Hayashi Tomoko, Morita Yohei, Mitani Hironobu, Murayama Hiroki, Anzai Toshihisa, Studer Rachel, Cotton Sarah, Jackson James, Bailey Hollie, Kitagawa Hiroshi, Oyama Naotsugu
Medical Division, Novartis Pharma K.K. Tokyo Japan.
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine Hokkaido Japan.
Circ Rep. 2020 Nov 17;2(12):722-729. doi: 10.1253/circrep.CR-20-0073.
We investigated the impact of heart failure (HF) on daily life and satisfaction with current HF medication from the patient perspective in a real-world study in Japan. A cross-sectional survey of 154 HF patients treated by 58 cardiologists was conducted in Japan using patient self-completed questionnaires about their daily life and satisfaction with HF medication, as well as patient record forms completed by their physicians capturing corresponding data. The mean age of patients was 72.7 years. The proportion of patients within New York Heart Association Class I, II, III, and IV was 39%, 44%, 16%, and 1%, respectively. Symptoms reported by patients included dyspnea when active (46%), nocturia (43%), anxiety (18%), and depression (6%). There was a discordance between physician- and patient-reported symptoms, especially for nocturia and inability to sleep. The most frequent lifestyle recommendation from physicians was 'reduce salt/sodium intake', but only 51% of patients receiving this recommendation followed the advice. In all, 44% of patients reported dissatisfaction with their current medication; according to the patients, 27% reported no discussion with their physicians about their prescribed medication, while physicians reported the opposite. HF negatively impacts patient daily life. There is discordance between patients and physicians in symptom reporting, lifestyle modification advice and adherence, and reported medication decision making. Gaps in patient-physician communication exist.
在日本的一项真实世界研究中,我们从患者角度调查了心力衰竭(HF)对日常生活的影响以及患者对当前HF药物治疗的满意度。在日本,我们对58位心脏病专家治疗的154例HF患者进行了横断面调查,使用患者自行填写的关于其日常生活和对HF药物治疗满意度的问卷,以及由医生填写的记录表格来收集相应数据。患者的平均年龄为72.7岁。纽约心脏协会I级、II级、III级和IV级患者的比例分别为39%、44%、16%和1%。患者报告的症状包括活动时呼吸困难(46%)、夜尿症(43%)、焦虑(18%)和抑郁(6%)。医生报告的症状与患者报告的症状之间存在不一致,尤其是夜尿症和失眠。医生最常给出的生活方式建议是“减少盐/钠摄入量”,但接受该建议的患者中只有51%遵循了该建议。总体而言,44%的患者报告对当前药物治疗不满意;据患者称,27%的患者表示未与医生讨论过所开药物,而医生的报告则相反。HF对患者的日常生活产生负面影响。患者与医生在症状报告、生活方式改变建议及依从性以及药物治疗决策报告方面存在不一致。医患沟通存在差距。