The influence of disease-specific symptoms on the health-related quality of life in patients with atrial fibrillation (Artikel)

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The influence of disease-specific symptoms on the health-related quality of life in patients with atrial fibrillation (Artikel)
Autor Thomas Wilke, Sabrina Müller, R. Bauersachs, G. Breithardt
In: Value in Health
Ausgabe 15 (7)
ISBN/ISSN:
Erscheinungsjahr 2012
Jahrgang November 2012
Seitenzahl A379
Hyperlink
Review

OBJECTIVES: To assess the health-related quality of life (HrQoL) in patients with atrial fibrillation (AF) in Germany and to identify the influence of the associated AF-specific symptoms on HrQoL. METHODS: HrQoL of AF patients recruited into a prospective cohort study was assessed by using the written version of the SF 36. General HrQoL as well as physical and mental component summary scores were calculated for each patient. Secondly, AF-related symptoms based on the EHRA AF symptoms classification (palpitations, fatigue, dizziness, dyspnea, chest pain, anxiety) were collected by asking each patient to fill out written questionnaires during visiting a GP. To identify the influence of these symptoms on HrQoL, a linear regression was conducted for each component summary score, while controlling for additional socio-demographic/AF-related clinical parameters. RESULTS: A total of 526 AF-patients were recruited in 71 study centers (female patients: 45.1 %, average age: 73.2 years, average CHA2DS2-VASc score: 3.8). The average SF-36-physical summary score was 38.6 (SD: 10.4). The average SF-36 mental component score was 46.5 (SD: 11.8). Only 14.8 % of the patients reported none of the EHRA-symptoms. The most frequent symptom was fatigue (72.1 % of all patients). The results of the first multivariate regression (R2�0.349) showed that the most important factors explaining the SF-36-physical component score were fatigue, chest pain, dizziness and dyspnea. Only two of the control variables had a significant influence on physical HrQoL (age; number of medications taken). In the second estimate addressing mental HrQoL (R2�0.349), none of these factors was significant. The most important factors explaining mental HrQoL were palpitations, dizziness and anxiety. CONCLUSIONS: AF patients in real life care have a limited physical/mental HrQoL. AF-related symptoms significantly explain the level of HrQoL. Consequently, in order to increase/maintain the HrQoL of AF patients, it is important to control/ improve scores measured for AF-related symptoms.