Heart failure is a condition that generally results in deterioration of quality of life (QoL) in addition to increased risk of mortality. While both of these factors influence patient treatment goals, assessing and improving QoL as well as length of life has not been the primary focus of most contemporary research.
In an article published in Circulation: Cardiovascular Quality and Outcomes researchers evaluated the feasibility and utility of incorporating adjustments for QoL in the frequently used “percentage days alive and out of hospital” (%DAOH), an important patient-centered outcome that measures mortality and morbidity together with duration and frequency of hospital stays.
The authors gathered QoL scores at various time points for 847 participants from the GUIDE-IT trial and 796 participants from the SODIUM-HF trial and used these scores to adjust for the %DAOH, which was calculated as a ratio between the number of days alive and out of hospital and the total number of days of follow-up in the trial for each participant.
No significant differences in treatment effect were observed between the two treatment groups in either the GUIDE-IT or SODIUM-HF trial participants for QoL adjusted %DAOH, however, this measurement shows promise as a simple means to effectively incorporate a patient perspective within a valuable and influential measure of treatment effectiveness. The authors recognize that while there are still some limitations, this approach is another step in the right direction towards helping patients and clinicians better understand treatments options and reach patient goals.
This research was undertaken by the CVC’s Pishoy Gouda, MB, BCh, BAO, MSc (Interventional Cardiology Fellow), Sarah Rathwell, MSc, and Justin Ezekowitz, MBBCh, MSc, along with Eloisa Colin-Ramirez, PhD (Universidad Anáhuac México), G. Michael Felker, MD and Christopher M. O’Connor, MD (Duke Clinical Research Institute), Heather Ross, MD, MHSc (Toronto General Hospital), Jorge Escobedo, MD (Instituto Mexicano del Seguro Social), Peter Macdonald, MD (St Vincent’s Hospital Sydney), and Richard W. Troughton, MBChB (Christchurch Heart Institute).
