Long term changes in health-related quality of life for people with heart failure: the ECHOES study

Andrea K. Roalfe; Clare J. Taylor; F.D. Richard Hobbs

doi:10.1002/ehf2.14182

Long term changes in health-related quality of life for people with heart failure: the ECHOES study

Andrea K. Roalfe^*, Clare J. Taylor, F.D. Richard Hobbs^*

^*Corresponding author for this work

Applied Health Research

Research output: Contribution to journal › Article › peer-review

Abstract

Aims: Heart failure (HF) impairs all aspects of health-related quality of life (HRQoL), but little is known about the effect of developing HF on HRQoL over time. We aimed to report changes in HRQoL over a 13-year period.

Methods and results: HRQoL was measured in the Echocardiographic Heart of England Screening (ECHOES) study and the ECHOES-X follow-up study (N = 1618) using the SF-36 questionnaire (Version 1). Mixed modelling compared changes in HRQoL across diagnostic groups, adjusting for potential predictors and design variables. Patients who had developed HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF) at rescreening had significantly greater reduction in physical functioning (PF) and role physical (RP) scores compared with those without HF; adjusted mean difference in PF: HFrEF −16.1, [95% confidence interval (CI) −22.2 to −10.1]; HFpEF −14.6, (95% CI −21.2 to −8.1); in RP: HFrEF −20.7, (95% CI −31.8 to −9.7); HFpEF −19.3, (95% CI −31.0 to −7.6). Changes in HRQoL of those with a HF diagnosis at baseline and rescreen, with exception of role emotion, were similar to those without HF but started from a much lower baseline score.

Conclusions: People with a new diagnosis of HF at rescreening had a significant reduction in HRQoL. Conversely, for those with HF detected on initial screening, little change was observed in HRQoL scores on rescreening. Further research is required to understand the development of HF over time and to test interventions designed to prevent decline in HRQoL, potentially through earlier diagnosis and treatment optimization.

Original language	English
Pages (from-to)	211-222
Number of pages	12
Journal	ESC heart failure
Volume	10
Issue number	1
Early online date	2 Oct 2022
DOIs	https://doi.org/10.1002/ehf2.14182
Publication status	Published - Feb 2023

Bibliographical note

Funding Information:
AKR is supported by the NIHR Oxford Biomedical Research Centre. FDRH acknowledges support from the NIHR Applied Research Collaborative (ARC) Oxford and Thames Valley and the NIHR Oxford BRC. CJT is funded by a NIHR Academic Clinical Lectureship. This work is part of the NIHR Community Healthcare Medtech and In Vitro Diagnostics Cooperative (MIC) long-term conditions theme led by CJT and FDRH. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. We acknowledge Dr Russell Davis and Rachel Iles for their contribution to the ECHOES studies.

Publisher Copyright:
© 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Keywords

Heart failure
Primary care
Quality of life
SF-36

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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Cite this

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title = "Long term changes in health-related quality of life for people with heart failure: the ECHOES study",

abstract = "Aims: Heart failure (HF) impairs all aspects of health-related quality of life (HRQoL), but little is known about the effect of developing HF on HRQoL over time. We aimed to report changes in HRQoL over a 13-year period. Methods and results: HRQoL was measured in the Echocardiographic Heart of England Screening (ECHOES) study and the ECHOES-X follow-up study (N = 1618) using the SF-36 questionnaire (Version 1). Mixed modelling compared changes in HRQoL across diagnostic groups, adjusting for potential predictors and design variables. Patients who had developed HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF) at rescreening had significantly greater reduction in physical functioning (PF) and role physical (RP) scores compared with those without HF; adjusted mean difference in PF: HFrEF −16.1, [95% confidence interval (CI) −22.2 to −10.1]; HFpEF −14.6, (95% CI −21.2 to −8.1); in RP: HFrEF −20.7, (95% CI −31.8 to −9.7); HFpEF −19.3, (95% CI −31.0 to −7.6). Changes in HRQoL of those with a HF diagnosis at baseline and rescreen, with exception of role emotion, were similar to those without HF but started from a much lower baseline score. Conclusions: People with a new diagnosis of HF at rescreening had a significant reduction in HRQoL. Conversely, for those with HF detected on initial screening, little change was observed in HRQoL scores on rescreening. Further research is required to understand the development of HF over time and to test interventions designed to prevent decline in HRQoL, potentially through earlier diagnosis and treatment optimization.",

keywords = "Heart failure, Primary care, Quality of life, SF-36",

author = "Roalfe, {Andrea K.} and Taylor, {Clare J.} and Hobbs, {F.D. Richard}",

note = "Funding Information: AKR is supported by the NIHR Oxford Biomedical Research Centre. FDRH acknowledges support from the NIHR Applied Research Collaborative (ARC) Oxford and Thames Valley and the NIHR Oxford BRC. CJT is funded by a NIHR Academic Clinical Lectureship. This work is part of the NIHR Community Healthcare Medtech and In Vitro Diagnostics Cooperative (MIC) long-term conditions theme led by CJT and FDRH. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. We acknowledge Dr Russell Davis and Rachel Iles for their contribution to the ECHOES studies. Publisher Copyright: {\textcopyright} 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.",

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doi = "10.1002/ehf2.14182",

language = "English",

volume = "10",

pages = "211--222",

journal = "ESC heart failure",

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T1 - Long term changes in health-related quality of life for people with heart failure

T2 - the ECHOES study

AU - Roalfe, Andrea K.

AU - Taylor, Clare J.

AU - Hobbs, F.D. Richard

N1 - Funding Information: AKR is supported by the NIHR Oxford Biomedical Research Centre. FDRH acknowledges support from the NIHR Applied Research Collaborative (ARC) Oxford and Thames Valley and the NIHR Oxford BRC. CJT is funded by a NIHR Academic Clinical Lectureship. This work is part of the NIHR Community Healthcare Medtech and In Vitro Diagnostics Cooperative (MIC) long-term conditions theme led by CJT and FDRH. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. We acknowledge Dr Russell Davis and Rachel Iles for their contribution to the ECHOES studies. Publisher Copyright: © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

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N2 - Aims: Heart failure (HF) impairs all aspects of health-related quality of life (HRQoL), but little is known about the effect of developing HF on HRQoL over time. We aimed to report changes in HRQoL over a 13-year period. Methods and results: HRQoL was measured in the Echocardiographic Heart of England Screening (ECHOES) study and the ECHOES-X follow-up study (N = 1618) using the SF-36 questionnaire (Version 1). Mixed modelling compared changes in HRQoL across diagnostic groups, adjusting for potential predictors and design variables. Patients who had developed HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF) at rescreening had significantly greater reduction in physical functioning (PF) and role physical (RP) scores compared with those without HF; adjusted mean difference in PF: HFrEF −16.1, [95% confidence interval (CI) −22.2 to −10.1]; HFpEF −14.6, (95% CI −21.2 to −8.1); in RP: HFrEF −20.7, (95% CI −31.8 to −9.7); HFpEF −19.3, (95% CI −31.0 to −7.6). Changes in HRQoL of those with a HF diagnosis at baseline and rescreen, with exception of role emotion, were similar to those without HF but started from a much lower baseline score. Conclusions: People with a new diagnosis of HF at rescreening had a significant reduction in HRQoL. Conversely, for those with HF detected on initial screening, little change was observed in HRQoL scores on rescreening. Further research is required to understand the development of HF over time and to test interventions designed to prevent decline in HRQoL, potentially through earlier diagnosis and treatment optimization.

AB - Aims: Heart failure (HF) impairs all aspects of health-related quality of life (HRQoL), but little is known about the effect of developing HF on HRQoL over time. We aimed to report changes in HRQoL over a 13-year period. Methods and results: HRQoL was measured in the Echocardiographic Heart of England Screening (ECHOES) study and the ECHOES-X follow-up study (N = 1618) using the SF-36 questionnaire (Version 1). Mixed modelling compared changes in HRQoL across diagnostic groups, adjusting for potential predictors and design variables. Patients who had developed HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF) at rescreening had significantly greater reduction in physical functioning (PF) and role physical (RP) scores compared with those without HF; adjusted mean difference in PF: HFrEF −16.1, [95% confidence interval (CI) −22.2 to −10.1]; HFpEF −14.6, (95% CI −21.2 to −8.1); in RP: HFrEF −20.7, (95% CI −31.8 to −9.7); HFpEF −19.3, (95% CI −31.0 to −7.6). Changes in HRQoL of those with a HF diagnosis at baseline and rescreen, with exception of role emotion, were similar to those without HF but started from a much lower baseline score. Conclusions: People with a new diagnosis of HF at rescreening had a significant reduction in HRQoL. Conversely, for those with HF detected on initial screening, little change was observed in HRQoL scores on rescreening. Further research is required to understand the development of HF over time and to test interventions designed to prevent decline in HRQoL, potentially through earlier diagnosis and treatment optimization.

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Long term changes in health-related quality of life for people with heart failure: the ECHOES study

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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