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. 2024 Aug;33(8):2181-2195.
doi: 10.1007/s11136-024-03674-4. Epub 2024 Jun 5.

Examining health-related quality of life in ambulatory adult patients with chronic heart failure: insights from Malaysia using EQ-5D-5L

Yi Jing Tan  1   2 , Siew Chin Ong  3 , Vee Sim Yong  4 , Wei Wern Khor  5 , Lie Jin Pang  5 , Yong Ying Choong  2 , Ainul Mardhiyyah Zameram  6 , Lin Yuing Tan  7 , James Yau Hon Voo  8 , Kar Kei Lam  8 , Chia How Yen  4 , Mohamed Jahangir Abdul Wahab  9 , Zarina Banu Abdulla  9
Affiliations

Examining health-related quality of life in ambulatory adult patients with chronic heart failure: insights from Malaysia using EQ-5D-5L

Yi Jing Tan et al. Qual Life Res. 2024 Aug.

Abstract

Purpose: Health-related quality-of-life (HRQoL) data for the chronic heart failure (HF) population in Malaysia are lacking. Using EQ-5D-5L, this study intended to describe their HRQoL, identify predictors of worse HRQoL, and derive EQ-5D-5L index scores for use in economic evaluations.

Methods: A cross-sectional survey was conducted between April and September 2023 to collect EQ-5D-5L, sociodemographic, and clinical data from outpatients with HF across seven public specialist hospitals in Malaysia. Multivariable logistic and linear regression models were used to identify independent predictors of reported problems in the EQ-5D-5L dimensions, and predictors of index scores and EQ-VAS, respectively.

Results: EQ-5D-5L data from 424 outpatients of multi-ethnic background (mean age: 57.1 years, 23.8% female, mean left ventricular ejection fraction: 35.7%, 89.7% NYHA class I-II) were collected using either Malay, English, or Chinese, achieving a 99.8% completion rate. Nearly half of the respondents reported issues in the Mobility, Usual Activities, and Pain/Discomfort dimensions. Mean EQ-5D-5L index was 0.820, lower than the general population, and significantly lower with NYHA class III-IV (0.747) versus NYHA class I (0.846) and NYHA class II (0.805). Besides NYHA class, independent predictors of worse HRQoL included Indian ethnicity, living alone, lower education, unemployment due to ill-health, and proxy-reported HRQoL, largely aligning with existing literature.

Conclusion: Community-dwelling Malaysians with HF reported poorer HRQoL compared to the general population. The observed disparities in HRQoL among HF patients may be linked to specific patient characteristics, suggesting potential areas for targeted interventions. HRQoL assessment using EQ-5D-5L proves feasible and should be considered for routine implementation in local clinics.

Keywords: EQ-5D-5L; Health state utility values; Health-related quality of life; Heart failure; Malaysia.

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