TY - JOUR
T1 - Patients with heart failure with and without a history of stroke in the Netherlands
T2 - a secondary analysis of psychosocial, behavioural and clinical outcomes up to three years from the COACH trial
AU - Ski, Chantal F
AU - van der Wal, Martje H L
AU - Le Grande, Michael
AU - van Veldhuisen, Dirk J
AU - Lesman-Leegte, Ivonne
AU - Thompson, David R
AU - Middleton, Sandy
AU - Cameron, Jan
AU - Jaarsma, Tiny
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2019.
PY - 2019/8/27
Y1 - 2019/8/27
N2 - Objective To identify differences in psychosocial, behavioural and clinical outcomes between patients with heart failure (HF) with and without stroke. Design and participants A secondary analysis of 1023 patients with heart failure enrolled in the Coordinating study evaluating Outcomes of Advising and Counselling in Heart failure. Setting Seventeen hospitals located across the Netherlands. Outcomes measures Depressive symptoms (Centre for Epidemiological Studies Depression Scale), quality of life (Minnesota Living with Heart Failure Questionnaire, Ladder of Life Scale), self-care (European Heart Failure Self-Care Behaviour Scale), adherence to HF management (modified version of the Heart Failure Compliance Questionnaire) and readmission for HF, cardiovascular-cause and all-cause hospitalisations at 18 months, and all-cause mortality at 18 months and 3 years. Results Compared with those without stroke, patients with HF with a stroke (10.3%; n=105) had twice the likelihood of severe depressive symptoms (OR 2.83, 95% CI 1.27 to 6.28, p=0.011; OR 2.24, 95% CI 1.03 to 4.88, p=0.043) at 12 and 18 months, poorer disease-specific and generic quality of life (OR 2.80, 95% CI 1.61 to 4.84, p<0.001; OR 2.00, 95% CI 1.09 to 3.50, p=0.019) at 12 months, poorer self-care (OR 1.80, 95% CI 1.05 to 3.11, p=0.034; OR 2.87, 95% CI 1.61 to 5.11, p<0.0011) and HF management adherence (OR 0.39, 95% CI 0.18 to 0.81, p=0.012; OR 0.35, 95% CI 0.17 to 0.72, p=0.004) at 12 and 18 months, higher rates of hospitalisations and mortality at 18 months and higher all-cause mortality (HR 1.43, 95% CI 1.07 to 1.91, p=0.016) at 3 years. Conclusions Patients with HF and stroke have worse psychosocial, behavioural and clinical outcomes, notably from 12 months, than those without stroke. To ameliorate these poor outcomes long-term, integrated disease management pathways are warranted.
AB - Objective To identify differences in psychosocial, behavioural and clinical outcomes between patients with heart failure (HF) with and without stroke. Design and participants A secondary analysis of 1023 patients with heart failure enrolled in the Coordinating study evaluating Outcomes of Advising and Counselling in Heart failure. Setting Seventeen hospitals located across the Netherlands. Outcomes measures Depressive symptoms (Centre for Epidemiological Studies Depression Scale), quality of life (Minnesota Living with Heart Failure Questionnaire, Ladder of Life Scale), self-care (European Heart Failure Self-Care Behaviour Scale), adherence to HF management (modified version of the Heart Failure Compliance Questionnaire) and readmission for HF, cardiovascular-cause and all-cause hospitalisations at 18 months, and all-cause mortality at 18 months and 3 years. Results Compared with those without stroke, patients with HF with a stroke (10.3%; n=105) had twice the likelihood of severe depressive symptoms (OR 2.83, 95% CI 1.27 to 6.28, p=0.011; OR 2.24, 95% CI 1.03 to 4.88, p=0.043) at 12 and 18 months, poorer disease-specific and generic quality of life (OR 2.80, 95% CI 1.61 to 4.84, p<0.001; OR 2.00, 95% CI 1.09 to 3.50, p=0.019) at 12 months, poorer self-care (OR 1.80, 95% CI 1.05 to 3.11, p=0.034; OR 2.87, 95% CI 1.61 to 5.11, p<0.0011) and HF management adherence (OR 0.39, 95% CI 0.18 to 0.81, p=0.012; OR 0.35, 95% CI 0.17 to 0.72, p=0.004) at 12 and 18 months, higher rates of hospitalisations and mortality at 18 months and higher all-cause mortality (HR 1.43, 95% CI 1.07 to 1.91, p=0.016) at 3 years. Conclusions Patients with HF and stroke have worse psychosocial, behavioural and clinical outcomes, notably from 12 months, than those without stroke. To ameliorate these poor outcomes long-term, integrated disease management pathways are warranted.
KW - comorbidity
KW - heart failure
KW - mortality
KW - psychosocial
KW - rehospitalisations
KW - stroke
UR - http://www.scopus.com/inward/record.url?scp=85071652849&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-025525
DO - 10.1136/bmjopen-2018-025525
M3 - Article
C2 - 31462460
SN - 2044-6055
VL - 9
SP - e025525
JO - BMJ Open
JF - BMJ Open
IS - 8
M1 - e025525
ER -