Health-related quality of life in unselected outpatients with heart failure across Spain in two different health care levels. Magnitude and determinants of impairment: the INCA study.
OBJECTIVE
To assess health-related quality of life (HRQL) in Spanish outpatients with chronic heart failure (CHF).


METHODS
Cross-sectional study carried out in a sample of CHF patients (echocardiography was performed in all of them) followed either in Primary Care (PC) centres or Cardiology outpatient clinics throughout Spain. HRQL was evaluated using the EuroQol 5D (EQ-5D) and Minnesota Living with Heart Failure (MLWHF) Questionnaire.


RESULTS
The study subjects were 2161 CHF patients (1412 PC; 749 Cardiology). Patients were older and had more severe disease in PC than in Cardiology settings. Their HRQL scores were likewise worse. After adjusting for clinical variables, the differences in global and physical MLWHF disappeared, but persisted to a smaller degree in EQ-5D and mental MLWHF. HRQL was worse than in a representative sample of the Spanish population and in other chronic conditions such as rheumatoid arthritis or type 2 diabetes, being only comparable to severe chronic obstructive pulmonary disease (COPD).


CONCLUSIONS
All domains of HRQL were significantly impaired in CHF patients. Differences found in HRQL between PC and Cardiology should possibly be attributed to a large extent to the different clinical characteristics of the patients attended. In spite of the differences between EQ-5D and MLWHF, our results suggest that both questionnaires adequately reflect the severity of the disease.
Medical Department, AstraZeneca Farmacéutica Spain, S.A., Parque Norte, Edificio Roble, Serrano Galvache, 56, 28033, Madrid, Spain. rivasotero@yahoo.es
Beatriz
B
de Rivas
Gaietà
G
Permanyer-Miralda
Carlos
C
Brotons
Joaquín
J
Aznar
Eduardo
E
Sobreviela
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011788:Quality of Life; D013030:Spain / Q000453:epidemiology; D055815:Young Adult