively associated with HRQOL, while having concerns about dyslipidemia medications (B = - 0.16, P < 0.01), number of medication (B = - 0.13, P = 0.02), duration of dyslipidemia (B = - 0.22, P < 0.01), receiving high-intensity statin (B = - 0.18, P < 0.01) or statin in combination with fibrate (B = - 0.15, P < 0.01) were associated with lower HRQOL.

CONCLUSION

HRQOL has considerable scope for improvement in patients with dyslipidemia in Jordan. Improving dyslipidemia medications' beliefs and simplifying medication regimen by prescribing less medications, particularly for patients with longer disease duration and those on statin therapy, should be considered in future management programs aim at improving HRQOL in patients with dyslipidemia.