Patients with heart failure with and without a history of stroke in the Netherlands : A secondary analysis of psychosocial, behavioural and clinical outcomes up to three years from the COACH trial
Ski, Chantal F., van der Wal, Martje H. L., Le Grande, Michael R., van Veldhuisen, Dirk J., Lesman-Leegte, Ivonne, Thompson, David R., Middleton, Sandy, Cameron, Jan and Jaarsma, Tiny. (2019). Patients with heart failure with and without a history of stroke in the Netherlands : A secondary analysis of psychosocial, behavioural and clinical outcomes up to three years from the COACH trial. BMJ Open. 9(8), p. Article e025525. https://doi.org/10.1136/bmjopen-2018-025525
|Authors||Ski, Chantal F., van der Wal, Martje H. L., Le Grande, Michael R., van Veldhuisen, Dirk J., Lesman-Leegte, Ivonne, Thompson, David R., Middleton, Sandy, Cameron, Jan and Jaarsma, Tiny|
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.
|Journal citation||9 (8), p. Article e025525|
|Publisher||BMJ Publishing Group|
|Digital Object Identifier (DOI)||https://doi.org/10.1136/bmjopen-2018-025525|
|PubMed Central ID||PMC6720343|
|Open access||Published as ‘gold’ (paid) open access|
|Research or scholarly||Research|
|Research Group||Nursing Research Institute|
File Access Level
|Online||27 Aug 2019|
|Publication process dates|
|Accepted||07 Jun 2019|
|License: CC BY-NC 4.0|
|File access level: Open|
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