It is time to move patient self-reported surveys from the realm of research into everyday clinical practice, according to an American Heart Association (AHA) scientific statement published online May 6 in Circulation. The authors argue that health-related quality of life (HRQL) assessments should be a component of patient-centered care.
John S. Rumsfeld, MD, PhD, chair of the writing committee and national director of cardiology for the Veterans Health Administration in Denver, and colleagues outlined three key components of patient health status: symptom burden, functional status and HRQL. They defined HRQL as “the perception of discrepancy between actual and desired functional status and overall impact of disease on well-being for a given patient. … Because each person differentially experiences the degree to which symptoms and functional limitations of disease and medical therapies impact their well-being, HRQL can only be accurately quantified by patient self-report.”
A number of validated disease-specific patient-reported health status surveys have been used in clinical studies, including surveys for coronary artery disease, heart failure, atrial fibrillation and peripheral artery disease. The instruments have been shown to not only measure outcomes but serve as predictors of mortality, cardiovascular events and costs.
“Indeed, patient health status surveys are complementary to history, physical, laboratory, and other diagnostic tests,” they wrote. “Patient health status may therefore be important for risk adjustment and may be useful in targeting healthcare resources such as disease management to those with the largest health deficits.”
The statement offers a list of disease-specific tools. The authors added that the surveys are standardized, easy to administer and use scoring algorithms.
Rumsfeld et al encouraged cardiologists to incorporate health status surveys into routine care. “Ultimately, efforts to improve the healthcare system will only be successful if they translate into better patient outcomes—not just longevity, but also how well patients live,” Rumsfeld said in a release. “This statement recommends increasing the standardized measurement of patient health status—so we can better understand, monitor and minimize the burden of disease on patients’ lives.”