Abstract 344 Patient-reported outcomes in short-time follow-up after discharge of patients with advanced heart failure

Background:
Guidelines for heart failure management commonly focus on mortality, hospitalization, or surrogate measures such as change in ejection fraction as outcome parameter. Reducing symptoms and increasing functional capacity and quality of life are commonly articulated goals, but there is no consensus on how best to achieve these outcomes.

Aim:
We aimed to evaluate the feasibility of routinely measurement of a defined standard pragmatic patient-reported outcome set.

Methods:
We assessed a panel of PROM assessment tools proposed by the International Consortium for Health Outcomes Measurement (ICHOM) in patients with advanced heart failure three months after discharge from Heart failure unit. Patients completed the Kansas City Cardiomyopathy Questionnaire (KCCQ-12), PROMIS Physical Function Short Form 4a as (PROMIS-4a) well as EQ 5D and Patient Health Questionnaire-2 (PHQ-2).

Results:

We included n=99 patients (33% female; mean age 64 years ±16 SD) into the study. Three months later, n=79 (80%) participated in PROM assessment. Eight patient died, ten patients were lost to follow-up and two patient were still at the ward. Nearly all patients (97%) suffered from systolic heart failure and two thirds had a reduced right ventricular function. Patients reported a mean KCCQ-12 overall score of 29.7 points (±12.0 SD). PHQ-2 score ≥3 points was found in 20 patients (25%). Further, patients reported a mean PROMIS-4a sum score of 12.6 (±4.8 SD) and a mean EQ-5D VAS of 56.8 points (±21.1 SD). In all questionnaires, we found <10% missing values.

A vast majority of patients (73%) agreed that their responses provided good insight into their health state and limitations due to heart failure. 71% of patients would approve adjusting heart failure treatment based on their responses.

Conclusions:
We measured relatively low mean scores of all PROM assessment tools, underpinning the burden of disease in advanced heart failure. Low percentage of missing data hallmarks the feasibility of PROM assessment. We conclude that routinely PROM assessment and standardization might improve heart failure care, monitor quality of life and therefore permit comparison across several therapeutic strategies.

Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02087-y
Patient-reported outcomes in short-time follow-up after discharge of patients with advanced heart failure
T. Wagner¹, L. Zhou¹, C. Magnussen¹, P. Kirchhof¹, H. Grahn¹
¹Universitäres Herzzentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg;
Background: Guidelines for heart failure management commonly focus on mortality, hospitalization, or surrogate measures such as change in ejection fraction as outcome parameter. Reducing symptoms and increasing functional capacity and quality of life are commonly articulated goals, but there is no consensus on how best to achieve these outcomes. Aim: We aimed to evaluate the feasibility of routinely measurement of a defined standard pragmatic patient-reported outcome set. Methods: We assessed a panel of PROM assessment tools proposed by the International Consortium for Health Outcomes Measurement (ICHOM) in patients with advanced heart failure three months after discharge from Heart failure unit. Patients completed the Kansas City Cardiomyopathy Questionnaire (KCCQ-12), PROMIS Physical Function Short Form 4a as (PROMIS-4a) well as EQ 5D and Patient Health Questionnaire-2 (PHQ-2). Results: We included n=99 patients (33% female; mean age 64 years ±16 SD) into the study. Three months later, n=79 (80%) participated in PROM assessment. Eight patient died, ten patients were lost to follow-up and two patient were still at the ward. Nearly all patients (97%) suffered from systolic heart failure and two thirds had a reduced right ventricular function. Patients reported a mean KCCQ-12 overall score of 29.7 points (±12.0 SD). PHQ-2 score ≥3 points was found in 20 patients (25%). Further, patients reported a mean PROMIS-4a sum score of 12.6 (±4.8 SD) and a mean EQ-5D VAS of 56.8 points (±21.1 SD). In all questionnaires, we found <10% missing values. A vast majority of patients (73%) agreed that their responses provided good insight into their health state and limitations due to heart failure. 71% of patients would approve adjusting heart failure treatment based on their responses. Conclusions: We measured relatively low mean scores of all PROM assessment tools, underpinning the burden of disease in advanced heart failure. Low percentage of missing data hallmarks the feasibility of PROM assessment. We conclude that routinely PROM assessment and standardization might improve heart failure care, monitor quality of life and therefore permit comparison across several therapeutic strategies.
https://dgk.org/kongress_programme/ht2022/aP367.html