Worse patient-reported outcomes, including lower physical/mental health and higher depression/anxiety, were significantly correlated with greater concern about future health (p<0.001).
Cross-Sectional (n=8,224)
Yes
In adults with congenital heart disease, greater concern about future health is significantly associated with worse physical and mental health status, lower quality of life, and higher depression and anxiety symptoms.
Effect estimate: r=-0.332 for PCS, r=0.264 for GAD-7
p-value: p=<0.001
Abstract Background Patient-reported outcomes (PROs) provide important insights into patients’ perspectives on living with their health conditions. PROs can be influenced by care already received, and may also shape patients’ expectations regarding future health. This is particularly relevant for individuals with chronic and lifelong conditions, such as congenital heart disease (CHD) Purpose To explore relationships between PROs and level of concern adults with CHD have about their future health. Methods This study is part of the ‘Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease – International Study II’ (APPROACH-IS II), an international cross-sectional investigation conducted in 32 countries across six continents. A total of 8,224 adults with CHD were enrolled (mean age 35.5y SD: 13.5; 54% women). PROs included perceived health status measured using the RAND-12 Health Survey (Physical Component Summary PCS and Mental Component Summary MCS) and the EuroQOL-5D Visual Analog Scale (EQ-VAS); depressive symptoms assessed with the Patient Health Questionnaire-8 (PHQ-8); anxiety measured using the General Anxiety Disorder-7 (GAD-7) and quality of life measured using a Linear Analog Scale (LASQOL). For the present study, we focused on one item from the assessment of advance care planning needs: "On a scale from 0 to 10, how concerned are you about your health in the future?" Bivariate analyses were conducted using Pearson correlation coefficients. Non-linearity was examined using restricted cubic splines with 4 knots. Results Participants’ mean score for concern about their future health was 5.6 (SD: 2.9). This value was statistically significantly correlated (p0.001) with all PROs: PCS (r=−0.332), MCS (r=−0.292), EQ-VAS (r=−0.293), PHQ-8 (r=0.257), GAD-7 (r=0.264), and LASQOL (r=−0.250). Visual inspection of the cubic splines (Fig 1) suggested that the relationships exhibited predominantly non-linear characteristics. Conclusion Greater concern about future health was associated with lower physical and mental health status and quality of life and higher depression and anxiety symptoms. The cross-sectional design of this study, however, does not allow to draw conclusions about the direction of effect. The observed associations were non-linear, indicating that the strength of the relationships varied across the range of PRO levels.
Desmedt et al. (Wed,) conducted a cross-sectional in congenital heart disease (CHD) (n=8,224). Patient-reported outcomes (PROs) was evaluated on Concern about future health (scale 0-10) (r=-0.332 for PCS, r=0.264 for GAD-7, p=<0.001). Worse patient-reported outcomes, including lower physical/mental health and higher depression/anxiety, were significantly correlated with greater concern about future health (p<0.001).