Specific patient characteristics linked to below average quality of life in patients with recent venous thromboembolism
Many associated factors are modifiable indicating potential benefit from planned strategies.
- Specific, definable patient characteristics are associated with below average quality of life (QoL) in patients with recent venous thromboembolism (VTE).
- The most notable factors associated with below average QoL were current depression and/or anxiety, unemployment, African American race, anticoagulant-related bleeding and difficulty getting VTE care.
- Importantly, factors associated with physical and mental QoL were different.
Why This Matters
Patients with VTE have been known to have deficits in QoL.
However, understanding regarding drivers of poorer QoL in patients with VTE is limited.
Potential strategies to address poor QoL in such patients could include increased counselling, patient-support network referral, better access to credible educational materials, transportation solutions for medical appointments, programmes to address affordability of anticoagulant medications and resources to assist with anxiety and depression.
- Study evaluated data from a cross-sectional national online survey of 907 adult patients (mean age, 52.4 years) who experienced at least one self-reported VTE episode within the past 2 years.
- The survey contained a variety of questions designed to ascertain QoL scores and potential factors associated with QoL.
- QoL score was collected using the Optum Health Survey Short Form-12 (SF-12).
- SF-12 comprised of Physical Health Component Summary (PCS) and Mental Health Component Summary (MCS) scores.
- Funding: Pfizer Independent Grants for Learning & Change, Bristol-Myers Squibb Independent Medical Education and The Joint Commission.
- Mean PCS and MCS scores were 41.7 (standard deviation [SD], 10.2) and 46.7 (SD, 10.9), respectively with majority of patients having below average PCS (76.0%) and MCS (56.7%) scores.
- Factors associated with below average PCS were:
- high depression scores (aOR, 4.02; 95% CI, 1.88-2.54);
- being unemployed (aOR, 3.77; 95% CI, 1.76-8.05);
- African American race (aOR, 6.54; 95% CI, 1.01-42.27);
- reporting blood in the stool (aOR, 2.54; 95% CI, 1.28-5.01);
- worry about clotting (aOR, 1.60; 95% CI, 1.04-2.48) and
- difficulty getting VTE care (aOR, 4.24; 95% CI, 1.77-10.17).
- Factors associated with below MCS scores were:
- high depression scores (aOR, 3.85; 95% CI, 1.6-9.28);
- being unemployed (aOR, 2.83; 95% CI 1.30-6.16);
- experiencing VTE within the past month (aOR, 3.85; 95% CI, 1.58-9.41);
- switching between direct oral anticoagulants (aOR, 4.24; 95% CI, 1.00-17.93) and
- high anxiety score (aOR, 9.17; 95% CI, 4.81-17.47).
- Experiencing more lifetime VTE episodes (aOR, 0.94; 95% CI, 0.89-0.99) and older age (aOR, 0.97; 95% CI, 0.95-0.99) were associated with above average PCS and MCS scores, respectively.
- Less than ideal response rate.
- Index VTE identification was self-reported.
- All variables potentially affecting QoL were not collected.
- Certain events may have been over- or under-reported due to patient recall bias.
Erickson RM, Feehan M, Munger MA, Tak C, Witt DM. Understanding Factors Associated with Quality of Life in Patients with Venous Thromboembolism. Thromb Haemost. 2019;119(11):1869-1876. doi: 10.1055/s-0039-1696717. PMID: 31587248