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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

Peters-Klimm, Frank ; Kunz, Cornelia U. ; Laux, Gunter ; Szecsenyi, Joachim ; Müller-Tasch, Thomas

In: Health and Quality of Life Outcomes, 8 (2010), Nr. 98. pp. 1-11. ISSN 1477-7525

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Download (330kB) | Lizenz: Creative Commons LizenzvertragPatient- 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 by Peters-Klimm, Frank ; Kunz, Cornelia U. ; Laux, Gunter ; Szecsenyi, Joachim ; Müller-Tasch, Thomas underlies the terms of Creative Commons Attribution 3.0 Germany

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Abstract

Background: 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. Methods: 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. Results: 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). Conclusions: 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.

Item Type: Article
Journal or Publication Title: Health and Quality of Life Outcomes
Volume: 8
Number: 98
Publisher: BioMed Central
Place of Publication: London
Date Deposited: 03 Feb 2016 10:03
Date: 2010
ISSN: 1477-7525
Page Range: pp. 1-11
Faculties / Institutes: Medizinische Fakultät Heidelberg > Medizinische Universitäts-Klinik und Poliklinik
Medizinische Fakultät Heidelberg > Psychosomatische Universitätsklinik
Medizinische Fakultät Heidelberg > Institut für Medizinische Biometrie und Informatik
Subjects: 610 Medical sciences Medicine
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