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Mendes JL, Dos Santos CM, Sousa-Pinto B. Assessment of patient-reported outcomes measures in heart failure: a systematic review. Heart Fail Rev 2024; 29:853-867. [PMID: 38630207 DOI: 10.1007/s10741-024-10404-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 06/19/2024]
Abstract
Heart failure (HF) is a prevalent global disease, particularly impacting developed countries. With the world's aging population, HF's impact on the quantity and quality of life is expected to grow. This review aims to ascertain the frequency, characteristics, and properties of all patient-reported outcomes measures (PROMs) studied in HF patients. We searched Ovid/Medline and Web of Science for original articles about PROMs performed in adults with HF. Using pre-established quality criteria for measurement properties, an overall rating was assigned to evaluate and compare different instruments. The quality of evidence was assessed with the COSMIN risk of bias checklist. Of 4283 records identified, we reviewed 296 full-text documents and included 64 papers, involving 30,185 participants. Thirty different PROMs were identified, with 14 specifically designed for HF being the most commonly used. Minnesota Living with Heart Failure (MLHF) and Kansas City Cardiomyopathy Questionnaire (KCCQ) were evaluated 16 and 13 times, respectively, demonstrating good psychometric properties. The MacNew Heart Disease Health-Related Quality of Life Questionnaire, a common heart disease-specific instrument, exhibited negative performances across various psychometric measures. Evidence for generic instruments was scant and unremarkable and they proved to be less responsive in HF populations. MLHF and KCCQ emerged as the most commonly used and well-supported PROMs, with robust overall evidence. They are comprehensive and accurate instruments, particularly suitable for application in clinical practice and research. Future research should explore how computer-adapted instruments can enhance precision, reduce respondent burden, and improve communication between clinicians and patients, thereby promoting more efficient and patient-centered services.
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Affiliation(s)
- João Lázaro Mendes
- Internal Medicine Department, Unidade Local de Saúde de Viseu Dão-Lafões, Viseu, Portugal.
| | | | - Bernardo Sousa-Pinto
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal
- Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Center for Health Technology and Services Research, Porto, Portugal
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2
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Moons P, Norekvål TM, Arbelo E, Borregaard B, Casadei B, Cosyns B, Cowie MR, Fitzsimons D, Fraser AG, Jaarsma T, Kirchhof P, Mauri J, Mindham R, Sanders J, Schiele F, Torbica A, Zwisler AD. Placing patient-reported outcomes at the centre of cardiovascular clinical practice: implications for quality of care and management. Eur Heart J 2023; 44:3405-3422. [PMID: 37606064 DOI: 10.1093/eurheartj/ehad514] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 05/01/2023] [Accepted: 07/25/2023] [Indexed: 08/23/2023] Open
Abstract
Patient-reported outcomes (PROs) provide important insights into patients' own perspectives about their health and medical condition, and there is evidence that their use can lead to improvements in the quality of care and to better-informed clinical decisions. Their application in cardiovascular populations has grown over the past decades. This statement describes what PROs are, and it provides an inventory of disease-specific and domain-specific PROs that have been developed for cardiovascular populations. International standards and quality indices have been published, which can guide the selection of PROs for clinical practice and in clinical trials and research; patients as well as experts in psychometrics should be involved in choosing which are most appropriate. Collaborations are needed to define criteria for using PROs to guide regulatory decisions, and the utility of PROs for comparing and monitoring the quality of care and for allocating resources should be evaluated. New sources for recording PROs include wearable digital health devices, medical registries, and electronic health record. Advice is given for the optimal use of PROs in shared clinical decision-making in cardiovascular medicine, and concerning future directions for their wider application.
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Affiliation(s)
- Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35 PB7001, 3000 Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Klipfontein Rd, Rondebosch, 7700 Cape Town, South Africa
| | - Tone M Norekvål
- Department of Heart Disease, Haukeland University Hospital, Haukelandsveien 22, 5009 Bergen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Jonas Lies veg, 875021 Bergen, Norway
| | - Elena Arbelo
- Cardiology Department, Hospital Clínic, Universitat de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain
- Institut d'Investigació August Pi i Sunyer (IDIBAPS). Rosselló 149-153, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Britt Borregaard
- Department of Cardiology, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19, 5000 Odense, Denmark
| | - Barbara Casadei
- Division of Cardiovascular Medicine, RDM, University of Oxford; Headley Way, Headington Oxford OX3 9DU, UK
- NIHR Biomedical Research Centre, Headley Way, Headington Oxford OX3 9DU, UK
| | - Bernard Cosyns
- Department of Cardiology, University Hospital Brussels, Laarbeeklaan 101, 1090 Jette, Belgium
| | - Martin R Cowie
- Royal Brompton Hospital & School of Cardiovascular Medicine, Faculty of Medicine & Lifesciences, King's College London, Sydney St, London SW3 6NP, UK
| | - Donna Fitzsimons
- School of Nursing & Midwifery, Queens University Belfast, 97 Lisburn Road, Belfast | BT9 7BL, Northern Ireland
| | - Alan G Fraser
- School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XW, UK
| | - Tiny Jaarsma
- Department of Medicine, Health and Caring Sciences, Linköping University, Campus Norrköping, 601 74 Norrköping, Sweden
- Nursing Science, Julius Center, University Medical Centre Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
| | - Paulus Kirchhof
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, D-20246 Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Martinistrasse 52, D-20246 Hamburg, Germany
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston Birmingham B15 2TT, UK
| | - Josepa Mauri
- Department of Cardiology, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916 Badalona, Barcelona, Spain
| | - Richard Mindham
- European Society of Cardiology (ESC) Patient Forum, 2035 route des colles, CS 80179 Biot, 06903 Sophia Antipolis Cedex, France
| | - Julie Sanders
- St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
- William Harvey Research Institute, Charterhouse Square, Queen Mary University of London, London EC1M 6BQ, UK
| | - Francois Schiele
- Department of Cardiology, University Hospital Besancon, 3 Bd Alexandre Fleming, 25030 Besançon, France
| | - Aleksandra Torbica
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Via Sarfatti, 10 20136 Milan, Italy
| | - Ann Dorthe Zwisler
- Department of Cardiology, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense, Denmark
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Vestergade 17, 5800 Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Campusvej 55, DK-5230 Odense, Denmark
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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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Waller A, Hobden B, Fakes K, Clark K. A Systematic Review of the Development and Implementation of Needs-Based Palliative Care Tools in Heart Failure and Chronic Respiratory Disease. Front Cardiovasc Med 2022; 9:878428. [PMID: 35498028 PMCID: PMC9043454 DOI: 10.3389/fcvm.2022.878428] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background The impetus to develop and implement tools for non-malignant patient groups is reflected in the increasing number of instruments being developed for heart failure and chronic respiratory diseases. Evidence syntheses of psychometric quality and clinical utility of these tools is required to inform research and clinical practice. Aims This systematic review examined palliative care needs tools for people diagnosed with advanced heart failure or chronic respiratory diseases, to determine their: (1) psychometric quality; and (2) acceptability, feasibility and clinical utility when implemented in clinical practice. Methods Systematic searches of MEDLINE, CINAHL, Embase, Cochrane and PsycINFO from database inception until June 2021 were undertaken. Additionally, the reference lists of included studies were searched for relevant articles. Psychometric properties of identified measures were evaluated against pre-determined and standard criteria. Results Eighteen tools met inclusion criteria: 11 were developed to assess unmet patient palliative care needs. Of those, 6 were generic, 4 were developed for heart failure and 1 was developed for interstitial lung disease. Seven tools identified those who may benefit from palliative care and include general and disease-specific indicators. The psychometric qualities of the tools varied. None met all of the accepted criteria for psychometric rigor in heart failure or respiratory disease populations. There is limited implementation of needs assessment tools in practice. Conclusion Several tools were identified, however further validation studies in heart failure and respiratory disease populations are required. Rigorous evaluation to determine the impact of adopting a systematic needs-based approach for heart failure and lung disease on the physical and psychosocial outcomes of patients and carers, as well as the economic costs and benefits to the healthcare system, is required.
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Affiliation(s)
- Amy Waller
- Health Behaviour Research Collaborative, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- *Correspondence: Amy Waller
| | - Breanne Hobden
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Kristy Fakes
- Health Behaviour Research Collaborative, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Katherine Clark
- Northern Sydney Local Health District (NSLHD) Supportive and Palliative Care Network, St Leonards, NSW, Australia
- Northern Clinical School, The University of Sydney, Darlington, NSW, Australia
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, NSW, Australia
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Comin-Colet J, Calero-Molina E, Corbella X, Muñiz J, San Saturnino M, Ibarrola C. [Recommendations to develop Care Models for patients with Heart Failure (MAIC Project) from macromanagement]. J Healthc Qual Res 2021; 37:100-109. [PMID: 34740549 DOI: 10.1016/j.jhqr.2021.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/09/2021] [Accepted: 09/19/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The general objective of the study was to reflect on the key factors to advance in optimal models of care for Heart Failure (HF) and specifically, on the macromanagement elements most necessary for the development of comprehensive HF management models. MATERIAL AND METHODS An Advisory Committee, composed of 15 experts and a multidisciplinary group of 31 additional experts, was appointed, together forming a Delphi panel of 46 experts. Based on a systematic bibliographic review and the analysis of the care course of the patient with HF, an initial battery of key factors for the development of HF care models was identified by the Advisory Committee. This proposal was adjusted and prioritized by the Delphi panel applying Delphi Rand/UCLA methodology. RESULTS After two Delphi rounds, 75 key factors grouped into 7 challenges were defined. In the first of the challenges, related to the development of HF management models, 16 key factors were identified, 7 of which were valued as high priority and related to the establishment of common objectives, resources for the continuity of care and improving the measurement of health outcomes. CONCLUSIONS The definition of management elements at the macro level was considered a priority to advance in the development of optimal models of assistance to HF.
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Affiliation(s)
- J Comin-Colet
- Hospital Universitario de Bellvitge y IDIBELL, Hospitalet de Llobregat, Barcelona; Departamento de Ciencias Médicas, Facultad de Medicina, Universidad de Barcelona.
| | | | - X Corbella
- Servicio de Medicina Interna. Hospital Universitario de Bellvitge-IDIBELL. Barcelona; Cátedra Hestia en Atención Integrada Social y Sanitaria, Facultad de Medicina, Universitat Internacional de Catalunya, Barcelona
| | - J Muñiz
- Universidade da Coruña - Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña; Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV). Instituto de Salud Carlos III, Madrid
| | - M San Saturnino
- Presidenta de la Asociación Cardioalianza (Asociación Española de organizaciones de pacientes con enfermedades cardiovasculares)
| | - C Ibarrola
- Parlamento de Navarra. Médico de Familia y Ex-Gerente del Servicio Navarro de Salud-Osasunbidea. Pamplona, Navarra
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6
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Ziegl A, Rzepka A, Kastner P, Vinatzer H, Edegger K, Hayn D, Prescher S, Moller V, Schreier G. mHealth 6-minute walk test - accuracy for detecting clinically relevant differences in heart failure patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:7095-7098. [PMID: 34892736 DOI: 10.1109/embc46164.2021.9630118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Heart failure is a serious disease which increases mortality as well as hospital admission rates for affected patients. Disease management programs supported by telehealth solutions are cost-effective approaches for reducing all-cause mortality and heart failure hospitalizations. A 6-minute walk test (6MWT) app could help heart failure patients to self-monitor their functional capacity. We have developed such an application capable of tracking the geolocation, guiding users through a 6MWT and providing the walked distance after six minutes. Besides common global navigation satellite system (GNSS) filtering methods like a Kalman filter, we have investigated the impact of positioning the device (tablet) and GNSS reception on the accuracy of the test. In a field experiment, we gathered 166 6MWT recordings with the developed mobile application. Applying the Kalman filter reduced the overall relative error from 35.5 % to 3.7 %. Wearing the tablet on the body led to significantly better results than holding it in the hand (p < .001). The average accuracy of 2.2 % of body-worn measurements was below previously defined thresholds for reliable results. It thus allows to define a procedure on how to perform and integrate an accurate 6MWT in telehealth settings for clinical decision support in heart failure patients.
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Kolk MZH, Blok S, De Wildt MCC, Tjong FVY, Winter MM, Tulevski II, van den Born BJH, Somsen GA. Patient-reported outcomes in symptom-driven remote arrhythmia monitoring: evaluation of the Dutch HartWacht-telemonitoring programme. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2021; 2:224-230. [PMID: 36712387 PMCID: PMC9707978 DOI: 10.1093/ehjdh/ztab030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/19/2021] [Accepted: 03/05/2021] [Indexed: 02/01/2023]
Abstract
Aims There is limited quantitative evidence on the effect of symptom-driven telemonitoring for cardiac arrhythmias on patient-reported outcomes. We evaluated the effect of a symptom-driven remote arrhythmia monitoring programme on the patient-reported health-related quality of life (HRQoL), sense of safety, physical limitations, and self-management. Methods and results This was an observational retrospective longitudinal study of the symptom-driven HartWacht-telemonitoring programme using a remote single-lead electrocardiogram monitoring system. Real-world patient data from participants who were enrolled in the telemonitoring programme for (suspected) symptomatic atrial fibrillation (AF) between July 2017 and September 2019 were evaluated. Primary outcomes were the patient-reported generic HRQoL, disease-specific HRQoL, sense of safety, physical limitations, and self-management at date of enrolment, 3 months and 6 months of follow-up. Outcomes were compared to a historical control group consisting of AF patients receiving standard care. A total of 109 participants in the HartWacht programme [59 men (54%); mean age 61 ± 11 years; 72% diagnosed AF] were included in complete case analysis. There was no significant change in HRQoL and sense of safety during follow-up. A significant improvement in the perceived physical limitations was observed. The level of self-management declined significantly during follow-up. Comparisons to the historic control group (n = 83) showed no difference between the patient-reported disease-specific HRQoL, sense of safety and physical limitations at 6 months of follow-up. Conclusion Symptom-driven remote arrhythmia monitoring for AF does not seem to affect HRQoL and sense of safety, whereas the perceived physical limitations tend to improve. Patient-reported self-management declined during the first 6 months of participation.
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Affiliation(s)
- Maarten Z H Kolk
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands,Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands,Corresponding author. Tel: 020 56 65550,
| | - Sebastiaan Blok
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands,Department of Internal and Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Fleur V Y Tjong
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands
| | - Michiel M Winter
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands,Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands
| | - Igor I Tulevski
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - Bert-Jan H van den Born
- Department of Internal and Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands,Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - G Aernout Somsen
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
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Ament SMC, Couwenberg IME, Boyne JJJ, Kleijnen J, Stoffers HEJH, van den Beuken MHJ, Engels Y, Bellersen L, Janssen DJA. Tools to help healthcare professionals recognize palliative care needs in patients with advanced heart failure: A systematic review. Palliat Med 2021; 35:45-58. [PMID: 33054670 PMCID: PMC7797617 DOI: 10.1177/0269216320963941] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The delivery of palliative care interventions is not widely integrated in chronic heart failure care as the recognition of palliative care needs is perceived as difficult. Tools may facilitate healthcare professionals to identify patients with palliative care needs in advanced chronic heart failure. AIM To identify tools to help healthcare professionals recognize palliative care needs in patients with advanced chronic heart failure. DESIGN This systematic review was registered in the PROSPERO database (CRD42019131896). Evidence of tools' development, evaluation, feasibility, and implementation was sought and described. DATA SOURCES Electronic searches to identify references of tools published until June 2019 were conducted in MEDLINE, CINAHL, and EMBASE. Hand-searching of references and citations was undertaken. Based on the identified tools, a second electronic search until September 2019 was performed to check whether all evidence about these tools in the context of chronic heart failure was included. RESULTS Nineteen studies described a total of seven tools. The tools varied in purpose, intended user and properties. The tools have been validated to a limited extent in the context of chronic heart failure and palliative care. Different health care professionals applied the tools in various settings at different moments of the care process. Guidance and instruction about how to apply the tool revealed to be relevant but may be not enough for uptake. Spiritual care needs were perceived as difficult to assess. CONCLUSION Seven tools were identified which showed different and limited levels of validity in the context of palliative care and chronic heart failure.
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Affiliation(s)
- Stephanie MC Ament
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Inge ME Couwenberg
- Department of Cardiology, Catharina Hospital, Eindhoven, North Brabant, The Netherlands
| | - Josiane JJ Boyne
- Department of Patient and Care, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands
| | - Jos Kleijnen
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Kleijnen Systematic Reviews Ltd, York, UK
| | - Henri EJH Stoffers
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Marieke HJ van den Beuken
- Centre of Expertise for Palliative Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Louise Bellersen
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Daisy JA Janssen
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Research and Education, Ciro, Horn, The Netherlands
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9
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Algurén B, Coenen M, Malm D, Fridlund B, Mårtensson J, Årestedt K. A scoping review and mapping exercise comparing the content of patient-reported outcome measures (PROMs) across heart disease-specific scales. J Patient Rep Outcomes 2020; 4:7. [PMID: 31974688 PMCID: PMC6977790 DOI: 10.1186/s41687-019-0165-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 12/11/2019] [Indexed: 12/14/2022] Open
Abstract
Background Over the past decade, the importance of person-centered care has led to increased interest in patient-reported outcome measures (PROMs). In cardiovascular care, selecting an appropriate PROM for clinical use or research is challenging because multimorbidity is often common in patients. The aim was therefore to provide an overview of heart-disease specific PROMs and to compare the content of those outcomes using a bio-psycho-social framework of health. Methods A scoping review of heart disease-specific PROMs, including arrhythmia/atrial fibrillation, congenital heart disease, heart failure, ischemic heart disease, and valve diseases was conducted in PubMed (January 2018). All items contained in the disease-specific PROMs were mapped to WHO’s International Classification of Functioning, Disability and Health (ICF) according to standardized linking rules. Results A total of 34 PROMs (heart diseases in general n = 5; cardiac arrhythmia n = 6; heart failure n = 14; ischemic heart disease n = 9) and 147 ICF categories were identified. ICF categories covered Body functions (n = 61), Activities & Participation (n = 69), and Environmental factors (n = 17). Most items were about experienced problems of Body functions and less often about patients’ daily activities, and most PROMs were specifically developed for heart failure and no PROM were identified for valve disease or congenital heart disease. Conclusions Our results motivate and provide information to develop comprehensive PROMs that consider activity and participation by patients with various types of heart disease.
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Affiliation(s)
- Beatrix Algurén
- Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, PO Box 300, 405 30, Gothenburg, Sweden. .,The Jönköping Academy for Improvement of Health and Welfare, School of Health Sciences, Jönköping University, Jönköping, Sweden.
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair of Public Health and Health Services Research, Research Unit for Biopsychosocial Health, LMU Munich, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany.,ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI)*, Nottwil, Switzerland
| | - Dan Malm
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Bengt Fridlund
- Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden
| | - Jan Mårtensson
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden.,The Research Section, Region Kalmar County, Kalmar, Sweden
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Plass AM, Van Praag D, Covic A, Gorbunova A, Real R, von Steinbuechel N. The psychometric validation of the Dutch version of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) after traumatic brain injury (TBI). PLoS One 2019; 14:e0210138. [PMID: 31647814 PMCID: PMC6812802 DOI: 10.1371/journal.pone.0210138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 09/14/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is one of the most common neurological conditions. It can have wide-ranging physical, cognitive and psychosocial effects. Most people recover within weeks to months after the injury, but a substantial proportion are at risk of developing lasting post-concussion symptoms. The Rivermead Post-Concussion Syndrome Questionnaire (RPQ) is a short validated 16-items self-report instrument to evaluate post-concussive symptoms. The aim of this study was to test psychometrics characteristics of the current Dutch translation of the RPQ. METHODS To determine the psychometric characteristics of the Dutch RPQ, 472 consecutive patients six months after they presented with a traumatic brain injury in seven medical centers in the Netherlands (N = 397), and in two in Belgium (Flanders) (N = 75) took part in the study which is part of the large prospective longitudinal observational CENTER-TBI-EU-study. Psychometric properties at six months post TBI, were assessed using exploratory and confirmatory factor analyses. Sensitivity was analyzed by comparing RPQ scores and self-reported recovery status of patients with mild vs. moderate and severe TBI. FINDINGS The Dutch version of RPQ proved good, showing excellent psychometric characteristics: high internal consistency (Cronbach's α .93), and good construct validity, being sensitive to self-reported recovery status at six months post TBI. Moreover, data showed a good fit to the three dimensional structure of separate cognitive, emotional and somatic factors (Chi2 = 119; df = 117; p = .4; CFI = .99; RMSEA = .006), reported earlier in the literature. DISCUSSION Psychometric characteristics of the Dutch version of RPQ proved excellent to good, and can the instrument therefore be applied for research purposes and in daily clinical practice.
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Affiliation(s)
- Anne Marie Plass
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
- * E-mail:
| | - Dominique Van Praag
- Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - Amra Covic
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
| | - Anastasia Gorbunova
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
| | - Ruben Real
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
| | - Nicole von Steinbuechel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
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Koole MAC, Kauw D, Winter MM, Dohmen DAJ, Tulevski II, de Haan R, Somsen GA, Schijven MP, Robbers-Visser D, Mulder BJM, Bouma BJ, Schuuring MJ. First real-world experience with mobile health telemonitoring in adult patients with congenital heart disease. Neth Heart J 2019; 27:30-37. [PMID: 30488380 PMCID: PMC6311159 DOI: 10.1007/s12471-018-1201-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Arrhythmias and heart failure are common and invalidating sequelae in adult patients with congenital heart disease (CHD). Mobile health (m-Health) enables daily monitoring and a timely response that might prevent deterioration. We present an observational prospective registry to evaluate feasibility of an m‑Health telemonitoring program for managing arrhythmia, heart failure and blood pressure in symptomatic adults with CHD. METHODS Symptomatic adult patients with CHD are enrolled in an m‑Health telemonitoring program, which evaluates single-lead ECG, blood pressure and weight measurements. In case of symptoms extra measurements could be performed. Data are collected by mobile apps, matched with individualised thresholds. Patients are contacted if thresholds were exceeded or if arrhythmias were found, for treatment adjustments or reassurance. Data on emergency care utilisation, hospitalisation and patient-reported outcome measures are used to assess quality of life and self-management. RESULTS 129 symptomatic CHD patients were invited to participate, 55 participated. Reasons for refusing consent included too time consuming to participate in research (30) and to monitor vital signs (14). At baseline 22 patients were in New York Heart Association class ≥ II heart failure, 43 patients had palpitations or documented arrhythmias, and 8 had hypertension. Mean follow-up was 3.0 months, one patient dropped out, and adherence was 97%. CONCLUSION The first results indicate that this program is feasible with high adherence.
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Affiliation(s)
- M A C Koole
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands.
- Department of Cardiology, Red Cross Hospital, Beverwijk, The Netherlands.
| | - D Kauw
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Netherlands Heart Institute, Utrecht, The Netherlands
| | - M M Winter
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - D A J Dohmen
- FocusCura, Driebergen-Rijsenburg, The Netherlands
| | - I I Tulevski
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - R de Haan
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - G A Somsen
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - M P Schijven
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - D Robbers-Visser
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - B J M Mulder
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - B J Bouma
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - M J Schuuring
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands
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Olivari Z, Giacomelli S, Gubian L, Mancin S, Visentin E, Di Francesco V, Iliceto S, Penzo M, Zanocco A, Marcon C, Anselmi M, Marchese D, Stafylas P. The effectiveness of remote monitoring of elderly patients after hospitalisation for heart failure: The renewing health European project. Int J Cardiol 2018; 257:137-142. [DOI: 10.1016/j.ijcard.2017.10.099] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/30/2017] [Accepted: 10/26/2017] [Indexed: 12/19/2022]
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