Skip to main content
Erschienen in: Advances in Therapy 4/2021

06.03.2021 | Original Research

From Health-Related Quality of Life (HRQoL) of Patients with Pulmonary Hypertension to Patient Experience with the Care Received: Should We Be More Aware of Current Patient Needs?

verfasst von: Amaya Martínez Meñaca, Isabel Blanco Vich, Manuel López Meseguer, Raquel López Reyes, Pedro Bedate Díaz, Teresa Elías Hernández, Inés Fernández-Cuesta Peñafiel, Gonzalo Fernández, Ana Álvez Liste, Pilar Escribano Subías

Erschienen in: Advances in Therapy | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Self-perceived health-related quality of life (HRQoL) of patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) and their experience with the care received are important for improving their management. We conducted a study to assess both patient-reported outcomes (PROs) and how they interrelate.

Methods

This was a cross-sectional, observational study of consecutive patients with PAH and CTEPH attending pulmonary hypertension (PH)-specialized units at 25 hospitals in Spain. PRO measurements used included CAMPHOR/EQ-5D-5L questionnaires (HRQoL) and IEXPAC (healthcare experience). Patient characteristics were collected. Relationships were analysed with Pearson’s correlation coefficient and linear regression analyses.

Results

A total of 185 patients with PAH and 93 patients with CTEPH aged 54.4 ± 14.4 and 64.8 ± 13.4 years were included: 63.6% and 72% were functional class (FC) I–II; median time from diagnosis was 3 and 2 years, respectively. Most patients with PAH received combination oral therapy. CAMPHOR scores indicated moderate-to-high impairment in the “activity” scale (PAH 21.6 ± 6.8; CTEPH 21.0 ± 6.3). EQ-5D-5L index and visual analogue scale (VAS) score (PAH 0.59 ± 0.15 and 65.55 ± 21.54; CTEPH 0.59 ± 0.13 and 66.95 ± 18.71, respectively) indicated moderate HRQoL impairment. HRQoL was mostly affected by FC. IEXPAC scores (PAH 7.08 ± 1.56 and CTEPH 7.13 ± 1.61) indicated good healthcare experience. In patients with PAH, the CAMPHOR “symptom” and “QoL” domains inversely correlated with the IEXPAC “patient self-management” factor.

Conclusion

In patients with long-standing PAH and CTEPH with good disease control, functional limitations greatly impact HRQoL while symptoms and generic QoL were less affected. Healthcare received was perceived as good; however, use of information and communication technologies, patient associations and promotion of self-management should improve for enhanced patient experience.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Sitbon O, Gomberg-Maitland M, Granton J, et al. Clinical trial design and new therapies for pulmonary arterial hypertension. Eur Respir J. 2019;53:1801908.CrossRef Sitbon O, Gomberg-Maitland M, Granton J, et al. Clinical trial design and new therapies for pulmonary arterial hypertension. Eur Respir J. 2019;53:1801908.CrossRef
3.
Zurück zum Zitat Guillevin L, Armstrong I, Aldrighetti R, et al. Understanding the impact of pulmonary arterial hypertension on patients’ and carers’ lives. Eur Respir Rev. 2013;22:535–42.CrossRef Guillevin L, Armstrong I, Aldrighetti R, et al. Understanding the impact of pulmonary arterial hypertension on patients’ and carers’ lives. Eur Respir Rev. 2013;22:535–42.CrossRef
4.
Zurück zum Zitat Delcroix M, Howard L. Pulmonary arterial hypertension: the burden of disease and impact on quality of life. Eur Respir Rev. 2015;24:621–9.CrossRef Delcroix M, Howard L. Pulmonary arterial hypertension: the burden of disease and impact on quality of life. Eur Respir Rev. 2015;24:621–9.CrossRef
5.
Zurück zum Zitat Galiè N, Humbert M, Vachiery JL, et al. ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2016;37:67–119.CrossRef Galiè N, Humbert M, Vachiery JL, et al. ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2016;37:67–119.CrossRef
6.
Zurück zum Zitat Schipper H, Clinch J, Powell V. Definitions and conceptual issues. In: Spilker B, editor. Quality of life assessments in clinical trials. New York: Raven; 1990. p. 11–24. Schipper H, Clinch J, Powell V. Definitions and conceptual issues. In: Spilker B, editor. Quality of life assessments in clinical trials. New York: Raven; 1990. p. 11–24.
7.
Zurück zum Zitat Chen H, Taichman DB, Doyle RL. Health-related quality of life and patient-reported outcomes in pulmonary arterial hypertension. Proc Am Thorac Soc. 2008;5:623–30.CrossRef Chen H, Taichman DB, Doyle RL. Health-related quality of life and patient-reported outcomes in pulmonary arterial hypertension. Proc Am Thorac Soc. 2008;5:623–30.CrossRef
8.
Zurück zum Zitat Revicki DA, Osoba D, Fairclough D, et al. Recommendations on health-related quality of life research to support labeling and promotional claims in the United States. Qual Life Res. 2000;9:887–900.CrossRef Revicki DA, Osoba D, Fairclough D, et al. Recommendations on health-related quality of life research to support labeling and promotional claims in the United States. Qual Life Res. 2000;9:887–900.CrossRef
9.
Zurück zum Zitat Chin KM, Gomberg-Maitland M, Channick RN, et al. Psychometric validation of the pulmonary arterial hypertension-symptoms and impact (PAH-SYMPACT) questionnaire: results of the SYMPHONY trial. Chest. 2018;154:848–61.CrossRef Chin KM, Gomberg-Maitland M, Channick RN, et al. Psychometric validation of the pulmonary arterial hypertension-symptoms and impact (PAH-SYMPACT) questionnaire: results of the SYMPHONY trial. Chest. 2018;154:848–61.CrossRef
10.
Zurück zum Zitat Rector TS, Kubo SH, Cohn JN. Patients’ self-assessment of their congestive heart failure: content, reliability and validity of a new measure, the Minnesota Living with Heart Failure Questionnaire. Heart Fail. 1987;1:198–209. Rector TS, Kubo SH, Cohn JN. Patients’ self-assessment of their congestive heart failure: content, reliability and validity of a new measure, the Minnesota Living with Heart Failure Questionnaire. Heart Fail. 1987;1:198–209.
11.
Zurück zum Zitat Yorke J, Corris P, Gaine S, et al. emPHasis-10: development of a health-related quality of life measure in pulmonary hypertension. Eur Respir J. 2014;43:1106–13.CrossRef Yorke J, Corris P, Gaine S, et al. emPHasis-10: development of a health-related quality of life measure in pulmonary hypertension. Eur Respir J. 2014;43:1106–13.CrossRef
12.
Zurück zum Zitat McKenna SP, Doughty N, Meads DM, et al. The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR): a measure of health-related quality of life and quality of life for patients with pulmonary hypertension. Qual Life Res. 2006;15:103–15.CrossRef McKenna SP, Doughty N, Meads DM, et al. The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR): a measure of health-related quality of life and quality of life for patients with pulmonary hypertension. Qual Life Res. 2006;15:103–15.CrossRef
13.
Zurück zum Zitat Galiè N, Channick RN, Frantz RP, et al. Risk stratification and medical therapy of pulmonary arterial hypertension. Eur Respir J. 2019;53:1801889.CrossRef Galiè N, Channick RN, Frantz RP, et al. Risk stratification and medical therapy of pulmonary arterial hypertension. Eur Respir J. 2019;53:1801889.CrossRef
14.
Zurück zum Zitat Doward LC, McKenna SP. Defining patient-reported outcomes. Value Health. 2004;7:S4-8.CrossRef Doward LC, McKenna SP. Defining patient-reported outcomes. Value Health. 2004;7:S4-8.CrossRef
15.
Zurück zum Zitat Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;3(1):e001570.CrossRef Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;3(1):e001570.CrossRef
17.
Zurück zum Zitat Mira JJ, Nuno-Solinis R, Guilabert-Mora M, et al. Development and validation of an instrument for assessing patient experience of chronic illness care. Int J Integr Care. 2016;16:13.CrossRef Mira JJ, Nuno-Solinis R, Guilabert-Mora M, et al. Development and validation of an instrument for assessing patient experience of chronic illness care. Int J Integr Care. 2016;16:13.CrossRef
18.
Zurück zum Zitat Escribano-Subias P, Blanco I, Lopez-Meseguer M, et al. Survival in pulmonary hypertension in Spain: insights from the Spanish registry. Eur Respir J. 2012;40:596–603.CrossRef Escribano-Subias P, Blanco I, Lopez-Meseguer M, et al. Survival in pulmonary hypertension in Spain: insights from the Spanish registry. Eur Respir J. 2012;40:596–603.CrossRef
19.
Zurück zum Zitat Hoeper MM, Bogaard HJ, Condliffe R, et al. Definitions and diagnosis of pulmonary hypertension. J Am Coll Cardiol. 2013;62:D42-50.CrossRef Hoeper MM, Bogaard HJ, Condliffe R, et al. Definitions and diagnosis of pulmonary hypertension. J Am Coll Cardiol. 2013;62:D42-50.CrossRef
20.
Zurück zum Zitat Aguirre-Camacho A, Stepanous J, Blanco-Donoso LM, et al. Adaptation and validation of the Cambridge pulmonary hypertension outcome review (CAMPHOR) for use in Spain. Rev Esp Cardiol (Engl Ed). 2017;70:467–73.CrossRef Aguirre-Camacho A, Stepanous J, Blanco-Donoso LM, et al. Adaptation and validation of the Cambridge pulmonary hypertension outcome review (CAMPHOR) for use in Spain. Rev Esp Cardiol (Engl Ed). 2017;70:467–73.CrossRef
21.
Zurück zum Zitat Badia X, Roset M, Montserrat S, et al. The Spanish version of EuroQol: a description and its applications. European Quality of Life scale. Med Clin (Barc). 1999;112:79–85. Badia X, Roset M, Montserrat S, et al. The Spanish version of EuroQol: a description and its applications. European Quality of Life scale. Med Clin (Barc). 1999;112:79–85.
22.
Zurück zum Zitat McCabe C, Bennett M, Doughty N, et al. Patient-reported outcomes assessed by the CAMPHOR questionnaire predict clinical deterioration in idiopathic pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Chest. 2013;144:522–30.CrossRef McCabe C, Bennett M, Doughty N, et al. Patient-reported outcomes assessed by the CAMPHOR questionnaire predict clinical deterioration in idiopathic pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Chest. 2013;144:522–30.CrossRef
23.
Zurück zum Zitat The EuroQol Group. EuroQol-a new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199–208.CrossRef The EuroQol Group. EuroQol-a new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199–208.CrossRef
24.
Zurück zum Zitat Matura LA, McDonough A, Carroll D. Predictors of health-related quality of life in patients with idiopathic pulmonary arterial hypertension. J Hosp Palliat Nurs. 2012;14:282–92.CrossRef Matura LA, McDonough A, Carroll D. Predictors of health-related quality of life in patients with idiopathic pulmonary arterial hypertension. J Hosp Palliat Nurs. 2012;14:282–92.CrossRef
25.
Zurück zum Zitat Reis A, Santos M, Vicente M, et al. Health-related quality of life in pulmonary hypertension and its clinical correlates: a cross-sectional study. Biomed Res Int. 2018;2018:3924517.CrossRef Reis A, Santos M, Vicente M, et al. Health-related quality of life in pulmonary hypertension and its clinical correlates: a cross-sectional study. Biomed Res Int. 2018;2018:3924517.CrossRef
26.
Zurück zum Zitat Yorke J, Deaton C, Campbell M, et al. Symptom severity and its effect on health-related quality of life over time in patients with pulmonary hypertension: a multisite longitudinal cohort study. BMJ Open Respir Res. 2018;5:e000263.CrossRef Yorke J, Deaton C, Campbell M, et al. Symptom severity and its effect on health-related quality of life over time in patients with pulmonary hypertension: a multisite longitudinal cohort study. BMJ Open Respir Res. 2018;5:e000263.CrossRef
27.
Zurück zum Zitat Cenedese E, Speich R, Dorschner L, et al. Measurement of quality of life in pulmonary hypertension and its significance. Eur Respir J. 2006;28:808–15.CrossRef Cenedese E, Speich R, Dorschner L, et al. Measurement of quality of life in pulmonary hypertension and its significance. Eur Respir J. 2006;28:808–15.CrossRef
28.
Zurück zum Zitat Martínez-Meñaca A, Fernández-Cuesta Peñafiel IIB, et al. Relationship between comorbidities and quality of life perceived by patients diagnosed with pulmonary hypertension: pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Eur Respir J. 2019;54:PA1442. Martínez-Meñaca A, Fernández-Cuesta Peñafiel IIB, et al. Relationship between comorbidities and quality of life perceived by patients diagnosed with pulmonary hypertension: pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Eur Respir J. 2019;54:PA1442.
29.
Zurück zum Zitat Bussotti M, Sommaruga M. Anxiety and depression in patients with pulmonary hypertension: impact and management challenges. Vasc Health Risk Manag. 2018;14:349–60.CrossRef Bussotti M, Sommaruga M. Anxiety and depression in patients with pulmonary hypertension: impact and management challenges. Vasc Health Risk Manag. 2018;14:349–60.CrossRef
30.
Zurück zum Zitat Hernandez G, Garin O, Pardo Y, et al. Validity of the EQ-5D-5L and reference norms for the Spanish population. Qual Life Res. 2018;27:2337–48.CrossRef Hernandez G, Garin O, Pardo Y, et al. Validity of the EQ-5D-5L and reference norms for the Spanish population. Qual Life Res. 2018;27:2337–48.CrossRef
31.
Zurück zum Zitat Roman A, Barbera JA, Castillo MJ, et al. Health-related quality of life in a national cohort of patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. Arch Bronconeumol. 2013;49:181–8.CrossRef Roman A, Barbera JA, Castillo MJ, et al. Health-related quality of life in a national cohort of patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. Arch Bronconeumol. 2013;49:181–8.CrossRef
32.
Zurück zum Zitat Ivarsson B, Hesselstrand R, Radegran G, et al. Health-related quality of life, treatment adherence and psychosocial support in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. Chron Respir Dis. 2019;16:1479972318787906.CrossRef Ivarsson B, Hesselstrand R, Radegran G, et al. Health-related quality of life, treatment adherence and psychosocial support in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. Chron Respir Dis. 2019;16:1479972318787906.CrossRef
33.
Zurück zum Zitat Orozco-Beltran D, de Toro J, Galindo MJ, et al. Healthcare experience and their relationship with demographic, disease and healthcare-related variables: a cross-sectional survey of patients with chronic diseases using the IEXPAC scale. Patient. 2019;12:307–17.CrossRef Orozco-Beltran D, de Toro J, Galindo MJ, et al. Healthcare experience and their relationship with demographic, disease and healthcare-related variables: a cross-sectional survey of patients with chronic diseases using the IEXPAC scale. Patient. 2019;12:307–17.CrossRef
34.
Zurück zum Zitat Turner A, Anderson JK, Wallace LM, et al. An evaluation of a self-management program for patients with long-term conditions. Patient Educ Couns. 2015;98:213–9.CrossRef Turner A, Anderson JK, Wallace LM, et al. An evaluation of a self-management program for patients with long-term conditions. Patient Educ Couns. 2015;98:213–9.CrossRef
35.
Zurück zum Zitat Graarup J, Ferrari P, Howard LS. Patient engagement and self-management in pulmonary arterial hypertension. Eur Respir Rev. 2016;25:399–407.CrossRef Graarup J, Ferrari P, Howard LS. Patient engagement and self-management in pulmonary arterial hypertension. Eur Respir Rev. 2016;25:399–407.CrossRef
36.
Zurück zum Zitat Carman KL, Dardess P, Maurer M, et al. Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Aff (Millwood). 2013;32:223–31.CrossRef Carman KL, Dardess P, Maurer M, et al. Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Aff (Millwood). 2013;32:223–31.CrossRef
Metadaten
Titel
From Health-Related Quality of Life (HRQoL) of Patients with Pulmonary Hypertension to Patient Experience with the Care Received: Should We Be More Aware of Current Patient Needs?
verfasst von
Amaya Martínez Meñaca
Isabel Blanco Vich
Manuel López Meseguer
Raquel López Reyes
Pedro Bedate Díaz
Teresa Elías Hernández
Inés Fernández-Cuesta Peñafiel
Gonzalo Fernández
Ana Álvez Liste
Pilar Escribano Subías
Publikationsdatum
06.03.2021
Verlag
Springer Healthcare
Erschienen in
Advances in Therapy / Ausgabe 4/2021
Print ISSN: 0741-238X
Elektronische ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-021-01625-w

Weitere Artikel der Ausgabe 4/2021

Advances in Therapy 4/2021 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.