Abstract 14694: Evaluation of Patient-Reported Disease Burden of Atrial Fibrillation

Abstract

Introduction: Atrial fibrillation (AF), the most common sustained arrhythmic disorder, causes a significant psychosocial and economic burden. This study examined the overall patient-reported disease burden of AF, comprising of physical and mental health, activity impairment, and healthcare resource utilization. Hypothesis: AF affects multiple dimensions of patient -reported quality of life (QoL) and health outcomes.

Methods: Data were analyzed from the US 2009 National Health and Wellness Survey (NHWS). Of 1,297 participants with AF diagnosis, 1,296 were matched by age and gender to an equal number of respondents without AF. Participants completed a self-administered questionnaire, including demographical and clinical information, the 12-Item Short Form Health Survey (SF-12), symptoms of depression, insomnia, and chronic pain, activity impairment, and healthcare resource utilization. Structural equation modelling (SEM) was used to construct an overall disease burden model, examining associations between multiple individual measures. Path analysis was performed to examine the impact of AF on overall disease burden after adjusting for potential confounders.

Results: AF patients had a mean age of 64.9±12.2 years and 65.1% were male. Relative to controls, AF patients had significantly lower mental, physical and utility scores and higher activity impairment score (all p-values < .001). AF patients reported more symptoms of depression (32.6% vs. 25.5%), chronic pain (47.2% vs. 35.2%), and insomnia (45.5% vs. 39.8%), and were more likely to be hospitalized (24.7% vs. 9.0%) and visit emergency room (28.6% vs. 11.5%) in the past 6 months (all p-values < .001). SEM generated a correlated second-order factor model (physical, mental, and utilization) with acceptable fit (CFI=0.970, RMSEA=0.057, [90% CI 0.051 - 0.063]). Path analysis demonstrated that AF had significant impact on the second-order factor (i.e., overall disease burden) after adjustment for demographics, CHADS₂ score, and other potential confounding factors.

Conclusions: AF affects multiple aspects of patients’ quality of life and increases healthcare resource utilization. Further studies should examine the applicability and validity of the overall disease burden measure.