title: Health related quality of life of patients with refractory angina before and one year after enrolment onto a refractory angina program.
abstract: OBJECTIVE
  This study was designed to assess the impact of a refractory angina programme on the health related quality of life for patients with chronic refractory angina (CRA) one year following enrolment.
  
  
  METHODS
  A one year prospective audit.
  
  
  METHODS
  Specialist refractory angina clinic at a tertiary cardiac referral centre.
  
  
  METHODS
  69 consecutive refractory angina patients referred to a regional refractory angina centre from 1/03/2001 to 1/09/2002.
  
  
  METHODS
  Pain treatment algorithm in accordance with the recommendations of the national refractory angina guideline committee.
  
  
  METHODS
  Improvements in quality of life indices were assessed using Seattle angina questionnaire (SAQ), and short form-12 (SF-12) with changes in mood determined using the hospital anxiety and depression (HAD) questionnaire.
  
  
  RESULTS
  All dimensions of the SF-12 and SAQ were superior at one year with significant improvement seen with the mental component of SF-12 (p = 0.023), and four of the five SAQ domains, angina stability (p = 0.028), angina frequency (p=0.02), treatment satisfaction (p=0.001) and quality of life (p < 0.001). All the significant changes within the SAQ domains were large enough to be considered clinically relevant. At one year the anxiety and depression domains were significantly improved from baseline (p = 0.015, 0.018) with clinical anxiety levels falling significantly from 55% to 40%, a relative reduction of 28% (p = 0.008).
  
  
  CONCLUSIONS
  Implementation of the national refractory angina guidelines in a prospective study of 69 consecutive CRA patients significantly improved health related quality of life status at one year.
authors.affiliation: National Refractory Angina Centre, Royal Liverpool & Broadgreen University Hospital NHS Trust, UK.
authors.forename: R K
authors.initials: RK
authors.lastname: Moore
authors.forename: D
authors.initials: D
authors.lastname: Groves
authors.forename: S
authors.initials: S
authors.lastname: Bateson
authors.forename: P
authors.initials: P
authors.lastname: Barlow
authors.forename: C
authors.initials: C
authors.lastname: Hammond
authors.forename: A A
authors.initials: AA
authors.lastname: Leach
authors.forename: M R
authors.initials: MR
authors.lastname: Chester
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000523:psychology / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009313:National Health Programs; D010148:Intractable Pain / Q000523:psychology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D013997:Time Factors; D006113:United Kingdom