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ABSTRACT
Objective: To describe satisfaction with current health status in patients with a recent history of an acute coronary syndrome (ACS) event and to determine the association between satisfaction and patient-specific variables.
Research design and methods: Patients from an ACS registry who were discharged from a university affiliated hospital over a 3-year period were mailed the study questionnaire.
Main outcomes measures: Data included demographics, cardiac-specific measures, and general health status (SF-8 PCS, MCS and the EQ-5D VAS) and health status preference weight (EQ-5D Health Index). Satisfaction with current health status was assessed by a single question derived for this study with a 5-point Likert scale from ‘not satisfied at all’ to ‘highly satisfied.’ ANOVA determined the association between levels of satisfaction and health status scores. A multivariate linear regression model determined the association of patient, disease, and treatment variables with satisfaction. Independent variables were determined to be significant if the p-value in the model was <0.05.
Results: Respondents (490, 40.3% response rate) averaged 65.2 ± 11.3 years of age; 71% male; 92% Caucasian; 64% with MI history; and 17% had their most recent cardiac event within 6 months. 63% of respondents were either mostly satisfied or highly satisfied with there current health status. Based on level of satisfaction, the mean PCS ranged from 36.9 ± 8.9 to 63.0 ± 6.2; mean MCS from 38.3 ± 13.1 to 55.7 ± 5.7; mean EQ-5D VAS from 37.0 ± 21.7 to 90.8 ± 20.7, and mean EQ-5D Health Index from 0.38 ± 0.3 to 0.93 ± 0.14, all ANOVA models p < 0.001. Statistically significant independent variables in the multivariate linear regression model included the number of symptoms, DASI cardiac function score, perceived severity of disease, and age. Satisfaction with current health state was associated with older age, fewer symptoms, better DASI cardiac function scores, and lower perceived severity of illness.
Conclusion: Health-related quality of life, or health status, and satisfaction with health status have a direct, positive association. Greater burden of illness and younger age were significantly associated with dissatisfaction with health status. Extrapolation of results is limited to determining association but not causation due to the cross sectional study design.
Acknowledgments
Declaration of interest: Grant support for this study was provided by the Clinical Research Resource Protocol fund administered by the University of Michigan College of Pharmacy. The investigators had sole control of the conduct of the study, interpretation of the results, and preparation of the manuscript. No additional assistance was used for the preparation of this manuscript.