Quality of life and the heart: evaluation of therapeutic alternatives.
The choice of criteria that should be used in cardiological disease in order to establish a meaningful measure of quality of life is influenced by the severity and nature of the disease, the expected benefits and adverse effects of treatment, and such considerations as the length of the study and availability of appropriate methods. Moreover, the selection of specific instrumentation should be made with a view to producing valid, repeatable results that allow sensitive assessment of the effects of treatment. The inclusion of a health index is one method of obtaining quality-of-life scores from patients who withdraw from a clinical trial or who die. Interpretation of quality-of-life results from clinical trials is not simple: for example, the effect of treatment must be distinguished from the benefit of trial inclusion; moreover, changes in quality-of-life scores should correspond to changes in the patients' own experiences of their daily lives. The measurement of quality of life, when the effect of treatment is being assessed, requires adequate control data. This usually necessitates a double-blind, randomised trial protocol. The quality of life of patients on long-term pharmacological treatment needs to be evaluated, and several groups of drugs commonly employed are discussed here. Transdermal nitrates for angina do impair quality of life if used continuously, by producing headaches and limiting social participation, while tolerance limits their efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)
Division of Geriatric Medicine, Royal Postgraduate Medical School, London.
C J
CJ
Bulpitt
A E
AE
Fletcher
D000787:Angina Pectoris / Q000188:drug therapy* / Q000523:psychology; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D006973:Hypertension / Q000523:psychology; D011788:Quality of Life
D000959:Antihypertensive Agents