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Patients With HF Report Worse HRQOL Than Those With Cancer

Patients with heart failure (HF) experience worse health-related quality of life (HRQOL) than patients undergoing cancer treatment, according to a pooled analysis of Medicare Health Outcomes Survey data being presented at AHA 2023 and simultaneously published Nov. 6 in JACC: Heart Failure.

Kriti P. Shah, BA, et al., included survey data from 2016 to 2020 from participants ≥65 years old with a self-reported history of HF (n=71,025; 54% female, 16% Black) or current treatment for lung (n=4,165), colon (n=4,270), breast (n=14,542) or prostate (n= 7,670) cancer. Most common comorbidities present among HF participants were hypertension, coronary artery disease/myocardial infarction, diabetes, chronic obstructive pulmonary disease and depression. HRQOL was measured using the Veterans RAND-12 physical component score (PCS) and mental component score (MCS). Scores range from zero to 100 with a mean score of 50 – based on the general U.S. population – and standard deviation of 10. Pairwise Student’s t-tests were used to analyze difference in scores among groups.

Patients with HF had a mean PCS of 29.5 and mean MCS of 47.9. The mean PCS among HF patients was significantly lower than scores for participants actively receiving cancer treatment, including lung (31.2), colorectal (35.6), breast (37.7) and prostate (39.6) cancer (all p<0.001). The same was found for MCS, with the mean for HF patients lower than the mean scores for lung (49.5), colon (50.0), breast (52.0) and prostate (53.0) cancer patients (all p<0.001).

Study authors note that “the magnitude of difference was relatively small between HF and lung cancer and larger between HF and colorectal, breast and prostate cancers.”

They also caution that the Medicare Advantage patient population is not fully representative of the general HF population. Additional study limitations were the survey response rate of 37.5% to 45.0%, which may lead to biased results, and lack of more specific data like type of HF, stage of cancer and treatment regimen.

“Our findings underscore the importance of having discussions with people with HF about their prognosis, the need to rapidly initiate and optimize guideline-directed medical therapy in people with HF analogously to the urgency of chemotherapy administration, and the importance of prioritizing multidisciplinary care,” state the authors.

Clinical Topics: Heart Failure and Cardiomyopathies, Prevention, Atherosclerotic Disease (CAD/PAD), Acute Heart Failure, Hypertension

Keywords: Outcome Assessment, Health Care, Heart Failure, Pulmonary Disease, Chronic Obstructive, Hypertension, Diabetes Mellitus, Myocardial Infarction, Lung, Prostate, Depression, Medicare, Self Report, Quality of Life, Coronary Artery Disease, AHA23, American Heart Association

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