Research On Quality Of Life And Influencing Factors In Chinese Patients With Stable Angina Pectoris

Objectives:①To validate and compare the psychometric properties of twogeneric preference-based HRQoL instruments, EuroQol (EQ-5D) and Short-Form6D(SF-6D) among stable angina pectoris (SAP) patients in China.②To examine thehealth-related quality of life (HRQoL) and associated factors in Chinese patients withSAP, in comparison with those of the general population.Methods: A cross sectional HRQoL survey of both SAP patients recruited fromgeneral hospitals (n=411) and the general population recruited from PhysicalExamination Centers (n=549) was conducted from July to Decmber,2011in Tianjin andChengdu cities. The general health status was assessed using EQ-5D, EQ-VAS, andSF-6D instruments. SAP-specific health status was assessed using the Seattle AnginaQuestionnaire (SAQ). Socio-demographic, clinical and life style information were alsocollected from the participants. Validity of the EQ-5D and SF-6D was examined witheight a priori hypotheses in conjunction with Seattle Angina Questionnaire (SAQ).Responsiveness was tested using the effect size (ES), relative efficiency (RE) andreceiver operating characteristic (ROC) curves. Hierarchical multiple regression analyseswere carried out to explore the associated factors of HRQoL of SAP patients, in whichclinical characters including SAP-specific health status, socio-demographic data and lifestyle variables were included via stepwise method.Results:①Validity was demonstrated by the moderate to strong correlationcoefficients (range:0.368-0.594, P<0.001) for four of the eight hypotheses in bothEQ-5D and SF-6D. There were no serious ceiling effects for EQ-5D and SF-6D butfloor effects for EQ-5D were large. SF-6D showed a better discriminative capacity(ES=0.573-1.179) between groups with different SAP-specific health status thanEQ-5D (ES=0.385-0.851). RE showed that SF-6D (32.7-218.7%) was more efficientthan EQ-5D. The areas under ROC of them all exceeded0.5(0.661-0.814, P<0.001).②Compared with the general population (44.2+/-10years,49.91%females), SAPpatients (68.1+/-12years,50.36%females) had significantly lower HRQoL scores inEQ-5D index (0.75+/-0.19vs.0.90+/-0.20, p<0.05), SF-6D utility index (0.68+/-0,12vs.0.85+/-0.11, p<0.05) and EQ-VAS (71.2+/-12.3vs.83.9+/-10.9, p<0.05).③Hierarchical multiple linear regression analyses indicated SAP-specific health status explained most of the variance, in which, disease perception, physical limitation andangina stability were the strongest predict tive variables for HRQoL. Among othercontrol variables, more exercises and better sleep were positively related with betterHRQoL.Conclusions:①This study provides evidence that EQ-5D and SF-6D are validand sensitive preference-based HRQoL instruments in Chinese SAP patients. SF-6Dmay be a more effective tool with lower flooring effect and greater sensitivity.②SAP patients experienced poorer HRQoL with lower health utility scores comparedwith the general population.③Enhancing disease education and good life habits arehelpful to improve the HRQoL of SAP patients.