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Assessment of patient-reported outcomes measures in heart failure: a systematic review

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Abstract

Heart failure (HF) is a prevalent global disease, particularly impacting developed countries. With the world’s aging population, HF’s impact on the quantity and quality of life is expected to grow. This review aims to ascertain the frequency, characteristics, and properties of all patient-reported outcomes measures (PROMs) studied in HF patients. We searched Ovid/Medline and Web of Science for original articles about PROMs performed in adults with HF. Using pre-established quality criteria for measurement properties, an overall rating was assigned to evaluate and compare different instruments. The quality of evidence was assessed with the COSMIN risk of bias checklist. Of 4283 records identified, we reviewed 296 full-text documents and included 64 papers, involving 30,185 participants. Thirty different PROMs were identified, with 14 specifically designed for HF being the most commonly used. Minnesota Living with Heart Failure (MLHF) and Kansas City Cardiomyopathy Questionnaire (KCCQ) were evaluated 16 and 13 times, respectively, demonstrating good psychometric properties. The MacNew Heart Disease Health-Related Quality of Life Questionnaire, a common heart disease-specific instrument, exhibited negative performances across various psychometric measures. Evidence for generic instruments was scant and unremarkable and they proved to be less responsive in HF populations. MLHF and KCCQ emerged as the most commonly used and well-supported PROMs, with robust overall evidence. They are comprehensive and accurate instruments, particularly suitable for application in clinical practice and research. Future research should explore how computer-adapted instruments can enhance precision, reduce respondent burden, and improve communication between clinicians and patients, thereby promoting more efficient and patient-centered services.

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Authors and Affiliations

  1. Internal Medicine Department, Unidade Local de Saúde de Viseu Dão-Lafões, Viseu, Portugal

    João Lázaro Mendes

  2. Public Health Unit, Unidade Local de Saúde de Viseu Dão-Lafões, Viseu, Portugal

    Cristina Mendes dos Santos

  3. Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal

    Bernardo Sousa-Pinto

  4. Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Center for Health Technology and Services Research, Porto, Portugal

    Bernardo Sousa-Pinto

Authors
  1. João Lázaro Mendes
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  2. Cristina Mendes dos Santos
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  3. Bernardo Sousa-Pinto
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Contributions

Bernardo Sousa-Pinto and João Lázaro Mendes contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Cristina Mendes dos Santos and João Lázaro Mendes. The first draft of the manuscript was written by João Lázaro Mendes and Cristina Mendes dos Santos. Bernardo Sousa-Pinto provided support for data collection and analysis and critically reviewed the final draft. All authors have read and agreed to the published version of the manuscript.

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Correspondence to João Lázaro Mendes.

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Mendes, J.L., dos Santos, C.M. & Sousa-Pinto, B. Assessment of patient-reported outcomes measures in heart failure: a systematic review. Heart Fail Rev (2024). https://doi.org/10.1007/s10741-024-10404-y

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  • DOI: https://doi.org/10.1007/s10741-024-10404-y

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