Hauber A Brett, Obi Engels N, Price Mark A, Whalley Diane, Chang Chun-Lan
a RTI Health Solutions , Research Triangle Park , NC , USA.
b Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA.
Curr Med Res Opin. 2017 Nov;33(11):2027-2038. doi: 10.1080/03007995.2017.1355782. Epub 2017 Aug 4.
To evaluate heart failure (HF) patients' disease knowledge and preferences for avoiding different disease outcomes.
An online survey was administered to 400 individuals with a self-reported diagnosis of HF to elicit relative importance weights (RIWs) for avoiding 11 potential HF symptoms and outcomes using best-worst scaling. The survey also included questions about individuals' HF knowledge, and demographic and disease-experience characteristics. Differences in RIWs among sub-groups, defined by HF knowledge, caregiver support, age, recent hospitalization or emergency room visit for HF, health-related quality-of-life, and cardiac device experience were examined.
Relative to limitations in usual activities (RIW 1.00), respondents preferred avoiding severe, infrequent cardiovascular events (e.g. stroke [RIW 8.51], heart transplant [RIW 7.84], or heart attack [RIW 5.3]) most, followed by difficulty breathing (RIW 2.55), inability to enjoy life (RIW 1.84), cardiac device implantation (RIW 1.74), and atrial fibrillation (RIW 1.57). Patients preferred avoiding swelling (RIW 0.47) and fatigue (RIW 0.58) least. RIWs for avoiding severe, infrequent events were higher among those with high disease knowledge, those without caregivers, and those without a recent hospitalization or emergency room visit.
Patients' preferences for avoiding HF outcomes vary across outcomes and by individuals' knowledge, caregiver status, and age. Healthcare providers should solicit and incorporate insights about patients' knowledge of HF and their preferences for avoiding HF outcomes into HF education and management planning efforts.
评估心力衰竭（HF）患者对疾病的了解程度以及对避免不同疾病结局的偏好。
对400名自我报告诊断为HF的个体进行在线调查，使用最佳-最差标度法得出避免11种潜在HF症状和结局的相对重要性权重（RIW）。该调查还包括有关个体HF知识、人口统计学和疾病经历特征的问题。研究了按HF知识、护理人员支持、年龄、近期因HF住院或急诊就诊、健康相关生活质量和心脏设备使用经历定义的亚组之间RIW的差异。
相对于日常活动受限（RIW 1.00），受访者最希望避免严重、不常见的心血管事件（如中风[RIW 8.51]、心脏移植[RIW 7.84]或心脏病发作[RIW 5.3]），其次是呼吸困难（RIW 2.55）、无法享受生活（RIW 1.84）、心脏设备植入（RIW 1.74）和心房颤动（RIW 1.57）。患者最不希望避免肿胀（RIW 0.47）和疲劳（RIW 0.58）。在疾病知识丰富、没有护理人员以及近期没有住院或急诊就诊的人群中，避免严重、不常见事件的RIW更高。
患者对避免HF结局的偏好因结局以及个体的知识、护理人员状况和年龄而异。医疗保健提供者应征求并将患者对HF的了解以及他们对避免HF结局的偏好纳入HF教育和管理规划工作中。
