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Symptoms and Functional Limitations in the First Year Following a Myocardial Infarction: A Qualitative Study

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Abstract

Background and Objectives

This qualitative interview study was designed to highlight the symptoms and functional limitations experienced by patients in the year following a myocardial infarction (MI). This information can support the use or development of patient-reported outcome (PRO) instruments in the post-MI population.

Methods

Individual face-to-face interviews were conducted with 38 participants who had experienced an MI (with or without ST segment elevation) within the past month to <6 months (n = 17), or 6 months to ≤12 months (n = 21). Using content and thematic analysis, patient reports of symptoms and functional limitations were coded and then grouped into categories. The specific content and frequency of the symptom and functional limitation reports were summarized.

Results

Nearly half of all symptom expressions were related to fatigue. Within this fatigue category, patients reported experiencing general tiredness, as well as a loss of physical energy, mental energy, and/or motivation. Chest pain and discomfort, sleep disruption, and shortness of breath were also frequently reported. Additionally, patients reported emotional effects, including worry and depression, as well as a negative impact on relationships and social activities.

Conclusions

Patients reported a wide variety of symptoms and functional limitations after an MI. Fatigue was the most commonly reported symptom and included several specific dimensions related to tiredness. Consideration of these concepts associated with the patient’s experience following an MI may yield novel endpoints for use in clinical trials and better therapies.

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Acknowledgments

The authors would like to thank Lorie Scrabis for managing the operational aspects of the study, and Carla Ascoytia for her efforts in conducting the patient interviews.

Author contributions

Chad Gwaltney, Meaghan Krohe, Mona Martin, and Heather Falvey contributed to the study conception and design. Mona Martin was also involved in the collection of data. All authors were involved in the analysis and interpretation of the data, as well as drafting and critical revision of the manuscript.

Author information

Authors and Affiliations

  1. ERT and Brown University, 1 Bucks Trail, Westerly, RI, 02891, USA

    Chad Gwaltney

  2. ERT, Peterborough Business Park, Lynch Wood, Peterborough, PE2 6FZ, UK

    Matthew Reaney

  3. Adelphi Values, 290 Congress Street, 7th Floor, Boston, MA, 02210, USA

    Meaghan Krohe

  4. Health Research Associates, 6505 216th St SW, Ste. 105, Mountlake Terrace, WA, 98043, USA

    Mona M. Martin

  5. 215 West Poplar Avenue, San Mateo, CA, 94402, USA

    Heather Falvey

  6. Novartis Pharma AG, Basel, Switzerland

    Patrick Mollon

Authors
  1. Chad Gwaltney
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  2. Matthew Reaney
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  3. Meaghan Krohe
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  4. Mona M. Martin
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  5. Heather Falvey
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  6. Patrick Mollon
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Corresponding author

Correspondence to Chad Gwaltney.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Essex Institutional Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

Chad Gwaltney, Matthew Reaney, Meaghan Krohe, and Mona Martin received consulting fees from Novartis Pharma AG for the completion of this work. Patrick Mollon holds stock from Pfizer Inc. and Novartis Pharma AG. Heather Falvey reports no conflicts of interest.

Funding

This study was funded by Novartis Pharma AG.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Gwaltney, C., Reaney, M., Krohe, M. et al. Symptoms and Functional Limitations in the First Year Following a Myocardial Infarction: A Qualitative Study. Patient 10, 225–235 (2017). https://doi.org/10.1007/s40271-016-0194-8

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  • DOI: https://doi.org/10.1007/s40271-016-0194-8

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