Societal costs of non-cardiac chest pain compared with ischemic heart disease - a longitudinal study

Mourad, Ghassan; Alwin, Jenny; Strömberg, Anna; Jaarsma, Tiny

doi:10.1186/1472-6963-13-403

Cited by 62 publications

(58 citation statements)

References 27 publications

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“…Non-cardiac chest pain is a common condition and has been found to be associated with high healthcare utilization rendering high healthcare and societal costs [12,36]. Yet, few studies have previously described HRQoL in patients with NCCP.…”

Section: Discussionmentioning

confidence: 99%

The associations between psychological distress and health-related quality of life in patients with non-cardiac chest pain

Mourad

Alwin

Jaarsma

et al. 2020

Health Qual Life Outcomes

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Background: Recurrent chest pain episodes with no clear explanation may affect patients' psychological wellbeing and health-related quality of life (HRQoL) negatively. Despite the fact that a significant amount of patients with non-cardiac chest pain (NCCP) might have a history of Cardiac Disease (CD), there is today a lack of knowledge on how CD influences the association between psychological wellbeing and HRQoL in patients with NCCP. Therefore, the aim of this study is to describe HRQoL in patients with NCCP, with or without history of CD, and to explore the association between HRQoL and cardiac anxiety, depressive symptoms, fear of body sensations and somatization. Methods: Five hundred fifty-two patients discharged with NCCP from four hospitals in Southeast Sweden completed the EQ-5D, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9, Body Sensations Questionnaire, and Patient Health Questionnaire-15. Results: Fifty precent reported at least moderate problems regarding pain/discomfort and 25% reported at least moderate problems in the HRQoL dimensions mobility, usual activities, and anxiety/depression. Patients with NCCP and history of CD reported significantly lower HRQoL (p ≤ 0.05) compared to patients with NCCP without CD. In the total study population, cardiac anxiety, depressive symptoms, and somatization had weak significant negative associations (beta = 0.187-0.284, p < 0.001) with HRQoL. In patients with history of CD, the association between depressive symptoms and HRQoL was moderate (beta = − 0.339, p < 0.001), compared to weak association in patients without CD (beta = − 0.193, p < 0.001). On the other hand, the association between cardiac anxiety and HRQoL was weak in both patients with history of CD (beta = − 0.156, p = 0.05), and in those without (beta = − 0.229, p < 0.001). Conclusions: Patients with NCCP, in particular those with history of CD, reported low levels of HRQoL, which was associated with psychological distress. This should be considered when developing psychological interventions aiming to improve HRQoL in patients with NCCP.

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Section: Discussionmentioning

confidence: 99%

The associations between psychological distress and health-related quality of life in patients with non-cardiac chest pain

Mourad

Alwin

Jaarsma

et al. 2020

Health Qual Life Outcomes

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“…Despite the favourable prognosis [4,5,12,13], patients with NCCP suffer from recurrent chest pain and have been found to use out-patient healthcare to the same extent as patients with cardiac pain [14,15], leading to high healthcare and societal costs [16][17][18][19]. A possible mechanism for this can be psychological distress, although there could be physical causes that have not been detected yet.…”

Section: Introductionmentioning

confidence: 99%

Depressive Symptoms, Cardiac Anxiety, and Fear of Body Sensations in Patients with Non-Cardiac Chest Pain, and Their Relation to Healthcare-Seeking Behavior: A Cross-Sectional Study

Mourad

Strömberg

Johansson

et al. 2015

Patient

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Results: About 26 % (n=141) of the study participants reported at least moderate depressive symptoms, 42 % (n=229) reported at least moderate cardiac anxiety, and 62 % (n=337) reported some degree of fear of body sensations. We found a strong positive relationship between depressive symptoms and cardiac anxiety (rs=0.49, p<.01), depressive symptoms and fear of body sensations (rs=0.50, p<.01), and cardiac anxiety and fear of body sensations (rs=0.56, p<.01). About 60 % of the participants sought care due to chest pain once, 26 % 2-3 times, and the rest more than 3 times. In a multivariable regression analysis, and after adjusting for multi-morbidity, cardiac anxiety was the only variable independently associated with healthcare seeking behaviour. Conclusions:Patients with NCCP and many healthcare consultations had high levels of depressive symptoms and cardiac anxiety, and moderate levels of fear of body sensations.Cardiac anxiety had the strongest relationship with healthcare seeking behaviour, and may 2 therefore be an important target for intervention to alleviate suffering and reduce healthcare use and costs. Key points for decision makers• Patients with non-cardiac chest pain and many healthcare consultations experience high levels of depressive symptoms and cardiac anxiety, and moderate levels of fear of body sensations.• Depressive symptoms, cardiac anxiety and fear of body sensations are strongly related to each other and to healthcare seeking behaviour.• Cardiac anxiety influence healthcare seeking behaviour the most and should therefore be targeted with interventions to improve patient outcomes and reduce healthcare costs.3

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“…5,7 Naerri helmingur þeirra hafði leitað áður á bráðadeild vegna brjóstverkja og þeir áttu að meðaltali jafn margar fyrri komur og hjartasjúklingar. Miðað við þessar tölur og þann umtalsverða kostnað sem þekkt er að fylgi greiningu og meðhöndlun sjúklinga með ótilgreinda brjóstverki í heilbrigðiskerfinu annars vegar og samfélagslegan kostnað þeim tengdum hins vegar, 24,25 má gera ráð fyrir að heildarkostnaður vegna þeirra sé talsverður hérlendis.…”

Section: Umraeðaunclassified

Ótilgreindir brjóstverkir og tengsl við viðvarandi verkjaupplifun og vanlíðan

Svansdóttir

Hreggvidsdottir

Sigurdardottir

et al. 2018

LBL

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Hjarta-og aeðasjúkdómar eru meðal algengustu dánarorsaka í heiminum og er meðferðarkostnaður og álag vegna þeirra gríðar-legt innan heilbrigðisþjónustu í Evrópu.1 Vegna þeirrar miklu áhaettu sem fylgir hjartaáföllum og mikilvaegis bráðainngripa til að koma í veg fyrir dauðsföll eða varanlegan skaða, hefur verið brýnt fyrir fólki að leita sér laeknisaðstoðar hið fyrsta fái það skyndilegan brjóstverk.2 Eðli málsins samkvaemt geta brjóstverkir vakið upp ótta, kvíða og aðra vanlíðan og fjölgað komum á bráða-deildir.3 Hjá meirihluta sjúklinga sem leita aðstoðar vegna brjóst-verkja eða óþaeginda fyrir brjósti finnast hins vegar engin merki um hjartasjúkdóm við ítarlega skoðun og rannsóknir, né önnur bráð veikindi sem gaetu skýrt verkinn. Slík tilvik má skilgreina sem ótilgreinda brjóstverki (non-cardiac chest pain).4 Ótilgreindir brjóstverkir geta stafað af margvíslegum vefraenum orsökum á borð við vélindabakflaeði og stoðkerfisverki en einnig af sálraen-um þáttum, eins og kvíða og þunglyndi. 4,5 Algengi ótilgreindra brjóstverkja hefur aukist undanfarin ár 6 en talið er að 50-75% allra koma á hjartabráðamóttökur séu vegna þeirra.5,7 Skráðar voru yfir 5000 bráðakomur á hjartagátt Landspít-Inngangur: Ótilgreindir brjóstverkir eru endurteknir brjóstverkir sem stafa ekki af kransaeðasjúkdómi eða öðrum bráðum veikindum. Erlendar rannsóknir hafa sýnt að 50-75% heimsókna á hjartabráðadeildir séu vegna þeirra. Markmið þessarar rannsóknar var að meta algengi ótilgreindra brjóstverkja á bráðadeildum Landspítala og tengsl þeirra við áfram-haldandi verkjaupplifun, andlega líðan, lífsgaeði, og ánaegju með meðferð. Efniviður og aðferðir: Þátttakendur voru 390 sjúklingar (18-65 ára) sem komu á Hjartagátt (236) eða bráðamóttöku Landspítala (154) vegna brjóstverkja frá október 2015 fram í maí 2016. Þátttakendur svöruðu stöðl-uðum spurningalistum, einum til átta mánuðum eftir útskrift, um líkamleg einkenni, andlega líðan og lífsgaeði, auk spurninga um áframhaldandi verki og meðferð. Niðurstöður: Alls 72% (283) þátttakenda töldust hafa ótilgreinda brjóst-verki og 24% sjúklinga (91) höfðu greiningu á hjartasjúkdómi. Sjúklingar með ótilgreinda brjóstverki höfðu svipaða byrði líkamlegra einkenna og þunglyndis, en ívið meiri kvíða og streitu en hjartasjúklingar. Jafnt hlutfall hjartasjúklinga og sjúklinga með ótilgreinda brjóstverki fundu fyrir brjóst-verkjum eftir útskrift, eða 60%. Áframhaldandi brjóstverkir tengdust meiri kvíða (β=0,19, p<0,001) og þunglyndi (β=0,17, p<0,003) meðal sjúklinga með ótilgreinda brjóstverki, en ekki meðal hjartasjúklinga. Þrjátíu prósent sjúklinga með ótilgreinda brjóstverki skorti skýrar leiðbeiningar um við-brögð við áframhaldandi verkjum (samanborið við 19% hjartasjúklinga, p<0,05) og einungis 40% sjúklinga með ótilgreinda brjóstverki fengu upplýsingar um aðrar mögulegar orsakir brjóstverkja. Ályktanir: Ótilgreindir brjóstverkir voru algengir meðal sjúklinga á bráða-deildum Landspítala. Meirihluti þeirra sjúklinga hafði áframhaldandi brjóstverki eftir útskrift sem tengdust andlegri vanlíðan, og þriðjungi þ...

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Societal costs of non-cardiac chest pain compared with ischemic heart disease - a longitudinal study

Cited by 62 publications

References 27 publications

The associations between psychological distress and health-related quality of life in patients with non-cardiac chest pain

The associations between psychological distress and health-related quality of life in patients with non-cardiac chest pain

Depressive Symptoms, Cardiac Anxiety, and Fear of Body Sensations in Patients with Non-Cardiac Chest Pain, and Their Relation to Healthcare-Seeking Behavior: A Cross-Sectional Study

Ótilgreindir brjóstverkir og tengsl við viðvarandi verkjaupplifun og vanlíðan

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