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Utility of Patient-Reported Outcome Instruments in Heart Failure
Anita A Kelkar1, John Spertus2, Peter Pang3
1Cardiology Division, Emory University, Atlanta, Georgia.
JACC. Heart Failure
|February 15, 2016
Summary
Patient-reported outcomes (PRO) are valuable for heart failure care but not integrated. Only two PRO instruments, the Minnesota Living with Heart Failure and Kansas City Cardiomyopathy questionnaire, met all criteria for clinical use.
Area of Science:
- Cardiology
- Health Services Research
- Patient-Centered Care
Background:
- Patient-reported outcomes (PRO) offer direct patient insights into health status and treatment effects.
- Despite their potential, PRO tools are underutilized in routine clinical practice for heart failure management.
- Systematic evaluation of PRO instruments is needed to assess their clinical utility.
Purpose of the Study:
- To systematically review and evaluate existing PRO instruments for heart failure.
- To assess the psychometric properties and clinical applicability of these PRO instruments.
- To identify validated PRO tools suitable for integration into heart failure care.
Main Methods:
- Systematic literature search of MEDLINE, PROMIS, PROQOLID, and Cochrane Library (July 2008-January 2015).
- Inclusion criteria: developed/tested for heart failure, described development and psychometric properties.
- Evaluation based on psychometric, clinical criteria, and symptom coverage.
Main Results:
- Identified 31 PRO instruments; 9 met initial inclusion criteria.
- Only the Minnesota Living with Heart Failure and Kansas City Cardiomyopathy questionnaire met all evaluation criteria.
- Significant gaps remain in PRO instrument validation and clinical integration.
Conclusions:
- Validated PRO instruments for heart failure exist but require better integration into clinical workflows.
- Enhanced provider education on PRO value and interpretation is crucial.
- Further research, including clinical trials, is needed to support routine PRO use in heart failure care.
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