Association of sex and atrial fibrillation therapies with patient-reported outcomes

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

Research output: Contribution to journalArticle

Abstract

Objectives: Women report higher atrial fibrillation (AF) symptom severity and receive less AF therapies than their male counterparts. It is understudied if differences in AF therapies received explains sex differences in AF symptom severity. We investigate the impact of sex and AF therapies on patient-reported outcomes. Methods: Participants were recruited (n=953) across four academic medical centres with an AF diagnosis and age ≥18 years. Patient-reported outcomes (AF symptom severity, AF-related quality of life, functional status and emotional status) were determined by biannual surveys. We performed multiple linear regressions on propensity-matched cohorts to determine the association of AF therapies and sex on patient-reported outcomes. Results: Our study population (n=953) was 65% male (n=616), 93% white (n=890) and 72 (±10) years old. Individuals receiving rate control therapy reported comparatively lower AF-related quality of life (-7.22, 95% CI -11.51 to -2.92) and poorer functional status (-3.69, 95% CI -5.27 to -2.12). Individuals receiving rhythm control strategies did not report significantly different patient-reported outcomes. Women were more likely to report poorer functional status (-2.63, 95% CI -3.86 to -1.40) and poorer AF-related quality of life, higher anxiety (2.33, 95% CI 1.07 to 3.59), higher symptoms of depression (1.48, 95% CI 0.31 to 2.65) and AF symptom severity (0.29, 95% CI 0.07 to 0.52). Conclusions: Female sex was associated with comparatively poorer AF symptom severity and quality of life, and this association remained after accounting for AF therapies received. Receiving rate control medication alone was associated with comparatively poorer AF-related quality of life and functional status.

Original languageEnglish (US)
JournalHeart
DOIs
StatePublished - Jan 1 2019

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Atrial Fibrillation
Therapeutics
Quality of Life
Patient Reported Outcome Measures
Sex Characteristics
Linear Models
Anxiety

Keywords

  • atrial fibrillation
  • electronic medical records
  • health care delivery
  • quality and outcomes of care

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Association of sex and atrial fibrillation therapies with patient-reported outcomes. / Gleason, Kelly; Dennison-Himmelfarb, Cheryl Renee; Ford, Daniel E; Lehmann, Harold P; Samuel, Laura J; Jain, Sandeep; Naccarelli, Gerald; Aggarwal, Vikas; Nazarian, Saman.

In: Heart, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Objectives: Women report higher atrial fibrillation (AF) symptom severity and receive less AF therapies than their male counterparts. It is understudied if differences in AF therapies received explains sex differences in AF symptom severity. We investigate the impact of sex and AF therapies on patient-reported outcomes. Methods: Participants were recruited (n=953) across four academic medical centres with an AF diagnosis and age ≥18 years. Patient-reported outcomes (AF symptom severity, AF-related quality of life, functional status and emotional status) were determined by biannual surveys. We performed multiple linear regressions on propensity-matched cohorts to determine the association of AF therapies and sex on patient-reported outcomes. Results: Our study population (n=953) was 65{\%} male (n=616), 93{\%} white (n=890) and 72 (±10) years old. Individuals receiving rate control therapy reported comparatively lower AF-related quality of life (-7.22, 95{\%} CI -11.51 to -2.92) and poorer functional status (-3.69, 95{\%} CI -5.27 to -2.12). Individuals receiving rhythm control strategies did not report significantly different patient-reported outcomes. Women were more likely to report poorer functional status (-2.63, 95{\%} CI -3.86 to -1.40) and poorer AF-related quality of life, higher anxiety (2.33, 95{\%} CI 1.07 to 3.59), higher symptoms of depression (1.48, 95{\%} CI 0.31 to 2.65) and AF symptom severity (0.29, 95{\%} CI 0.07 to 0.52). Conclusions: Female sex was associated with comparatively poorer AF symptom severity and quality of life, and this association remained after accounting for AF therapies received. Receiving rate control medication alone was associated with comparatively poorer AF-related quality of life and functional status.",
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T1 - Association of sex and atrial fibrillation therapies with patient-reported outcomes

AU - Gleason, Kelly

AU - Dennison-Himmelfarb, Cheryl Renee

AU - Ford, Daniel E

AU - Lehmann, Harold P

AU - Samuel, Laura J

AU - Jain, Sandeep

AU - Naccarelli, Gerald

AU - Aggarwal, Vikas

AU - Nazarian, Saman

PY - 2019/1/1

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N2 - Objectives: Women report higher atrial fibrillation (AF) symptom severity and receive less AF therapies than their male counterparts. It is understudied if differences in AF therapies received explains sex differences in AF symptom severity. We investigate the impact of sex and AF therapies on patient-reported outcomes. Methods: Participants were recruited (n=953) across four academic medical centres with an AF diagnosis and age ≥18 years. Patient-reported outcomes (AF symptom severity, AF-related quality of life, functional status and emotional status) were determined by biannual surveys. We performed multiple linear regressions on propensity-matched cohorts to determine the association of AF therapies and sex on patient-reported outcomes. Results: Our study population (n=953) was 65% male (n=616), 93% white (n=890) and 72 (±10) years old. Individuals receiving rate control therapy reported comparatively lower AF-related quality of life (-7.22, 95% CI -11.51 to -2.92) and poorer functional status (-3.69, 95% CI -5.27 to -2.12). Individuals receiving rhythm control strategies did not report significantly different patient-reported outcomes. Women were more likely to report poorer functional status (-2.63, 95% CI -3.86 to -1.40) and poorer AF-related quality of life, higher anxiety (2.33, 95% CI 1.07 to 3.59), higher symptoms of depression (1.48, 95% CI 0.31 to 2.65) and AF symptom severity (0.29, 95% CI 0.07 to 0.52). Conclusions: Female sex was associated with comparatively poorer AF symptom severity and quality of life, and this association remained after accounting for AF therapies received. Receiving rate control medication alone was associated with comparatively poorer AF-related quality of life and functional status.

AB - Objectives: Women report higher atrial fibrillation (AF) symptom severity and receive less AF therapies than their male counterparts. It is understudied if differences in AF therapies received explains sex differences in AF symptom severity. We investigate the impact of sex and AF therapies on patient-reported outcomes. Methods: Participants were recruited (n=953) across four academic medical centres with an AF diagnosis and age ≥18 years. Patient-reported outcomes (AF symptom severity, AF-related quality of life, functional status and emotional status) were determined by biannual surveys. We performed multiple linear regressions on propensity-matched cohorts to determine the association of AF therapies and sex on patient-reported outcomes. Results: Our study population (n=953) was 65% male (n=616), 93% white (n=890) and 72 (±10) years old. Individuals receiving rate control therapy reported comparatively lower AF-related quality of life (-7.22, 95% CI -11.51 to -2.92) and poorer functional status (-3.69, 95% CI -5.27 to -2.12). Individuals receiving rhythm control strategies did not report significantly different patient-reported outcomes. Women were more likely to report poorer functional status (-2.63, 95% CI -3.86 to -1.40) and poorer AF-related quality of life, higher anxiety (2.33, 95% CI 1.07 to 3.59), higher symptoms of depression (1.48, 95% CI 0.31 to 2.65) and AF symptom severity (0.29, 95% CI 0.07 to 0.52). Conclusions: Female sex was associated with comparatively poorer AF symptom severity and quality of life, and this association remained after accounting for AF therapies received. Receiving rate control medication alone was associated with comparatively poorer AF-related quality of life and functional status.

KW - atrial fibrillation

KW - electronic medical records

KW - health care delivery

KW - quality and outcomes of care

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