Patient-reported outcomes in patients with heart failure

The key challenge in heart failure care research is to explore new directions for optimizing care on an individual and population level. This thesis aimed to investigate the use of different patient-reported outcomes in patients with heart failure and the perception of these outcomes by the patients themselves. We assessed the preferences of outpatients and showed that the majority awards more weight to quality of life over longevity. The prevalence of impairments due to heart failure and the degree of perceived harshness was also investigated. Highly prevalent impairments are not by definition perceived as severely harsh. With a qualitative study we analysed which treatment goal patients perceived as important. ‘Not getting worse’ was perceived as the treatment goal that matters most. We have also studied possibilities to improve health-related quality of life in these patients and found an association between optimism and health-related quality of life and between anemia and health-related quality of life. These associations may serve as emerging targets for improving health-related quality of life. We also studied the effect of using telemonitoring in patients with heart failure, and found that the use of telemonitoring is safe and can reduce heart failure related visits to the outpatient clinic. However we did not find differences in rehospitalisation-, mortality rates and health-related quality of life measurements between patients who used telemonitoring or not. Finally, with a literature review we investigated the satisfaction of patients with using telemedicine. We showed that patient satisfaction is still underexposed in the literature about non-invasive telemedicine research