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    Health-related quality of life of heart failure and coronary artery disease patients improved during participation in disease management programs: a longitudinal observational study

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    Authors
    Martin, Marie
    Blaisdell-Gross, Bonnie
    Fortin, Elizabeth W.
    Maruish, Mark E.
    Manocchia, Michael
    Sun, Xiaowu
    Walker, David R.
    Apple, Joanna L.
    Ware, John E. Jr.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2007-06-26
    Keywords
    Adult
    Aged
    Aged, 80 and over
    Coronary Artery Disease
    Cost of Illness
    *Disease Management
    Female
    Health Surveys
    Heart Failure
    Humans
    Male
    Middle Aged
    Program Development
    *Program Evaluation
    Prospective Studies
    *Quality of Life
    Questionnaires
    *Sickness Impact Profile
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1089/dis.2007.103612
    Abstract
    The objective of the study was to examine the burden of coronary artery disease (CAD) and heart failure (HF) on health-related quality of life (HRQOL) and the HRQOL trajectory among participants in a disease management (DM) program characterized by personalized models of education, counseling, and supportive contact. In all, 2,590 CAD and 3,182 HF patients were assessed at baseline and at 3, 6, 9, and 12 months post-enrollment. HRQOL was measured via a computerized dynamic test, whose core consisted of SF-8 items. HRQOL burden was assessed by comparing physical component summary (PCS) and mental component summary (MCS) scores to demographically adjusted US norms and to historical controls. Disease trajectories were assessed with change score analyses and by a categorization of participants as improving, stable, or deteriorating. Among the results, both groups showed between 1.7 to 2.6 times the likelihood of improving over worsening after a full year of DM participation in all measures. In contrast, historical controls experienced no significant HRQOL improvement or decline after 2 years of standard treatment. After 1 or 2 years they were more likely to decline than to improve in their PCS scores and were about as likely to improve as to worsen in their MCS scores. In conclusion, HF places a substantial burden on HRQOL, and the burden of CAD is also noticeable. While the study design does not allow causal interpretations, HRQOL significantly improved for both CAD and HF patients during DM program participation. This trend is in contrast to historic controls, where no significant HRQOL improvement occurred over time.
    Source
    Dis Manag. 2007 Jun;10(3):164-78. Link to article on publisher's site
    DOI
    10.1089/dis.2007.103612
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47467
    PubMed ID
    17590147
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1089/dis.2007.103612
    Scopus Count
    Collections
    Population and Quantitative Health Sciences Publications

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