Association of sex, age and education level with patient reported outcomes in atrial fibrillation

Kelly Gleason, Cheryl Renee Dennison-Himmelfarb, Daniel E Ford, Harold P Lehmann, Laura J Samuel, Hae Ra Han, Sandeep K. Jain, Gerald V. Naccarelli, Vikas Aggarwal, Saman Nazarian

Research output: Contribution to journalArticle

Abstract

Background: In atrial fibrillation (AF), there are known sex and sociodemographic disparities in clinical outcomes such as stroke. We investigate whether disparities also exist with respect to patient-reported outcomes. We explored the association of sex, age, and education level with patient-reported outcomes (AF-related quality of life, symptom severity, and emotional and functional status). Methods: The PaTH AF cohort study recruited participants (N = 953) with an AF diagnosis and age ≥ 18 years across 4 academic medical centers. We performed longitudinal multiple regression with random effects to determine if individual characteristics were associated with patient-reported outcomes. Results: Women reported poorer functional status (β − 2.23, 95% CI: -3.52, − 0.94) and AF-related quality of life (β − 4.12, 95% CI: -8.10, − 0.14), and higher symptoms of anxiety (β 2.08, 95% CI: 0.76, 3.40), depression (β 1.44, 95% CI: 0.25, 2.63), and AF (β 0.29, 95% CI: 0.08, 0.50). Individuals < 60 years were significantly (p < 0.05) more likely to report higher symptoms of depression, anxiety, and AF, and poorer AF-related quality of life. Lack of college education was associated with reporting higher symptoms of AF (β 0.42, 95% CI: 0.17, 0.68), anxiety (β 1.86, 95% CI: 0.26, 3.45), and depression (β 1.11, 95% CI: 0.15, 2.38), and lower AF-related quality of life (β − 4.41, 95% CI: -8.25, − 0.57) and functional status. Conclusion: Women, younger adults, and individuals with lower levels of education reported comparatively poor patient-reported outcomes. These findings highlight the importance of understanding why individuals experience AF differently based on certain characteristics.

Original languageEnglish (US)
Article number85
JournalBMC Cardiovascular Disorders
Volume19
Issue number1
DOIs
StatePublished - Apr 5 2019

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Sex Education
Atrial Fibrillation
Quality of Life
Anxiety
Depression
Patient Reported Outcome Measures
Education
Young Adult
Cohort Studies
Stroke

Keywords

  • Age
  • Atrial fibrillation
  • Longitudinal cohort study
  • Patient-reported outcomes
  • Quality of life
  • Sex
  • Symptoms

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Association of sex, age and education level with patient reported outcomes in atrial fibrillation. / Gleason, Kelly; Dennison-Himmelfarb, Cheryl Renee; Ford, Daniel E; Lehmann, Harold P; Samuel, Laura J; Han, Hae Ra; Jain, Sandeep K.; Naccarelli, Gerald V.; Aggarwal, Vikas; Nazarian, Saman.

In: BMC Cardiovascular Disorders, Vol. 19, No. 1, 85, 05.04.2019.

Research output: Contribution to journalArticle

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abstract = "Background: In atrial fibrillation (AF), there are known sex and sociodemographic disparities in clinical outcomes such as stroke. We investigate whether disparities also exist with respect to patient-reported outcomes. We explored the association of sex, age, and education level with patient-reported outcomes (AF-related quality of life, symptom severity, and emotional and functional status). Methods: The PaTH AF cohort study recruited participants (N = 953) with an AF diagnosis and age ≥ 18 years across 4 academic medical centers. We performed longitudinal multiple regression with random effects to determine if individual characteristics were associated with patient-reported outcomes. Results: Women reported poorer functional status (β − 2.23, 95{\%} CI: -3.52, − 0.94) and AF-related quality of life (β − 4.12, 95{\%} CI: -8.10, − 0.14), and higher symptoms of anxiety (β 2.08, 95{\%} CI: 0.76, 3.40), depression (β 1.44, 95{\%} CI: 0.25, 2.63), and AF (β 0.29, 95{\%} CI: 0.08, 0.50). Individuals < 60 years were significantly (p < 0.05) more likely to report higher symptoms of depression, anxiety, and AF, and poorer AF-related quality of life. Lack of college education was associated with reporting higher symptoms of AF (β 0.42, 95{\%} CI: 0.17, 0.68), anxiety (β 1.86, 95{\%} CI: 0.26, 3.45), and depression (β 1.11, 95{\%} CI: 0.15, 2.38), and lower AF-related quality of life (β − 4.41, 95{\%} CI: -8.25, − 0.57) and functional status. Conclusion: Women, younger adults, and individuals with lower levels of education reported comparatively poor patient-reported outcomes. These findings highlight the importance of understanding why individuals experience AF differently based on certain characteristics.",
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AU - Gleason, Kelly

AU - Dennison-Himmelfarb, Cheryl Renee

AU - Ford, Daniel E

AU - Lehmann, Harold P

AU - Samuel, Laura J

AU - Han, Hae Ra

AU - Jain, Sandeep K.

AU - Naccarelli, Gerald V.

AU - Aggarwal, Vikas

AU - Nazarian, Saman

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N2 - Background: In atrial fibrillation (AF), there are known sex and sociodemographic disparities in clinical outcomes such as stroke. We investigate whether disparities also exist with respect to patient-reported outcomes. We explored the association of sex, age, and education level with patient-reported outcomes (AF-related quality of life, symptom severity, and emotional and functional status). Methods: The PaTH AF cohort study recruited participants (N = 953) with an AF diagnosis and age ≥ 18 years across 4 academic medical centers. We performed longitudinal multiple regression with random effects to determine if individual characteristics were associated with patient-reported outcomes. Results: Women reported poorer functional status (β − 2.23, 95% CI: -3.52, − 0.94) and AF-related quality of life (β − 4.12, 95% CI: -8.10, − 0.14), and higher symptoms of anxiety (β 2.08, 95% CI: 0.76, 3.40), depression (β 1.44, 95% CI: 0.25, 2.63), and AF (β 0.29, 95% CI: 0.08, 0.50). Individuals < 60 years were significantly (p < 0.05) more likely to report higher symptoms of depression, anxiety, and AF, and poorer AF-related quality of life. Lack of college education was associated with reporting higher symptoms of AF (β 0.42, 95% CI: 0.17, 0.68), anxiety (β 1.86, 95% CI: 0.26, 3.45), and depression (β 1.11, 95% CI: 0.15, 2.38), and lower AF-related quality of life (β − 4.41, 95% CI: -8.25, − 0.57) and functional status. Conclusion: Women, younger adults, and individuals with lower levels of education reported comparatively poor patient-reported outcomes. These findings highlight the importance of understanding why individuals experience AF differently based on certain characteristics.

AB - Background: In atrial fibrillation (AF), there are known sex and sociodemographic disparities in clinical outcomes such as stroke. We investigate whether disparities also exist with respect to patient-reported outcomes. We explored the association of sex, age, and education level with patient-reported outcomes (AF-related quality of life, symptom severity, and emotional and functional status). Methods: The PaTH AF cohort study recruited participants (N = 953) with an AF diagnosis and age ≥ 18 years across 4 academic medical centers. We performed longitudinal multiple regression with random effects to determine if individual characteristics were associated with patient-reported outcomes. Results: Women reported poorer functional status (β − 2.23, 95% CI: -3.52, − 0.94) and AF-related quality of life (β − 4.12, 95% CI: -8.10, − 0.14), and higher symptoms of anxiety (β 2.08, 95% CI: 0.76, 3.40), depression (β 1.44, 95% CI: 0.25, 2.63), and AF (β 0.29, 95% CI: 0.08, 0.50). Individuals < 60 years were significantly (p < 0.05) more likely to report higher symptoms of depression, anxiety, and AF, and poorer AF-related quality of life. Lack of college education was associated with reporting higher symptoms of AF (β 0.42, 95% CI: 0.17, 0.68), anxiety (β 1.86, 95% CI: 0.26, 3.45), and depression (β 1.11, 95% CI: 0.15, 2.38), and lower AF-related quality of life (β − 4.41, 95% CI: -8.25, − 0.57) and functional status. Conclusion: Women, younger adults, and individuals with lower levels of education reported comparatively poor patient-reported outcomes. These findings highlight the importance of understanding why individuals experience AF differently based on certain characteristics.

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KW - Quality of life

KW - Sex

KW - Symptoms

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