Author + information
- Received September 14, 2015
- Revision received October 21, 2015
- Accepted October 22, 2015
- Published online March 1, 2016.
- Anita A. Kelkar, MD, MPHa,
- John Spertus, MDb,
- Peter Pang, MDc,
- Renee F. Pierson, MBAd,
- Robert J. Cody, MD, MBAd,
- Ileana L. Pina, MDe,
- Adrian Hernandez, MDf and
- Javed Butler, MD, MPHg,∗ ()
- aCardiology Division, Emory University, Atlanta, Georgia
- bHealth Outcomes Research, Saint Luke’s Mid America Heart Institute, Kansas City, Missouri
- cDepartment of Emergency Medicine, Indiana University, Indianapolis, Indiana
- dPatient Reported Outcomes, Janssen Pharmaceutical Companies of Johnson & Johnson
- eDivision of Cardiology, Montefiore Medical Center, Bronx, New York
- fDepartment of Cardiology, Duke University, Durham, North Carolina
- gCardiology Division, Stony Brook University, Stony Brook, New York
- ↵∗Reprint requests and correspondence:
Dr. Javed Butler, Cardiology Division, Stony Brook University, Health Sciences Center, T-16, Room 080, SUNY at Stony Brook, Stony Brook, New York 11794.
Patient-reported outcomes (PRO) are defined as reports coming directly from patients about how they feel or function in relation to a health condition and its therapy. Although there are numerous compelling reasons why PRO could be an important help in clinical care, they have not evolved into clinical tools integrated into care. The purpose of this review is to assess existing PRO instruments for heart failure with respect to their psychometric properties and potential for use in clinical care. We performed a systematic search of articles published between July 2008 and January 2015 within the MEDLINE, PROMIS, PROQOLID, and Cochrane Library databases. Included instruments had to be developed and tested for heart failure and have had their development processes and psychometric properties described. A total of 31 instruments were identified, 9 of which met all inclusion criteria. After evaluating each remaining instrument in terms of psychometric and clinical criteria and symptom coverage, only 2 instruments—Minnesota Living with Heart Failure and Kansas City Cardiomyopathy questionnaire—met all evaluation criteria. Although clinically useful PRO instruments exist, increasing education to providers on the value and interpretability of PRO instruments, as well as a more streamlined approach to their implementation in the clinical setting is necessary. A clinical trial comparing the routine use of disease-specific PRO with clinical care could further support their incorporation into practice.
Dr. Spertus has received research grants from Eli Lilly, EveHeart, Genentech, and Gilead; consulting fees from St. Jude Medical, United Healthcare, Amgen, Gilead, Genentech, Janssen, and Novartis; and holds copyrights/patents for Seattle Angina Questionnaire, Kansas City Cardiomyopathy Questionnaire, and Peripheral Artery Questionnaire (US Patents: 7,643,969; 7,853,456; 12/965,656; 13/615,401). Dr. Pang has received consulting fees or honoraria from Cardioxyl, Intersection Medical, INSYS, Janssen Pharmaceuticals, Medtronic, Novartis, Palatin Technologies, Roche Diagnostics, Relypsa, Trevena, and scPharmaceuticals; and has served as Associate Editor for JACC: Heart Failure. Dr. Pierson is a director with Janssen Pharmaceuticals. Dr. Cody is an employee of Merck and Co. Dr. Hernandez has received research support from the American Heart Association, Amgen, AstraZeneca, Novartis, Merck, and the National Heart and Lung Blood Institute; and honoraria from Amgen, AstraZeneca, Janssen, Merck, and Novartis. Dr. Butler has received research support from the National Institutes of Health, and European Union; and has received consulting fees from Amgen, Bayer, Cardiocell, Celladon, Medtronic, Novartis, Otsuka, Takeda, Trevena, and Zensun. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received September 14, 2015.
- Revision received October 21, 2015.
- Accepted October 22, 2015.
- American College of Cardiology Foundation