Quality of life post heart failure diagnosis: population-level trends in the U.S.
Abstract Background Individuals with heart failure (HF) experience various symptoms making both diagnosis and disease burden estimates challenging. While HF-specific patient-reported outcome measures (PROMs) are widely used, their focus on clinical cohorts limits their generalizability. Preference-b...
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BMC
2025-05-01
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| Series: | Health and Quality of Life Outcomes |
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| Online Access: | https://doi.org/10.1186/s12955-025-02372-0 |
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| author | Maria Alva Sarahfaye Dolman Slaven Sikirica Paul Kolm Katherine Andrade Zugui Zhang William S. Weintraub |
| author_facet | Maria Alva Sarahfaye Dolman Slaven Sikirica Paul Kolm Katherine Andrade Zugui Zhang William S. Weintraub |
| author_sort | Maria Alva |
| collection | DOAJ |
| description | Abstract Background Individuals with heart failure (HF) experience various symptoms making both diagnosis and disease burden estimates challenging. While HF-specific patient-reported outcome measures (PROMs) are widely used, their focus on clinical cohorts limits their generalizability. Preference-based measures like the EQ-5D enable standardized health-related quality of life (HRQoL) comparisons across conditions, supporting resource allocation decisions. The CDC’s Healthy Days (HD) Survey—a simple two-question tool that can be mapped to the EQ-5D—offers a broader approach to tracking HRQoL but remains underutilized in HF populations. Methods Using a nationally representative U.S. sample, we mapped HD Survey responses to EQ-5D utility scores to compare HRQoL between individuals with and without HF and examined changes in HRQoL over time. We assessed whether HD-derived scores align with HF-specific utility measures to support population-level health monitoring. Results Individuals with HF report significantly more physically unhealthy days (8.46 vs. 3.42) and mentally unhealthy days (5.42 vs. 3.86) compared to those without HF. HF respondents are, on average, 20 years older than those without HF, consistent with HF’s prevalence in older adults. The likelihood of an HF diagnosis is similar for men and women but higher among non-Hispanic whites and blacks than Hispanics and other races. Those with HF are more likely to have health insurance. Adjusting for age, sex, race, and insurance, mean EQ-5D utility scores for individuals with and without HF are 0.785 (95% CI: 0.714–0.825) and 0.840 (95% CI: 0.827–0.851), respectively. Utility scores for HF patients remain significantly lower than those without HF up to 10 years post-diagnosis. Conclusion HF reduces HRQoL by 6.55%, surpassing the clinically significant threshold of a 1–2% decrement. These findings highlight the potential of the HD Survey to inform public health monitoring and underscore the need for tailored interventions to address HRQoL deficits in HF populations. |
| format | Article |
| id | doaj-art-c830c4c8105d4d38bf51b9dca5f0f9b9 |
| institution | DOAJ |
| issn | 1477-7525 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Health and Quality of Life Outcomes |
| spelling | doaj-art-c830c4c8105d4d38bf51b9dca5f0f9b92025-08-20T03:22:11ZengBMCHealth and Quality of Life Outcomes1477-75252025-05-012311710.1186/s12955-025-02372-0Quality of life post heart failure diagnosis: population-level trends in the U.S.Maria Alva0Sarahfaye Dolman1Slaven Sikirica2Paul Kolm3Katherine Andrade4Zugui Zhang5William S. Weintraub6Department of Health Management and Policy, Georgetown UniversityMedStar Health Research InstituteLexicon PharmaceuticalsMedStar Health Research InstituteOptum Life SciencesChristiana Care Health SystemMedStar Health Research InstituteAbstract Background Individuals with heart failure (HF) experience various symptoms making both diagnosis and disease burden estimates challenging. While HF-specific patient-reported outcome measures (PROMs) are widely used, their focus on clinical cohorts limits their generalizability. Preference-based measures like the EQ-5D enable standardized health-related quality of life (HRQoL) comparisons across conditions, supporting resource allocation decisions. The CDC’s Healthy Days (HD) Survey—a simple two-question tool that can be mapped to the EQ-5D—offers a broader approach to tracking HRQoL but remains underutilized in HF populations. Methods Using a nationally representative U.S. sample, we mapped HD Survey responses to EQ-5D utility scores to compare HRQoL between individuals with and without HF and examined changes in HRQoL over time. We assessed whether HD-derived scores align with HF-specific utility measures to support population-level health monitoring. Results Individuals with HF report significantly more physically unhealthy days (8.46 vs. 3.42) and mentally unhealthy days (5.42 vs. 3.86) compared to those without HF. HF respondents are, on average, 20 years older than those without HF, consistent with HF’s prevalence in older adults. The likelihood of an HF diagnosis is similar for men and women but higher among non-Hispanic whites and blacks than Hispanics and other races. Those with HF are more likely to have health insurance. Adjusting for age, sex, race, and insurance, mean EQ-5D utility scores for individuals with and without HF are 0.785 (95% CI: 0.714–0.825) and 0.840 (95% CI: 0.827–0.851), respectively. Utility scores for HF patients remain significantly lower than those without HF up to 10 years post-diagnosis. Conclusion HF reduces HRQoL by 6.55%, surpassing the clinically significant threshold of a 1–2% decrement. These findings highlight the potential of the HD Survey to inform public health monitoring and underscore the need for tailored interventions to address HRQoL deficits in HF populations.https://doi.org/10.1186/s12955-025-02372-0Heart failureHealthy days (HD) surveyEQ-5D utility scoresHealth-related quality of life (HRQoL) |
| spellingShingle | Maria Alva Sarahfaye Dolman Slaven Sikirica Paul Kolm Katherine Andrade Zugui Zhang William S. Weintraub Quality of life post heart failure diagnosis: population-level trends in the U.S. Health and Quality of Life Outcomes Heart failure Healthy days (HD) survey EQ-5D utility scores Health-related quality of life (HRQoL) |
| title | Quality of life post heart failure diagnosis: population-level trends in the U.S. |
| title_full | Quality of life post heart failure diagnosis: population-level trends in the U.S. |
| title_fullStr | Quality of life post heart failure diagnosis: population-level trends in the U.S. |
| title_full_unstemmed | Quality of life post heart failure diagnosis: population-level trends in the U.S. |
| title_short | Quality of life post heart failure diagnosis: population-level trends in the U.S. |
| title_sort | quality of life post heart failure diagnosis population level trends in the u s |
| topic | Heart failure Healthy days (HD) survey EQ-5D utility scores Health-related quality of life (HRQoL) |
| url | https://doi.org/10.1186/s12955-025-02372-0 |
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