Authors

• Ksenija Tušek Bunc — Faculty of Medicine, University of Maribor, Maribor, Slovenia — ORCID: 0000-0003-1474-9090

Abstract

Background: Quality management of patients with coronary heart disease significantly contributes to better health-related quality of life (HRQoL). (1, 2) Patients and Methods: The study was cross-sectional and included 423 patients with coronary heart disease from 36 family medicine from all Slovenian regions. The purpose of the study was to identify factors associated with HRQoL at the patient level. A comprehensive questionnaire for patients included, among others, the standardized the EuroQol instrument (EQ-5D) for measuring quality of life. Multivariate regression analysis was performed. Results: The average age of participants was 68.0 (SD=10.8) years, 64.8% were male. Multivariate regression analysis of factors impacting the patient, the presence of vascular co-morbidity, and anxiety-depressive disorders on HRQoL (as measured by the Visual Analogue Scale), showed (**Table 1**) significant association between patient age, frequency of family practice visits, heart failure, anxiety-depressive disorders, and the patient chronic illness care evaluation (p10 years | 1.85 | (-2.46 – 6.16) | 2.19 | 0.04 | 0.84 | 0.399 | | Practice attendance within 12 months | -4.31 | (-6.96 – -1.65) | 1.35 | -0.15 | -3.19 | 0.002 | | Angina pectoris | 1.68 | (-2.05 – 5.41) | 1.90 | 0.04 | 0.89 | 0.376 | | Myocardial infarction | 2.68 | (-1.08 – 6.44) | 1.91 | 0.07 | 1.40 | 0.161 | | Stent/By pass | -3.62 | (-7.53 – 0.28) | 1.98 | -0.09 | -1.83 | 0.069 | | Heart failure | -6.86 | (-10.91 – -2.80) | 2.06 | -0.17 | -3.32 | 0.001 | | Stroke | 2.54 | (-4.89 – 9.97) | 3.78 | 0.03 | 0.67 | 0.502 | | Peripheral artery disease | -1.85 | (-5.95 – 2.25) | 2.08 | -0.04 | -0.89 | 0.376 | | Anxiety / Depression | -10.28 | (-14.17 – -6.39) | 1.98 | -0.25 | -5.20 | 10 years | 0.00 | (-0.04 – 0.04) | 0.02 | 0.00 | -0.03 | 0.973 | | Practice attendance within 12 months | -0.02 | (-0.04 – 0.00) | 0.01 | -0.08 | -1.87 | 0.062 | | Angina pectoris | -0.02 | (-0.05 – 0.01) | 0.02 | -0.05 | -1.24 | 0.216 | | Myocardial infarction | -0.03 | (-0.06 – 0.00) | 0.02 | -0.07 | -1.80 | 0.073 | | Heart failure | -0.05 | (-0.08 – -0.02) | 0.02 | -0.13 | -2.92 | 0.004 | | Stroke | 0.01 | (-0.05 – 0.07) | 0.03 | 0.02 | 0.39 | 0.698 | | PAD | -0.06 | (-0.10 – -0.03) | 0.02 | -0.15 | -3.64 | <0.001 | | Self-percived health | 0.10 | (0.08 – 0.12) | 0.01 | 0.45 | 10.24 | <0.001 | | Medication | 0.03 | (-0.06 – 0.12) | 0.05 | 0.03 | 0.72 | 0.475 | | Patient satisfaction (EUROPEP) | 0.00 | (-0.03 – 0.04) | 0.02 | 0.01 | 0.27 | 0.785 | | Patient assessment of chronic illness care (PACIC) | -0.01 | (-0.03 – 0.01) | 0.01 | -0.03 | -0.61 | 0.543 | [†] R˛=0.450; F = 18.386; p < 0.001 95% CI = 95% confidence interval; SE = standard error Discussion: HRQoL in patients with coronary artery disease is associated with patient characteristics, with vascular co-morbidity and anxiety-depressive disorders. Of the demographic factors related to HRQoL, older age is associated with a worse HRQoL. Another factor predicting a worse HRQoL is frequency of family practice visits. On the other hand, higher education, better self-assessment of health, and better assessment of chronic illness care are associated with a better HRQoL. Heart failure, peripheral artery disease, and anxiety-depressive disorders stand out as diseases predicting of a worse HRQoL.

Keywords

quality of life, patients, coronary heart disease

DOI

Literature

1. Dickens C, Cherrington A, McGowan L. Depression and health-related quality of life in people with coronary heart disease: a systematic review. Eur J Cardiovasc Nurs. 2012;11:265–75. https://doi.org/10.1177/1474515111430928
2. de Graaff JC, Ubbink DT, Kools EI, Chamuleau SA, Jacobs MJ. The impact of peripheral and coronary artery disease on health-related quality of life. Ann Vasc Surg. 2002;16:495–500. https://doi.org/10.1007/s10016-001-0121-9