title: Quality of life effects of automatic external defibrillators in the home: results from the Home Automatic External Defibrillator Trial (HAT).
abstract: BACKGROUND
  Public access automatic external defibrillators (AEDs) can save lives, but most deaths from out-of-hospital sudden cardiac arrest occur at home. The Home Automatic External Defibrillator Trial (HAT) found no survival advantage for adding a home AED to cardiopulmonary resuscitation (CPR) training for 7,001 patients with a prior anterior wall myocardial infarction. Quality of life (QOL) outcomes for both the patient and spouse/companion were secondary end points.
  
  
  METHODS
  A subset of 1,007 study patients and their spouse/companions was randomly selected for ascertainment of QOL by structured interview at baseline and 12 and 24 months after enrollment. The primary QOL measures were the Medical Outcomes Study 36-Item Short-Form psychological well-being (reflecting anxiety and depression) and vitality (reflecting energy and fatigue) subscales.
  
  
  RESULTS
  For patients and spouse/companions, the psychological well-being and vitality scales did not differ significantly between those randomly assigned an AED plus CPR training and controls who received CPR training only. None of the other QOL measures collected showed a clinically and statistically significant difference between treatment groups. Patients in the AED group were more likely to report being extremely or quite a bit reassured by their treatment assignment. Spouse/companions in the AED group reported being less often nervous about the possibility of using AED/CPR treatment than those in the CPR group.
  
  
  CONCLUSIONS
  Adding access to a home AED to CPR training did not affect QOL either for patients with a prior anterior myocardial infarction or their spouse/companion but did provide more reassurance to the patients without increasing anxiety for spouse/companions.
authors.affiliation: Outcomes Research Group, Duke Clinical Research Institute PO Box 17969 Durham, NC 27715, USA. daniel.mark@duke.edu
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Mark
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Anstrom
authors.forename: Steven E
authors.initials: SE
authors.lastname: McNulty
authors.forename: Greg C
authors.initials: GC
authors.lastname: Flaker
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Tonkin
authors.forename: Warren M
authors.initials: WM
authors.lastname: Smith
authors.forename: William D
authors.initials: WD
authors.lastname: Toff
authors.forename: Paul
authors.initials: P
authors.lastname: Dorian
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Clapp-Channing
authors.forename: Jill
authors.initials: J
authors.lastname: Anderson
authors.forename: George
authors.initials: G
authors.lastname: Johnson
authors.forename: Eleanor B
authors.initials: EB
authors.lastname: Schron
authors.forename: Jeanne E
authors.initials: JE
authors.lastname: Poole
authors.forename: Kerry L
authors.initials: KL
authors.lastname: Lee
authors.forename: Gust H
authors.initials: GH
authors.lastname: Bardy
mesh_terms: D000368:Aged; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D047548:Defibrillators; D005260:Female; D033062:Friends; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D018454:Spouses; D013315:Stress, Psychological / Q000209:etiology*