Patient- and provider-related determinants of generic and specific health-related quality of life of patients with chronic systolic heart failure in primary care: a cross-sectional study
<p>Abstract</p> <p>Background</p> <p>Identifying the determinants of health-related quality of life (HRQOL) in patients with systolic heart failure (CHF) is rare in primary care; studies often lack a defined sample, a comprehensive set of variables and clear HRQOL outco...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2010-09-01
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| Series: | Health and Quality of Life Outcomes |
| Online Access: | http://www.hqlo.com/content/8/1/98 |
| _version_ | 1828470059285086208 |
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| author | Peters-Klimm Frank Kunz Cornelia U Laux Gunter Szecsenyi Joachim Müller-Tasch Thomas |
| author_facet | Peters-Klimm Frank Kunz Cornelia U Laux Gunter Szecsenyi Joachim Müller-Tasch Thomas |
| author_sort | Peters-Klimm Frank |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Identifying the determinants of health-related quality of life (HRQOL) in patients with systolic heart failure (CHF) is rare in primary care; studies often lack a defined sample, a comprehensive set of variables and clear HRQOL outcomes. Our aim was to explore the impact of such a set of variables on generic and disease-specific HRQOL.</p> <p>Methods</p> <p>In a cross-sectional study, we evaluated data from 318 eligible patients. HRQOL measures used were the SF-36 (Physical/Mental Component Summary, PCS/MCS) and four domains of the KCCQ (Functional status, Quality of life, Self efficacy, Social limitation). Potential determinants (instruments) included socio-demographical variables (age, sex, socio-economic status: SES), clinical (e.g. NYHA class, LVEF, NT-proBNP levels, multimorbidity (CIRS-G)), depression (PHQ-9), behavioural (EHFScBs and prescribing) and provider (e.g. list size of and number. of GPs in practice) variables. We performed linear (mixed) regression modelling accounting for clustering.</p> <p>Results</p> <p>Patients were predominantly male (71.4%), had a mean age of 69.0 (SD: 10.4) years, 12.9% had major depression, according to PHQ-9. Across the final regression models, eleven determinants explained 27% to 55% of variance (frequency across models, lowest/highest β): Depression (6×, -0.3/-0.7); age (4×, -0.1/-0.2); multimorbidity (4×, 0.1); list size (2×, -0.2); SES (2×, 0.1/0.2); and each of the following once: no. of GPs per practice, NYHA class, COPD, history of CABG surgery, aldosterone antagonist medication and Self-care (0.1/-0.2/-0.2/0.1/-0.1/-0.2).</p> <p>Conclusions</p> <p>HRQOL was determined by a variety of established individual variables. Additionally the presence of multimorbidity burden, behavioural (self-care) and provider determinants may influence clinicians in tailoring care to individual patients and highlight future research priorities.</p> |
| first_indexed | 2024-12-11T04:47:25Z |
| format | Article |
| id | doaj.art-df1dc342f5cf4f6a8612feb3fd96d800 |
| institution | Directory Open Access Journal |
| issn | 1477-7525 |
| language | English |
| last_indexed | 2024-12-11T04:47:25Z |
| publishDate | 2010-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Health and Quality of Life Outcomes |
| spelling | doaj.art-df1dc342f5cf4f6a8612feb3fd96d8002022-12-22T01:20:29ZengBMCHealth and Quality of Life Outcomes1477-75252010-09-01819810.1186/1477-7525-8-98Patient- and provider-related determinants of generic and specific health-related quality of life of patients with chronic systolic heart failure in primary care: a cross-sectional studyPeters-Klimm FrankKunz Cornelia ULaux GunterSzecsenyi JoachimMüller-Tasch Thomas<p>Abstract</p> <p>Background</p> <p>Identifying the determinants of health-related quality of life (HRQOL) in patients with systolic heart failure (CHF) is rare in primary care; studies often lack a defined sample, a comprehensive set of variables and clear HRQOL outcomes. Our aim was to explore the impact of such a set of variables on generic and disease-specific HRQOL.</p> <p>Methods</p> <p>In a cross-sectional study, we evaluated data from 318 eligible patients. HRQOL measures used were the SF-36 (Physical/Mental Component Summary, PCS/MCS) and four domains of the KCCQ (Functional status, Quality of life, Self efficacy, Social limitation). Potential determinants (instruments) included socio-demographical variables (age, sex, socio-economic status: SES), clinical (e.g. NYHA class, LVEF, NT-proBNP levels, multimorbidity (CIRS-G)), depression (PHQ-9), behavioural (EHFScBs and prescribing) and provider (e.g. list size of and number. of GPs in practice) variables. We performed linear (mixed) regression modelling accounting for clustering.</p> <p>Results</p> <p>Patients were predominantly male (71.4%), had a mean age of 69.0 (SD: 10.4) years, 12.9% had major depression, according to PHQ-9. Across the final regression models, eleven determinants explained 27% to 55% of variance (frequency across models, lowest/highest β): Depression (6×, -0.3/-0.7); age (4×, -0.1/-0.2); multimorbidity (4×, 0.1); list size (2×, -0.2); SES (2×, 0.1/0.2); and each of the following once: no. of GPs per practice, NYHA class, COPD, history of CABG surgery, aldosterone antagonist medication and Self-care (0.1/-0.2/-0.2/0.1/-0.1/-0.2).</p> <p>Conclusions</p> <p>HRQOL was determined by a variety of established individual variables. Additionally the presence of multimorbidity burden, behavioural (self-care) and provider determinants may influence clinicians in tailoring care to individual patients and highlight future research priorities.</p>http://www.hqlo.com/content/8/1/98 |
| spellingShingle | Peters-Klimm Frank Kunz Cornelia U Laux Gunter Szecsenyi Joachim Müller-Tasch Thomas Patient- and provider-related determinants of generic and specific health-related quality of life of patients with chronic systolic heart failure in primary care: a cross-sectional study Health and Quality of Life Outcomes |
| title | Patient- and provider-related determinants of generic and specific health-related quality of life of patients with chronic systolic heart failure in primary care: a cross-sectional study |
| title_full | Patient- and provider-related determinants of generic and specific health-related quality of life of patients with chronic systolic heart failure in primary care: a cross-sectional study |
| title_fullStr | Patient- and provider-related determinants of generic and specific health-related quality of life of patients with chronic systolic heart failure in primary care: a cross-sectional study |
| title_full_unstemmed | Patient- and provider-related determinants of generic and specific health-related quality of life of patients with chronic systolic heart failure in primary care: a cross-sectional study |
| title_short | Patient- and provider-related determinants of generic and specific health-related quality of life of patients with chronic systolic heart failure in primary care: a cross-sectional study |
| title_sort | patient and provider related determinants of generic and specific health related quality of life of patients with chronic systolic heart failure in primary care a cross sectional study |
| url | http://www.hqlo.com/content/8/1/98 |
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