Assessment of the Quality of Life of Saudi Patients in Pharmacist-Led Heart Failure Clinics: A Cross-Sectional Observational Study

TL;DR

This study evaluates the quality of life of Saudi heart failure patients treated in pharmacist-led clinics and finds their overall quality of life is fair to good.

Contribution

The study provides the first assessment of quality of life for Saudi patients in pharmacist-led heart failure clinics.

Findings

Patients reported a fair to good quality of life with a summary score of 75.4 on the KCCQ-12.

Pharmacist interventions, such as counseling and medication management, were common but showed a weak, non-significant correlation with quality of life.

Physical limitations were moderate, while social limitations were minimal among the patients.

Abstract

Objectives

Heart failure (HF) is a global health challenge with high morbidity and mortality, significantly impacting patients' quality of life (QOL). The QOL of Saudi patients, who were treated in the pharmacist-led HF clinics, is unknown. This study aims to evaluate HF patients' QOL using the validated Kansas City Cardiomyopathy Questionnaire (KCCQ-12).

Methods

A cross-sectional observational study was conducted with 111 randomly selected HF patients. QOL was assessed using the KCCQ-12, which encompasses domains evaluating physical limitations, HF-specific symptoms (swelling, shortness of breath (SOB), and fatigue), QOL, and social impact, with a score ranging from 0 (poorest health) to 100 (best health). The interpretation of health status is based on the overall summary KCCQ score as follows: very poor to poor (0-24), poor to fair (25-49), fair to good (50-74), and good to excellent (75-100).

Results

Overall, the highest score was in symptom frequency (82.7), indicating a few symptoms. The score for the dimension Social Limitation was 79.4, reflecting minimal social restrictions, while that for Physical Limitation was 71.7, indicating moderate physical activity limitations. The reported QOL score was 68.9, reflecting their fair to good QOL. The summary score was 75.4, reflecting an overall positive QOL assessment. The distribution of pharmacist interventions included the following: patient counseling was performed in 111 (100%) of cases, while the guideline-directed medical therapy (GDMT) monitoring follow-up was done for 58 (52.25%) of patients, and the initiation and titration of GDMT were conducted in 52 (46.85%) and 41 (36.94%) of cases, respectively. There is a weak positive correlation (rho=0.183) between the KCCQ-12 Summary Score and the total number of interventions received by patients, with a p-value of 0.056. This suggests a trend where an increased number of interventions may be associated with a slightly higher QOL, although this correlation is not statistically significant (p>0.05).

Conclusion

Based on the KCCQ findings, this study demonstrates the significant influence of clinical pharmacist interventions on the HF patient's QOL, which identifies the importance of HF clinics run by a cardiology clinical pharmacist within a multidisciplinary team.

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