title: Self-Rated Health Among Patients with Coronary Artery Disease Enrolled in a Cardiovascular Risk Reduction Service.
abstract: Little is known about the use of the single self-rated health (SRH) status item measuring health-related quality of life among people with coronary artery disease (CAD). The objective of this study was to assess relationships between SRH and recurrent coronary events, mortality, health care utilization, and intermediate clinical outcomes and to assess predictors of fair/poor SRH. A total of 5573 patients enrolled in a comprehensive cardiac risk reduction service managed by clinical pharmacy specialists were evaluated over a 2-year period. Regression modeling explored relationships among variables, modeling SRH separately as an independent and a dependent variable. The 1374 (24.7%) respondents reporting fair/poor SRH differed statistically from 4199 (75.3%) respondents reporting good/very good/excellent SRH in terms of age, sex, ethnicity, number of comorbid conditions, DxCG scores, lifestyle behaviors, blood pressure control, and inpatient and emergency department (ED) utilization. Respondents reporting fair/poor health were more likely to have recurrent major coronary events (MCE), including death. Fair/poor SRH was consistently statistically significant when it was included as a predictor in regression modeling for poor blood pressure control, health care utilization, MCE, and all-cause mortality. Variables associated with fair/poor SRH in regression modeling included females, Hispanic ethnicity, ≥1 baseline ED visit, and DxCG score. Exercising <30 minutes per week was strongly associated with fair/poor SRH. Single-item SRH status may help identify patients with CAD at higher risk of poor blood pressure control, recurrent MCE, and death and those who may benefit from interventions to increase physical activity.
authors.affiliation: 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado.
authors.forename: Kari L
authors.initials: KL
authors.lastname: Olson
authors.affiliation: 2 Center for Population Health, Care Management Institute , Kaiser Permanente, Oakland, California.
authors.forename: Matt
authors.initials: M
authors.lastname: Stiefel
authors.affiliation: 3 Institute for Health Research , Kaiser Permanente Colorado, Denver, Colorado.
authors.forename: Colleen
authors.initials: C
authors.lastname: Ross
authors.affiliation: 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado.
authors.forename: Sheila
authors.initials: S
authors.lastname: Stadler
authors.affiliation: 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado.
authors.forename: Roseanne
authors.initials: R
authors.lastname: Hornak
authors.affiliation: 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado.
authors.forename: Brian
authors.initials: B
authors.lastname: Sandhoff
authors.affiliation: 4 Colorado Permanente Medical Group , Aurora, Colorado.
authors.forename: John A
authors.initials: JA
authors.lastname: Merenich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003120:Colorado; D003324:Coronary Artery Disease; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011315:Preventive Medicine; D012189:Retrospective Studies; D057566:Self Report