Disability and quality of life in heart failure patients: a cross-sectional study

Abstract

Background: Although both hospitalization and mortality due to heart failure (HF) have been widely studied, less is known about the impact of HF on disability and quality of life.

Aim: To assess the degree of disability and quality of life in HF patients attended at family medicine centres.

Design and setting: Cross-sectional study of a cohort of HF patients attended at family medicine centres.

Methods: Disability was assessed with the WHODAS 2 questionnaire, which provides a global and six domain scores that is understanding and communication, getting around, self-care, getting along with people, life activities and participation in society. Quality of life was assessed with the Minnesota Living with Heart Failure Questionnaire, which furnishes a global and two domain scores, physical and emotional.

Results: A breakdown of the results showed that 28% of patients had moderate disability and 16.7% had severe disability, with the most important areas affected being: life activities, 8.9% extreme disability and 30.3% severe disability; getting around, 34.6% severe disability and 2% extreme disability; and participation in society, 53.3% moderate-severe disability. Quality of life was mildly affected. New York Heart Association (NYHA) Functional Classification and sex were the major determinants of disability and quality of life. Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists were associated with better scores in the "getting around" and "life activity" domains.

Conclusion: HF patients in primary care show an important degree of disability and an acceptable quality of life.

Keywords: Disability; International Classification of Functioning Disability and Health; family practice; heart failure; primary health care; quality of life.