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Jourdain P, Pages N, Amara W, Maribas P, Lafitte S, Lemieux H, Barritault F, Seronde MF, Labarre JP, Chaouky H, Bedel C, Betito L, Nisse-Durgeat S, Picard F. Perceptions and satisfaction of patients with chronic heart failure when using a remote monitoring web application named Satelia® Cardio. Ann Cardiol Angeiol (Paris) 2023; 72:101606. [PMID: 37244215 DOI: 10.1016/j.ancard.2023.101606] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 04/15/2023] [Accepted: 05/10/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION The use of telehealth, such as remote patient monitoring (RPM), for chronic heart failure (CHF) impacts patient pathways. Patient-centricity in chronic disease management is valuable. Even though RPM is recommended in practice, the evaluation of patient satisfaction has been limited to date. The objective of this study was to assess the perceptions and satisfaction of patients with CHF when using RPM. METHODS A voluntary declarative survey was conducted with users of Satelia® Cardio, an RPM web application which was included in an experimental model program in France funded by the ETAPES program initiative sponsored by the French Ministry of Health. Monitoring was based on patient-reported outcomes (seven questions on symptoms, one question on weight) which were answered online (digitally literate patients) or by phone with a nurse (patients with poor digital literacy). The survey included questions on perceived usefulness, ease of use and impact on quality of life (QoL). RESULTS Overall, 87% of the 825 patients were satisfied with having their CHF digitally monitored. Patients found that the application was easy to use (94%), problem free (95%), provided well-timed notifications (98%), easily accessible (96.5%), understandable (89%), and did not require an unreasonable amount of time to answer questions (99%). Most patients felt that RPM helped physicians provide better care during their follow-ups (70%, mean score: 7.98/10) and 45% of the digitally literate patients indicated an improved QoL. CONCLUSION Poor digitally literate patients may need human-based or assisted RPM. Patients monitored daily for CHF through RPM expressed strong satisfaction and acceptance.
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Affiliation(s)
- Patrick Jourdain
- Paris-Saclay University Faculty of Medicine, Cardiology Department, Le Kremlin-Bicetre, France.
| | - Nicolas Pages
- CHU de Bordeaux Hôpital Cardiologique, Pessac, Nouvelle-Aquitaine, France
| | - Walid Amara
- Hospital Tenon, Cardiology Department, Paris, France
| | - Philippe Maribas
- Parly II Private Hospital Le Chesnay, Cardiology Department, Le Chesnay, France
| | - Stephane Lafitte
- CHU de Bordeaux Hôpital Cardiologique, Pessac, Nouvelle-Aquitaine, France
| | - Herve Lemieux
- Clinical Esquirol Saint Hilaire - Elsan, Cardiology Department, Agen, France
| | | | | | - Jean-Philippe Labarre
- Clinique du Pont de Chaume, Cardiology Department, Montauban, Languedoc-Roussillon-Midi, France
| | - Hamida Chaouky
- Centre Hospitalier de Pau, Cardiology Department, Pau, Aquitaine-Limousin-Poitou, France
| | | | | | | | - Francois Picard
- CHU de Bordeaux Hôpital Cardiologique, Pessac, Nouvelle-Aquitaine, France
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Seid E, Engidawork E, Alebachew M, Mekonnen D, Berha AB. Evaluation of drug therapy problems, medication adherence and treatment satisfaction among heart failure patients on follow-up at a tertiary care hospital in Ethiopia. PLoS One 2020; 15:e0237781. [PMID: 32857798 PMCID: PMC7454938 DOI: 10.1371/journal.pone.0237781] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 08/03/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Drug therapy problems (DTPs) are major concerns of healthcare and have been identified to contribute to negative clinical outcomes. The occurrence of DTPs in heart failure patients is associated with worsening of outcomes. The aim of this study was to assess DTPs, associated factors and patient satisfaction among ambulatory heart failure patients at Tikur Anbessa Specialized Hospital (TASH). METHODS A hospital based prospective cross-sectional study was conducted on 423 heart failure patients on follow up at TASH. Data was collected through patient interview and chart review. Descriptive statistics, binary and multiple logistic regressions were used for analyses and P < 0.05 was used to declare association. RESULTS Majority of the patients were in NYHA class III (55.6%) and 66% of them had preserved systolic function. DTPs were identified in 291(68.8%) patients, with an average number of 2.51±1.07.per patient. The most common DTPs were drug interaction (27.3%) followed by noncompliance (26.2%), and ineffective drug use (13.7%). β blockers were the most frequent drug class involved in DTPs followed by angiotensin converting enzyme inhibitors. The global satisfaction was 78% and the overall mean score of treatment satisfaction was 60.5% (SD, 10.5). CONCLUSION Prevalence of DTPs as well as non-adherence among heart failure patients on follow up is relatively high. Detection and prevention of DTPs along with identifying patients at risk can save lives, help to adopt efficient strategies to closely monitor patients at risk, enhance patient's quality of life and optimize healthcare costs.
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Affiliation(s)
- Elham Seid
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Minyahil Alebachew
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Desalew Mekonnen
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemseged Beyene Berha
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
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Ryskina KL, Andy AU, Manges KA, Foley KA, Werner RM, Merchant RM. Association of Online Consumer Reviews of Skilled Nursing Facilities With Patient Rehospitalization Rates. JAMA Netw Open 2020; 3:e204682. [PMID: 32407501 PMCID: PMC7225899 DOI: 10.1001/jamanetworkopen.2020.4682] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/01/2020] [Indexed: 11/17/2022] Open
Abstract
Importance There are areas of skilled nursing facility (SNF) experience of importance to the public that are not currently included in public reporting initiatives on SNF quality. Whether patients, hospitals, and payers can leverage the information available from unsolicited online reviews to reduce avoidable rehospitalizations from SNFs is unknown. Objectives To assess the association between rehospitalization rates and online ratings of SNFs; to compare the association of rehospitalization with ratings from a review website vs Medicare Nursing Home Compare (NHC) ratings; and to identify specific topics consistently reported in reviews of SNFs with the highest vs lowest rehospitalization rates using natural language processing. Design, Setting, and Participants A retrospective cross-sectional study of 1536 SNFs with online reviews on Yelp (a website that allows consumers to rate and review businesses and services, scored on a 1- to 5-star rating scale, with 1 star indicating the lowest rating and 5 stars indicating the highest rating) posted between January 1, 2014, and December 31, 2018. The combined data set included 1536 SNFs with 8548 online reviews, NHC ratings, and readmission rates. Main Outcomes and Measures A mean rating from the review website was calculated through the end of each year. Risk-standardized rehospitalization rates were obtained from NHC. Linear regression was used to measure the association between the rehospitalization rate of a SNF and the online ratings. Natural language processing was used to identify topics associated with reviews of SNFs in the top and bottom quintiles of rehospitalization rates. Results The 1536 SNFs in the sample had a median of 6 reviews (interquartile range, 3-13 reviews), with a mean (SD) review website rating of 2.7 (1.1). The SNFs with the highest rating on both the review website and NHC had 2.0% lower rehospitalization rates compared with the SNFs with the lowest rating on both websites (21.3%; 95% CI, 20.7%-21.8%; vs 23.3%; 95% CI, 22.7%-24.0%; P = .04). Compared with the NHC ratings alone, review website ratings were associated with an additional 0.4% of the variation in rehospitalization rates across SNFs (adjusted R2 = 0.009 vs adjusted R2 = 0.013; P = .003). Thematic analysis of qualitative comments on the review website for SNFs with high vs low rehospitalization rates identified several areas of importance to the reviewers, such as the quality of physical infrastructure and equipment, staff attitudes and communication with caregivers. Conclusions and Relevance Skilled nursing facilities with the best rating on both a review website and NHC had slightly lower rehospitalization rates than SNFs with the best rating on NHC alone. However, there was marked variation in the volume of reviews, and many SNF characteristics were underrepresented. Further refinement of the review process is warranted.
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Affiliation(s)
- Kira L. Ryskina
- Perelman School of Medicine, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
| | - Anietie U. Andy
- Center for Digital Health, University of Pennsylvania Health System, Philadelphia
| | - Kirstin A. Manges
- Perelman School of Medicine, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia
- University of Pennsylvania, Philadelphia
| | | | - Rachel M. Werner
- Perelman School of Medicine, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Raina M. Merchant
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
- Center for Digital Health, University of Pennsylvania Health System, Philadelphia
- Perelman School of Medicine, Department of Emergency Medicine, Department of Medicine, University of Pennsylvania, Philadelphia
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Bergmann K, Kugler J, Klewer J, Schoenfelder T. Predictors of patient satisfaction after cardiac pacemaker implantation or ICD implantation. J Card Surg 2020; 35:140-145. [DOI: 10.1111/jocs.14333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Katharina Bergmann
- Department of Health Sciences/Public Health, Dresden Medical School Technische Universität Dresden Dresden Germany
| | - Joachim Kugler
- Department of Health Sciences/Public Health, Dresden Medical School Technische Universität Dresden Dresden Germany
| | - Joerg Klewer
- Department of Public Health and Health Care Management University of Applied Sciences Zwickau Zwickau Germany
| | - Tonio Schoenfelder
- Department of Health Sciences/Public Health, Dresden Medical School Technische Universität Dresden Dresden Germany
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Johansson P, Agnebrink M, Dahlström U, Broström A. Measurement of Health-Related Quality of Life in Chronic Heart Failure, from a Nursing Perspective—a Review of the Literature. Eur J Cardiovasc Nurs 2017; 3:7-20. [PMID: 15053884 DOI: 10.1016/j.ejcnurse.2003.09.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2003] [Revised: 06/10/2003] [Accepted: 09/23/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND Living with chronic heart failure (CHF) is distressful and affects daily life. Because of the lack of a cure for CHF, there has been a progressive interest in using health-related quality of life (Hr-QoL) as an outcome measurement of the treatment in patients with CHF. OBJECTIVE The aim of this review was to describe the instruments/questionnaires used in different studies in the measurement of Hr-QoL in patients with CHF, and how they were put into operation as seen from a nursing perspective. METHOD MEDLINE and CINAHL databases were searched from January 1995 to June 2002, by using the keywords CHF, heart failure, QoL and Hr-QoL. A total of 33 articles were analysed. RESULTS Thirty-two different Hr-QoL questionnaires were found. Generic, disease-specific and battery approaches were different ways used to measure Hr-QoL. To assess/describe Hr-QoL, evaluate the impact of interventions and examine relations/predictors were three main objectives. However, different aspects of the concept Hr-QoL, influencing factors, how to implement the questionnaires and a lack of unified CHF criteria existed. CONCLUSIONS To create a guideline for the measurement of Hr-QoL in CHF patients is of great importance for nurses and might generate homogeneity in the measurement methods and promote the scientific approach in the nursing care process.
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Affiliation(s)
- Peter Johansson
- Department of Cardiology, Linköping University Hospital, Linköping S-58185, Sweden.
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Johansson P, Dahlström U, Broström A. Factors and Interventions Influencing Health-Related Quality of Life in Patients with Heart Failure: A Review of the Literature. Eur J Cardiovasc Nurs 2016; 5:5-15. [PMID: 15967727 DOI: 10.1016/j.ejcnurse.2005.04.011] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2004] [Revised: 04/25/2005] [Accepted: 04/28/2005] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Because of the lack of a cure for patients with chronic heart failure (HF), there has been a progressive interest in the use of health-related quality of life (Hr-QoL) as complementary end-point to mortality and morbidity. AIM The aim of this review was from a nursing perspective to describe Hr-QoL and the influencing factors of Hr-QoL, as well as to identify interventions aimed at influencing Hr-QoL in HF patients. METHOD Medline, Cinahl and PsycInfo databases were searched from 1995 to 2004. A total of 58 papers were included. RESULTS HF symptoms and activity status influence Hr-QoL negatively. However, several individual characteristics such as personality, gender and age must also be taken into consideration because different values might exist regarding what constitutes a good Hr-QoL. Nurse led interventions based on education, support and exercise can influence Hr-QoL positively. There is also a need of more studies about the effects of depression, sleep disturbances, support as well as education on Hr-QoL. There is also a need of exercise studies with larger sample sizes and older patients in higher NYHA classes. CONCLUSION Several individual factors impact Hr-QoL, therefore, must nursing interventions are individually adapted to the patient's resources.
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Affiliation(s)
- Peter Johansson
- Department of Cardiology, Linköping University Hospital, S-58185 Linköping, Sweden.
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Kasten KR, Marcello PW, Roberts PL, Read TE, Schoetz DJ, Hall JF, Francone TD, Ricciardi R. All things not being equal: readmission associated with procedure type. J Surg Res 2014; 194:430-440. [PMID: 25541235 DOI: 10.1016/j.jss.2014.11.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 11/05/2014] [Accepted: 11/26/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND There is an accelerated effort to reduce hospital readmissions despite minimal data detailing risk factors associated with this outcome. MATERIALS AND METHODS We analyzed National Surgical Quality Improvement Project data from January 1, 2011-December 31, 2011, evaluating all patients undergoing one of 34 targeted operative procedures across all surgical specialties. Multivariate regression models of risk for readmission were developed including targeted procedure codes, demographic variables, preoperative variables, intraoperative variables, and postoperative adverse events. Our main outcome measure was hospital readmission. RESULTS A total of 217, 389 patients met study inclusion criteria. Minimal associations existed between patient factors and risk of readmission. Adverse events including unplanned operating room return (odds ratio [OR] 8.5; confidence interval [CI] 8.0-9.0), pulmonary embolism (OR 8.2; CI 7.1-9.6), deep incisional infection (OR 7.5; CI 6.7-8.5), and organ space infection (OR 5.8; CI 5.3-6.3) were associated with increased risk of readmission. Our data suggest the type of procedure performed is significantly associated with risk of readmission. Furthermore, multivariate analysis revealed procedures, involving the pancreas, rectum, bladder, and lower extremity vascular bypass, were associated with the highest risk of readmission. CONCLUSIONS Postoperative complications demonstrated stronger association with readmission than patient factors. Focused analysis of higher risk procedures may provide insight into strategies for risk reduction.
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Affiliation(s)
- Kevin R Kasten
- Section of Colon and Rectal Surgery, Brody School of Medicine at ECU, Greenville, North Carolina
| | - Peter W Marcello
- Department of Colon and Rectal Surgery, Lahey Hospital & Medical Center, Burlington, Massachusetts
| | - Patricia L Roberts
- Department of Colon and Rectal Surgery, Lahey Hospital & Medical Center, Burlington, Massachusetts
| | - Thomas E Read
- Department of Colon and Rectal Surgery, Lahey Hospital & Medical Center, Burlington, Massachusetts
| | - David J Schoetz
- Department of Colon and Rectal Surgery, Lahey Hospital & Medical Center, Burlington, Massachusetts
| | - Jason F Hall
- Department of Colon and Rectal Surgery, Lahey Hospital & Medical Center, Burlington, Massachusetts
| | - Todd D Francone
- Department of Colon and Rectal Surgery, Lahey Hospital & Medical Center, Burlington, Massachusetts
| | - Rocco Ricciardi
- Department of Colon and Rectal Surgery, Lahey Hospital & Medical Center, Burlington, Massachusetts.
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Lambrinou E, Protopapas A, Kalogirou F. Educational Challenges to the Health Care Professional in Heart Failure Care. Curr Heart Fail Rep 2014; 11:299-306. [DOI: 10.1007/s11897-014-0203-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Hassali MA, Alrasheedy AA, Ab Razak BA, Al-Tamimi SK, Saleem F, Ul Haq N, Aljadhey H. Assessment of general public satisfaction with public healthcare services in Kedah, Malaysia. Australas Med J 2014; 7:35-44. [PMID: 24567765 DOI: 10.4066/amj.2014.1936] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Patient satisfaction is considered an essential component of healthcare services evaluation and an additional indicator of the quality of healthcare. Moreover, patient satisfaction may also predict health-related behaviours of patients such as adherence to treatment and recommendations. AIMS The study aimed to assess patients' level of satisfaction with public healthcare services and to explore the association between socio-demographic and other study variables and patient satisfaction level. METHOD A cross-sectional study was conducted using selfadministered questionnaires distributed to a convenience sample of the general public in Kedah, Malaysia. RESULTS A total of 435 out of 500 people invited to participate in the study agreed to take part, giving a response rate of 87 per cent. In this study, only approximately half of the participants (n=198, 45.5 per cent) were fully satisfied with the current healthcare services. The majority of the participants agreed that doctors had given enough information about their state of health (n=222, 51 per cent) and were competent and sympathetic (n=231, 53.1 per cent). Almost half of the participants (n=215, 49.5 per cent) agreed that the doctors took their problems seriously. Only 174 (40 per cent) participants agreed that doctors had spent enough time on their consultation session. Some respondents (n=266, 61.2 per cent) agreed that healthcare professionals in the public health sector were highly skilled. The majority of the respondents described amenities, accessibility and facilities available in the public healthcare sector as good or better. In this study, waiting time was significantly associated with patient satisfaction as the results showed that those who waited longer than two hours were less satisfied with the services than those who waited under two hours. CONCLUSION The study findings showed that approximately half of the respondents were fully satisfied with current healthcare services. In this study, waiting time was the main factor that affected patient satisfaction level. Other factors that influenced satisfaction level included the length of consultation sessions and the process of patient registration. Hence, improvement in the health services that leads to a shorter waiting time may increase the satisfaction level of patients.
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Affiliation(s)
- Mohammed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Alian A Alrasheedy
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Basyirah Afifah Ab Razak
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Saleh Karamah Al-Tamimi
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Fahad Saleem
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Noman Ul Haq
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Hisham Aljadhey
- Medication Safety Research Chair, Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Health span or life span: the role of patient-reported outcomes in informing health policy. Health Policy 2010; 100:96-104. [PMID: 20813420 DOI: 10.1016/j.healthpol.2010.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Revised: 06/21/2010] [Accepted: 07/03/2010] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Population ageing and the increasing burden of chronic conditions challenge traditional metrics of assessing the efficacy of health care interventions and as a consequence policy and planning. Using chronic heart failure (CHF) as an exemplar this manuscript seeks to describe the importance of patient-reported outcomes to inform policy decisions. METHODS The method of an integrative review has been used to identify patient-reported outcomes (PROs) in assessing CHF outcomes. Using the Innovative Care for Chronic Conditions the case for developing a metric to incorporate PROs in policy planning, implementation and evaluation is made. RESULTS In spite of the increasing use of PROs in assessing CHF outcomes, their incorporation in the policy domain is limited. CONCLUSIONS Effective policy and planning is of health care services is dependent on the impact on the individual and their families. Epidemiological transitions and evolving treatment paradigms challenge traditional metrics of morbidity and mortality underscoring the importance of assessing PROs.
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Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW. 2009 Focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation. J Am Coll Cardiol 2009; 53:e1-e90. [PMID: 19358937 DOI: 10.1016/j.jacc.2008.11.013] [Citation(s) in RCA: 1185] [Impact Index Per Article: 79.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW. 2009 focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 2009; 119:e391-479. [PMID: 19324966 DOI: 10.1161/circulationaha.109.192065] [Citation(s) in RCA: 1080] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Höfer S, Schmid JP, Frick M, Benzer W, Laimer H, Oldridge N, Saner H. Psychometric properties of the MacNew heart disease health-related quality of life instrument in patients with heart failure. J Eval Clin Pract 2008; 14:500-6. [PMID: 18462292 DOI: 10.1111/j.1365-2753.2007.00905.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Heart failure (HF) is a severe chronic disease and impairs health-related quality of life (HRQL). While validated specific HRQL instruments are required for evaluation of treatment and rehabilitation in patients with HF, a single validated measure to document changes in HRQL for patients with different heart disease diagnoses would be invaluable. The purpose of this analysis was the psychometric analysis of the German MacNew Heart Disease Questionnaire (MacNew) in HF patients, which has previously been shown to be reliable and valid in patients with myocardial infarction, angina pectoris and arrhythmia. METHODS We recruited 89 patients (61.7+/-11.5 years; 84.3% male) in two Austrian and one Swiss cardiology department with documented HF (effect sizes 28.9+/-10.1%). The self-administered MacNew, the Short Form-36 (SF-36) and the Hospital Anxiety and Depression Scale were completed. Internal consistency reliability (Cronbach's alpha), discriminative and evaluative validity were assessed. RESULTS Cronbach's alpha exceeded 0.80. Each MacNew scale differentiated between patients with and without anxiety (3.9+/-1.0 vs. 5.3+/-0.8, all P<0.001), with and without depression (4.2+/-1.2 vs. 5.2+/-0.9 all P<0.03) and by the SF-36 health transition item (deteriorate=4.39, no change=4.95, improve=5.45, all P<0.02). Evaluative validity was demonstrated with effect sizes >0.70 for a subsample attending a 12-week outpatient rehabilitation programme. CONCLUSIONS The German language version of the MacNew demonstrates consistently acceptable psychometric properties of reliability, validity and responsiveness in patients with documented HF. Together with previous documentation of reliability, validity and responsive, these findings strengthen the argument for the MacNew as a potential 'core' HRQL measure, at least in the German language.
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Affiliation(s)
- Stefan Höfer
- Department of Medical Psychology and Psychotherapy, Medical University Innsbruck, Austria.
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Zickmund SL, Blasiole JA, Brase V, Arnold RM. Congestive Heart Failure Patients Report Conflict With Their Physicians. J Card Fail 2006; 12:546-53. [PMID: 16952789 DOI: 10.1016/j.cardfail.2006.03.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Revised: 03/08/2006] [Accepted: 03/15/2006] [Indexed: 11/28/2022]
Abstract
BACKGROUND Given the importance of the doctor-patient relationship, we examined the prevalence and nature of patients' perceived conflicts with the physicians caring for their congestive heart failure (CHF). METHODS AND RESULTS This cross-sectional study recruited patients with CHF in the outpatient and inpatient service of a tertiary referral hospital. Patients completed demographics, semistructured interviews, and surveys of emotional and health status. CHF physiologic measures and comorbidities were abstracted from the medical record. A team of 2 blinded coders analyzed the interviews. Thirty-one percent of the 289 patients reported difficulties with physicians. In the bivariate analysis, only marital status was significantly associated with conflict. Major problems included the providers' poor communication skills (20%), trust in the physicians' competence (18%), and insufficient medical information (16%). Patients identified care outside the tertiary referral hospital (13%) and inadequate communication between physicians (9%) as additional sources of difficulty. CONCLUSION Perceived conflict with providers is common in patients with CHF. Patient-level factors, however, did not predict conflict, which differs from our previous findings with hepatitis C patients. Perceived conflict is troubling because it can undermine the trust in the doctor-patient relationship, thereby weakening the therapeutic bond necessary to care for this sick and often vulnerable population.
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Affiliation(s)
- Susan L Zickmund
- Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania, USA
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Hunt SA. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol 2005; 46:e1-82. [PMID: 16168273 DOI: 10.1016/j.jacc.2005.08.022] [Citation(s) in RCA: 1123] [Impact Index Per Article: 59.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Castle NG, Brown J, Hepner KA, Hays RD. Review of the literature on survey instruments used to collect data on hospital patients' perceptions of care. Health Serv Res 2005; 40:1996-2017. [PMID: 16316435 PMCID: PMC1361245 DOI: 10.1111/j.1475-6773.2005.00475.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To review the existing literature (1980-2003) on survey instruments used to collect data on patients' perceptions of hospital care. STUDY DESIGN Eight literature databases were searched (PubMED, MEDLINE Pro, MEDSCAPE, MEDLINEplus, MDX Health, CINAHL, ERIC, and JSTOR). We undertook 51 searches with each of the eight databases, for a total of 408 searches. The abstracts for each of the identified publications were examined to determine their applicability for review. METHODS OF ANALYSIS For each instrument used to collect information on patient perceptions of hospital care we provide descriptive information, instrument content, implementation characteristics, and psychometric performance characteristics. PRINCIPAL FINDINGS The number of institutional settings and patients used in evaluating patient perceptions of hospital care varied greatly. The majority of survey instruments were administered by mail. Response rates varied widely from very low to relatively high. Most studies provided limited information on the psychometric properties of the instruments. CONCLUSIONS Our review reveals a diversity of survey instruments used in assessing patient perceptions of hospital care. We conclude that it would be beneficial to use a standardized survey instrument, along with standardization of the sampling, administration protocol, and mode of administration.
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Abstract
OBJECTIVE To explore, over a one-year period, the ideas and attitudes of patients with end-stage cardiac failure concerning dying. DESIGN Prospective longitudinal multiple case study using qualitative interview techniques. PARTICIPANTS Thirty-one patients from two hospitals who fulfilled one or more of the following criteria: NYHA III or IV, ejection fraction < 25%, at least one hospitalization for heart failure. MAIN OUTCOMES Statements of patients with advanced heart failure, expressed in semi-structured interviews, concerning the quality of dying and medical decisions at the end of life. RESULTS Many respondents only thought about death during exacerbations. Mentioned aspects of appropriate dying include: a degree of usefulness, prognostic knowledge, appropriate duration and mental awareness. Few respondents were in favour of euthanasia or suicide, but all wanted life-prolonging treatment to be withheld or withdrawn when appropriate. CONCLUSIONS Our study found some elements of 'appropriate dying' that differ from other studies and that are relatively specific for advanced heart failure. The tendency of patients not to think about death raises ethical concerns.
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Affiliation(s)
- D L Willems
- Department of General Practice, Academic Medical Centre/University of Amsterdam, Amsterdam, The Netherlands.
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Gasquet I, Dehé S, Gaudebout P, Falissard B. Regular Visitors Are Not Good Substitutes for Assessment of Elderly Patient Satisfaction With Nursing Home Care and Services. J Gerontol A Biol Sci Med Sci 2003; 58:1036-41. [PMID: 14630886 DOI: 10.1093/gerona/58.11.m1036] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Due to physical and psychological impairments, elderly patients residing in homes are often unable to participate in studies on satisfaction with care services. While their regular visitors provide interesting information, patient-visitor response concordance requires study. Our objective was to measure patient-visitor agreement on quality of care and accommodation. METHODS A survey was conducted on elderly people in 13 nursing homes and their visitors. The 125 patient-visitor pairs completed the same Nursing Home Satisfaction Questionnaire (NHSQ) independently, for which reliability and internal validity have previously been explored. Satisfaction scores for room comfort, meal provision, information, and medical/nursing care were calculated. To estimate patient-visitor concordance, intraclass coefficients, a bias index, and Pearson's correlation coefficients were calculated. RESULTS Patient satisfaction scores ranged from 57.8 (information) to 78.6 (room comfort), and visitor satisfaction from 67.9 (meal provision) to 85.9 (medical/nursing care). Mean visitor scores were higher for all scales, with a small-to-moderate index bias statistically significant for medical/nursing care (p <.001), information (p <.001), and meal provision (p =.006). Intraclass correlation coefficients were low for room comfort, information, and medical/nursing care scales (0.08 to 0.18), and nearly acceptable for the meal provision scale (0.46). CONCLUSIONS Visitors were not able to provide information on elderly patients' satisfaction with nursing home. Their assessments were milder than patient assessments. The NHSQ is reliable for use in either population, but patient and visitor assessments should not be merged in satisfaction studies.
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Affiliation(s)
- Isabelle Gasquet
- Service Evaluation Qualité Accréditation et Sécurité Sanitaire, Direction de la Politique Médicale, Assistance Publique, Hôpitaux de Paris, Paris, France.
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Arena R, Humphrey R, Peberdy MA. Relationship between the Minnesota Living With Heart Failure Questionnaire and key ventilatory expired gas measures during exercise testing in patients with heart failure. JOURNAL OF CARDIOPULMONARY REHABILITATION 2002; 22:273-7. [PMID: 12202848 DOI: 10.1097/00008483-200207000-00010] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study assessed the relationship between the Minnesota Living With Heart Failure Questionnaire (MLWHFQ) and key ventilatory expired gas measures during a symptom-limited exercise test in the heart failure (HF) population. Specifically, is there evidence to indicate that perceived quality of life (QOL) influences exercise performance independent of physiologic function in the HF population? METHODS Thirty-one subjects (21 male/10 female), diagnosed with compensated HF, underwent exercise testing and completed the MLWHFQ. Mean age and left ventricular ejection fraction were 52.8 years and 27.2%, respectively. Partial correlation, controlling for age and sex, assessed the relationship between MLWHFQ (overall and subscores) and key ventilatory expired gas measures. Intraclass correlation coefficient (ICC) analysis was used to determine reliability of the MLWHFQ. RESULTS MLWHQ overall score (mean = 38.9, median = 36.0), physical subscore (mean = 14.8, median = 16.0), and psychosocial/symptomatology subscore (mean = 24.1, median = 19.0), were significantly correlated (P < or =.05) with peak oxygen consumption (VO2). The relationship between MLWHFQ and the minute ventilation-carbon dioxide production (VE/VCO2) slope was, however, not significant. ICC analysis revealed high reliability (0.95) for the MLWHFQ. CONCLUSIONS The MLWHFQ demonstrates a significant relationship with peak VO2, a measure whose validity is dependent upon subject effort. VE/VCO2 slope, which is independent of subject effort and therefore potentially a better predictor of true physiologic function, does not appear to have a relationship with perceived QOL. These findings have implications for how the MLWHFQ is assessed, related to an exercise test, and used during clinical practice.
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Affiliation(s)
- Ross Arena
- Department of Physical Therapy, Medical College of VA, Virginia Commonwealth University, 1200 East Broad Street, PO Box 980224, Richmond, VA 23298-0224, USA
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Ruiz de Velasco I, Quintana JM, Padierna JA, Aróstegui I, Bernal A, Pérez-Izquierdo J, Ojanguren JM, Anitua C, González N, Etxeberria Y. Validez del cuestionario de calidad de vida SF-36 como indicador de resultados de procedimientos médicos y quirúrgicos. ACTA ACUST UNITED AC 2002. [DOI: 10.1016/s1134-282x(02)77506-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Riedinger MS, Dracup KA, Brecht ML, Padilla G, Sarna L, Ganz PA. Quality of life in patients with heart failure: do gender differences exist? Heart Lung 2001; 30:105-16. [PMID: 11248713 DOI: 10.1067/mhl.2001.114140] [Citation(s) in RCA: 143] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate gender differences in quality of life (QOL) in a large sample of age-matched and ejection fraction (EF)-matched patients with heart failure. DESIGN Matched comparisons of secondary data were used. SETTING The setting consisted of multicenter Studies of Left Ventricular Dysfunction trials. SAMPLE The sample included 1382 patients (691 men and 691 women) who were age-matched and EF-matched. OUTCOME MEASURES Global QOL and the QOL dimensions of physical function, emotional distress, social health, and general health were measured using the Ladder of Life, items from the Profile of Mood States Inventory, the Functional Status Questionnaire, the beta-Blocker Heart Attack Trial instrument, and an item from the RAND Medical Outcomes Study instrument. RESULTS Women had significantly worse general life satisfaction, physical function, and social and general health scores than men. There were no significant differences found between gender groups for current life situation or emotional distress. After controlling for New York Heart Association classification, women still had significantly worse ratings for intermediate activities of daily living (a sub-dimension of physical functioning) and social activity. CONCLUSIONS Despite controlling for age, EF, and New York Heart Association classification, women had worse QOL ratings than did men for intermediate activities of daily living and social activity. Research should focus on identifying why differences exist and developing measures to improve QOL, particularly physical functioning, in women with heart failure.
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Affiliation(s)
- M S Riedinger
- University of California-Los Angeles, School of Nursing, Cedars-Sinai Medical Center, 90048, USA
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Riedinger MS, Dracup KA, Brecht ML. Predictors of quality of life in women with heart failure. SOLVD Investigators. Studies of Left Ventricular Dysfunction. J Heart Lung Transplant 2000; 19:598-608. [PMID: 10867341 DOI: 10.1016/s1053-2498(00)00117-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Two and one half million women have heart failure (HF). Yet little is known about quality of life (QOL) in this population and the factors influencing it. Given the importance of QOL as an outcome of care, we conducted a study to evaluate predictors of QOL in women with HF. METHODS Using baseline QOL data collected in the Studies of Left Ventricular Dysfunction (SOLVD) trials, we studied predictors of QOL in 691 women with HF. Univariate, bivariate, and multiple regression analyses were used. Potential predictors included age, education, tobacco use, social isolation, life stresses, comorbidity index, New York Heart Association (NYHA) class, HF symptoms, etiology, and medications. We measured global QOL and QOL dimensions of physical function, emotional distress, and social and general health. RESULTS Women were older (61+/-10.5 years), predominantly Caucasian (75%), and their mean ejection fraction was 0.27 (+/-6.51). Variables with the strongest relationship to QOL included dyspnea, NYHA class, and life stresses. As dyspnea, life stresses, and NYHA class increased, QOL decreased. Additionally, smoking behavior and vasodilator use was associated with decreased QOL. Heart failure etiology of ischemic origin was associated with decreased social life satisfaction, and use of digitalis was predictive of increased social life satisfaction. Finally, increasing age was related to an increase in general life satisfaction. CONCLUSION Symptom amelioration, which may improve functional ability, has the greatest potential for increasing QOL in women with HF. Programs to increase physical activity in women with HF should be developed and tested. Finally, clinicians may need to optimize HF medications in women.
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Affiliation(s)
- M S Riedinger
- Cedars-Sinai Medical Center, Los Angeles, California, USA.
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