Office- versus home-based evaluation of quality of life in heart failure with reduced ejection fraction: A randomized study

Autores da FMUP

• Joaquim Adelino Correia Ferreira Leite Moreira

  Autor

• João Pedro Melo Marques Pinho Ferreira

  Autor

Participantes de fora da FMUP

• de Almeida Pinho I.
• Pimentel M.J.
• Oliveira C.
• Matos M.I.
• Vale C.
• Matias P.
• Pereira J.
• Marques P.
• Friões F.
• Vasques-Nóvoa F.

Unidades de investigação

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Background: Heart failure (HF) patients often experience poor health-related quality-of-life (HR-QoL). The Kansas City Cardiomyopathy Questionnaire (KCCQ) is frequently used for assessing HR-QoL in HF. Whether KCCQ scores vary in a clinical meaningful manner according to the setting (home vs office) where patients respond to the questionnaire is currently unknown. Aims: Assess the differences in the responses to KCCQ-23 questionnaire when completed at home or office. Methods: Randomized parallel-group study, including patients with HF with reduced ejection fraction (HFrEF). Primary outcome was home vs office comparison of overall summary score (KCCQ-OSS). Main secondary outcomes were clinical summary score (KCCQ-CSS) and total symptom score (KCCQ-TSS). Results: A total of 100 patients were included in the study: 50 home vs 50 office. Mean age was 71 yrs. Most baseline characteristics were well balanced between groups, except male sex, MRA use, and prior HF hospitalizations which were more frequent in the home group. No statistically-significant between-group differences were found regarding KCCQ-OSS (median [percentile25–75]) scores: home 69.1 (42.0–86.5) vs office 63.1 (44.3–82.3) points, P-value = 0.59, or main secondary outcomes: KCCQ-CSS home 62.2 (46.5–79.9) vs office 68.1 (51.9–79.2) points, P-value = 0.69, and KCCQ-TSS home 84.7 (59.7–97.2) vs office 76.4 (66.7–94.4) points, P-value = 0.85. Results remained similar after adjustment for differences in baseline characteristics and using non-parametric regressions. Conclusions: No major differences were found in KCCQ-23 scores regardless of whether the questionnaire was completed at home or office. These findings can be useful to make HR-QoL more accessible, allowing patients to respond at home using email or cell-phone applications. © 2024 Elsevier B.V.

Copyright © 2024 Elsevier B.V. All rights reserved.

Keywords

• Aged; Aged, 80 and over; Female; Heart Failure; Home Care Services; Humans; Male; Middle Aged; Office Visits; Quality of Life; Stroke Volume; Surveys and Questionnaires; angiotensin receptor antagonist; beta adrenergic receptor blocking agent; sodium glucose cotransporter 2 inhibitor; acute heart failure; adult; aged; Article; atrial fibrillation; blood pressure; body mass; cardiogenic shock; chronic kidney failure; chronic obstructive lung disease; diabetes mellitus; diastolic blood pressure; echocardiography; electronic health record; female; health status; heart ejection fraction; heart failure with reduced ejection fraction; home; human; hypertension; hypoglycemia; kidney failure; major clinical study; male; middle aged; observational study; office versus Home; outcome assessment; proteinuria; quality of life; questionnaire; randomized controlled trial; scientific literature; six minute walk test; sleep apnea syndromes; social status; statistical analysis; systolic blood pressure;