Preferences of heart failure patients in daily clinical practice: quality of life or longevity?

Imke H Kraai, Karin M Vermeulen, Marie Louise A Luttik, Tialda Hoekstra, Tiny Jaarsma, Hans L Hillege

Onderzoeksoutput: ArticleAcademicpeer review

Uittreksel

AIMS: Knowledge of patient preferences is vital for delivering optimal healthcare. This study uses utility measurement to assess the preferences of heart failure (HF) patients regarding quality of life or longevity. The utility approach represents the perspective of a patient; facilitates the combination of mortality, morbidity, and treatment regimen into a single score; and makes it possible to compare the effects of different interventions in healthcare.

METHODS AND RESULTS: Patient preferences of 100 patients with HF were assessed in interviews using the time trade-off (TTO) approach. Health-related quality of life (HR-QoL) was assessed with the EQ-5D and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Patients' own estimation of life expectancy was assessed with a visual analogue scale (VAS). Of the 100 patients (mean age 70 ± 9 years; 71% male), 61% attach more weight to quality of life over longevity; while 9% and 14% were willing to trade 6 and 12 months, respectively, for perfect health and attach more weight to quality of life. Patients willing to trade time had a significantly higher level of NT-proBNP and reported significantly more dyspnoea during exertion. Predictors of willingness to trade time were higher NT-proBNP and lower EQ VAS.

CONCLUSION: The majority of HF patients attach more weight to quality of life over longevity. There was no difference between both groups with respect to life expectancy described by the patients. These insights enable open and personalized discussions of patients' preferences in treatment and care decisions, and could guide the future development of more patient-centred care.

Originele taal-2English
Pagina's (van-tot)1113-1121
TijdschriftEuropean journal of heart failure
Volume15
Nummer van het tijdschrift10
DOI's
StatusPublished - 2013

Keywords

  • ouderen
  • depressies
  • dyspnea
  • vermoeidheid
  • gezondheidsstatus
  • hartfalen
  • logistieke modellen
  • levensduur
  • multivariabele analyse
  • kwaliteit van leven
  • sociale steun

Citeer dit

Kraai, Imke H ; Vermeulen, Karin M ; Luttik, Marie Louise A ; Hoekstra, Tialda ; Jaarsma, Tiny ; Hillege, Hans L. / Preferences of heart failure patients in daily clinical practice : quality of life or longevity?. In: European journal of heart failure. 2013 ; Vol. 15, Nr. 10. blz. 1113-1121.
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title = "Preferences of heart failure patients in daily clinical practice: quality of life or longevity?",
abstract = "AIMS: Knowledge of patient preferences is vital for delivering optimal healthcare. This study uses utility measurement to assess the preferences of heart failure (HF) patients regarding quality of life or longevity. The utility approach represents the perspective of a patient; facilitates the combination of mortality, morbidity, and treatment regimen into a single score; and makes it possible to compare the effects of different interventions in healthcare.METHODS AND RESULTS: Patient preferences of 100 patients with HF were assessed in interviews using the time trade-off (TTO) approach. Health-related quality of life (HR-QoL) was assessed with the EQ-5D and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Patients' own estimation of life expectancy was assessed with a visual analogue scale (VAS). Of the 100 patients (mean age 70 ± 9 years; 71{\%} male), 61{\%} attach more weight to quality of life over longevity; while 9{\%} and 14{\%} were willing to trade 6 and 12 months, respectively, for perfect health and attach more weight to quality of life. Patients willing to trade time had a significantly higher level of NT-proBNP and reported significantly more dyspnoea during exertion. Predictors of willingness to trade time were higher NT-proBNP and lower EQ VAS.CONCLUSION: The majority of HF patients attach more weight to quality of life over longevity. There was no difference between both groups with respect to life expectancy described by the patients. These insights enable open and personalized discussions of patients' preferences in treatment and care decisions, and could guide the future development of more patient-centred care.",
keywords = "elderly patients, depressions, dyspnea, fatigue, health status, heart failure, logistic models, longevity, multivariate analysis, quality of life, social support, ouderen, depressies, dyspnea, vermoeidheid, gezondheidsstatus, hartfalen, logistieke modellen, levensduur, multivariabele analyse, kwaliteit van leven, sociale steun",
author = "Kraai, {Imke H} and Vermeulen, {Karin M} and Luttik, {Marie Louise A} and Tialda Hoekstra and Tiny Jaarsma and Hillege, {Hans L}",
year = "2013",
doi = "10.1093/eurjhf/hft071",
language = "English",
volume = "15",
pages = "1113--1121",
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Preferences of heart failure patients in daily clinical practice : quality of life or longevity? / Kraai, Imke H; Vermeulen, Karin M; Luttik, Marie Louise A; Hoekstra, Tialda; Jaarsma, Tiny; Hillege, Hans L.

In: European journal of heart failure, Vol. 15, Nr. 10, 2013, blz. 1113-1121.

Onderzoeksoutput: ArticleAcademicpeer review

TY - JOUR

T1 - Preferences of heart failure patients in daily clinical practice

T2 - quality of life or longevity?

AU - Kraai, Imke H

AU - Vermeulen, Karin M

AU - Luttik, Marie Louise A

AU - Hoekstra, Tialda

AU - Jaarsma, Tiny

AU - Hillege, Hans L

PY - 2013

Y1 - 2013

N2 - AIMS: Knowledge of patient preferences is vital for delivering optimal healthcare. This study uses utility measurement to assess the preferences of heart failure (HF) patients regarding quality of life or longevity. The utility approach represents the perspective of a patient; facilitates the combination of mortality, morbidity, and treatment regimen into a single score; and makes it possible to compare the effects of different interventions in healthcare.METHODS AND RESULTS: Patient preferences of 100 patients with HF were assessed in interviews using the time trade-off (TTO) approach. Health-related quality of life (HR-QoL) was assessed with the EQ-5D and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Patients' own estimation of life expectancy was assessed with a visual analogue scale (VAS). Of the 100 patients (mean age 70 ± 9 years; 71% male), 61% attach more weight to quality of life over longevity; while 9% and 14% were willing to trade 6 and 12 months, respectively, for perfect health and attach more weight to quality of life. Patients willing to trade time had a significantly higher level of NT-proBNP and reported significantly more dyspnoea during exertion. Predictors of willingness to trade time were higher NT-proBNP and lower EQ VAS.CONCLUSION: The majority of HF patients attach more weight to quality of life over longevity. There was no difference between both groups with respect to life expectancy described by the patients. These insights enable open and personalized discussions of patients' preferences in treatment and care decisions, and could guide the future development of more patient-centred care.

AB - AIMS: Knowledge of patient preferences is vital for delivering optimal healthcare. This study uses utility measurement to assess the preferences of heart failure (HF) patients regarding quality of life or longevity. The utility approach represents the perspective of a patient; facilitates the combination of mortality, morbidity, and treatment regimen into a single score; and makes it possible to compare the effects of different interventions in healthcare.METHODS AND RESULTS: Patient preferences of 100 patients with HF were assessed in interviews using the time trade-off (TTO) approach. Health-related quality of life (HR-QoL) was assessed with the EQ-5D and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Patients' own estimation of life expectancy was assessed with a visual analogue scale (VAS). Of the 100 patients (mean age 70 ± 9 years; 71% male), 61% attach more weight to quality of life over longevity; while 9% and 14% were willing to trade 6 and 12 months, respectively, for perfect health and attach more weight to quality of life. Patients willing to trade time had a significantly higher level of NT-proBNP and reported significantly more dyspnoea during exertion. Predictors of willingness to trade time were higher NT-proBNP and lower EQ VAS.CONCLUSION: The majority of HF patients attach more weight to quality of life over longevity. There was no difference between both groups with respect to life expectancy described by the patients. These insights enable open and personalized discussions of patients' preferences in treatment and care decisions, and could guide the future development of more patient-centred care.

KW - elderly patients

KW - depressions

KW - dyspnea

KW - fatigue

KW - health status

KW - heart failure

KW - logistic models

KW - longevity

KW - multivariate analysis

KW - quality of life

KW - social support

KW - ouderen

KW - depressies

KW - dyspnea

KW - vermoeidheid

KW - gezondheidsstatus

KW - hartfalen

KW - logistieke modellen

KW - levensduur

KW - multivariabele analyse

KW - kwaliteit van leven

KW - sociale steun

U2 - 10.1093/eurjhf/hft071

DO - 10.1093/eurjhf/hft071

M3 - Article

VL - 15

SP - 1113

EP - 1121

JO - European journal of heart failure

JF - European journal of heart failure

SN - 1388-9842

IS - 10

ER -