Health-Related Quality of Life and Its Influencing Factors in Patients with Coronary Heart Disease in China

Abstract

Lei Dou,1– 3 Zhuxin Mao,4 Qiang Fu,5 Gang Chen,6 Shunping Li1– 3 1Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China; 2NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, People’s Republic of China; 3Center for Health Preference Research, Shandong University, Jinan, People’s Republic of China; 4School of Insurance, Southwestern University of Finance and Economics, Chengdu, People’s Republic of China; 5Department of Cardiovascular Surgery, General Hospital of Tianjin Medical University, Tianjin, People’s Republic of China; 6Center for Health Economics, Monash Business School, Monash University, Melbourne, VIC, AustraliaCorrespondence: Shunping Li, Center for Health Management and Policy Research, School of Public Health, Shandong University, Wenhua Xi Road 44, Jinan, Shandong Province, 250012, People’s Republic of China, Tel +86-131-8893-4998, Email lishunping@sdu.edu.cnPurpose: This study aimed to comprehensively evaluate Chinese coronary heart disease (CHD) patients’ health-related quality of life (HRQoL) using various measures and explore influencing factors associated with HRQoL.Methods: A cross-sectional study was conducted from April to September 2019 in the General Hospital of Tianjin Medical University. A convenience sampling framework was used to successively recruit 316 inpatients with CHD. Two generic preference-based instruments (EQ-5D-5L and 15D), a disease-specific instrument (Seattle Angina Questionnaire, SAQ), and the WHO-5 well-being index (WHO-5) were administered. Tobit regression model and multiple linear regression were used for data analyses.Results: A total of 305 patients (mean age was 62.9) with CHD participated in this study. The mean health state utility (HSU) scores of EQ-5D-5L and 15D were 0.85 (SD=0.14) and 0.89 (SD=0.07), respectively. For EQ-5D-5L, pain/discomfort was the most frequently reported, followed by anxiety/depression. As for 15D, discomfort and symptoms was the most severely impaired dimension. For SAQ, more limitations were found in the domains of angina stability and disease perception. For WHO-5, the mean score was 16.93. Marital status, disease state and comorbidity were influencing factors associated with HRQoL, patient’s subjective well-being had a positive impact on HRQoL.Conclusion: To improve the HRQoL of CHD patients in China, more attention needs to be paid to unmarried and relapsed patients, especially those with comorbidity of hypertension. Additionally, more social support and psychological counseling should be provided to patients.Keywords: coronary heart disease, health-related quality of life, subjective well-being, EQ-5D-5L, 15D, SAQ