The relevance of health related quality of life in paced patients

Abstract

With the tremendous advances in cardiac pacing during the past four decades, cardiac pacemaker implantation is now a common clinical procedure. In recent years, the indications for permanent pacemakers have expanded. This increase in reasons for pacing and shift in mode of pacing have been caused by the evolution of pacemaker therapy from a life-saving measure (mortality), to one aimed at improving healthrelated quality of life (HRQoL). Until now the efficacy of pacing therapy has predominantly been measured using bobjectiveQ criteria. However, in recent years the importance of HRQoL as an outcome measure has increasingly been recognized as patients prefer quality over quantity of life.In this review we describe the development and testing of Aquarel, a new developed HRQoL questionnaire for pacemaker patients, composed of a generic core module with disease specific add-ons. Current and future research to improve the Aquarel questionnaire is also described. D 2005 Elsevier Ireland Ltd. All rights reserved.Keywords: Cardiac pacing; Quality of life; Aquarel In the Netherlands there is an increased implantation rate of cardiac pacemakers in patients of all ages over the past decade (Fig. 1). This increase in the number of implanted pacemaker-units and leads combined with a rising population age contribute to an increase in hospitalisation, care and follow-up. Until now the efficacy of pacing therapy has predominantly been measured using clinical outcomes such as improvement of prognosis, relief of symptoms, complications, technical failures and recalls. However, to evaluate the full spectrum of outcome of pacemaker therapy patient reported outcomes as well as clinical outcomes should be measured. In recent years the importance of health-related quality of life (HRQoL) as an outcome measure has increasingly been recognized [1,2]. This has particular relevance in cardiac pacing because the goal of therapy for most patients with chronic disease is improvement in function, not cure [3]. These measures should be incorporated as one of the primary measures of outcome in the evaluation of new therapies in chronic diseases including cardiac pacing. Doing so, clinicians, patients, policymakers, health care providers and HRQoL researchers gain experience with these measures.To measure HRQoL, appropriate instruments should be used and a large number of questionnaires has been developed in the past two decades. However, in the field of cardiac pacing until recently several instruments were used to measure HRQoL that were not properly validated and applied [4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Consequently these HRQoL data should be interpreted cautiously. HRQoL is typically measured either in a generic or a specific way. Generic means that an instrument gives information on several dimensions and is useful for a variety of illnesses, diseases and different (patient-) populations, allowing for comparison between these (patient-) populations. Disease specific questionnaires focus on dimensions most relevant ...

Correlation between quality of life, functional class and age in patients with cardiac pacemaker

“…Therefore, this study also showed a direct relationship of functional class, which reflects the degree of heart failure, quality of life in patients with pacemakers, confirming reports by other authors, such as Stofmeel et al [18] Oliveira et al [8,23]; Cunha et al [9].…”

“…However, it is still debatable the correlation between functional class and quality of life of definitive cardiac pacemaker users. This question is the basis of this study, therefore, it is necessary to deeply discuss the theme "functional capacity and quality of life in patients with pacemaker", as suggested in studies by Stofmeel et al [18] Oliveira et al [8] and Cunha et al [9].…”

Sensor Acceptance Model – Measuring Patient Acceptance of Wearable Sensors

“…In addition to thisq uestionnaire,H opp et al used separatequestionsmeasuring satisfaction with the telehealth equipmentf or the intervention group, with questionsfrom the National AmbulatoryC areS urvey, which theym odified for usei ne valuating telehealth services. Stofmeel et al [16] have developed andtested adisease-specificquestionnaire,Aquarel, for pacemaker patients, to investigateH RQoL.I tw as arguedt hat Aquarelcoversthe fullspectrumofrelevant outcomes, and can be used in addition to the SF-36 whichi sam ore genericH RQoL questionnaire.D oll et al [ 17] have formulatedamodel of End-User Computer Satisfaction as an instrument to evaluate systems to be compared, andDemiris hasdescribed importantp rinciplesi nd esign andt esting surveysfor telemedicine applications [18].…”

Quality of life of patients undergoing conventional vs leadless pacemaker implantation: A multicenter observational study

“…These changes are interesting; we found smaller positive intragroup differences than differences published in other QoL studies. Previous studies of QoL in patients with C‐PM showed important general improvements in QoL after implantation of a pacemaker, in terms of both physical and psychological health; however, the use of different tools to measure QoL makes comparisons difficult. We think our lower improvement can be explained by the mean age of our population (80 years), which is higher than the mean age in previous studies.…”