and the HRQOL trajectory among
participants in a disease management (DM) program characterized by personalized models
of education, counseling, and supportive contact. In all, 2,590 CAD and 3,182 HF patients were
assessed at baseline and at 3, 6, 9, and 12 months post-enrollment. HRQOL was measured via
a computerized dynamic test, whose core consisted of SF-8 items. HRQOL burden was assessed
by comparing physical component summary (PCS) and mental component summary
(MCS) scores to demographically adjusted US norms and to historical controls. Disease trajectories
were assessed with change score analyses and by a categorization of participants as
improving, stable, or deteriorating. Among the results, both groups showed between 1.7 to
2.6 times the likelihood of improving over worsening after a full year of DM participation in
all measures. In contrast, historical controls experienced no significant HRQOL improvement
or decline after 2 years of standard treatment. After 1 or 2 years they were more likely to decline
than to improve in their PCS scores and were about as likely to improve as to worsen
in their MCS scores. In conclusion, HF places a substantial burden on HRQOL, and the burden
of CAD is also noticeable. While the study design does not allow causal interpretations,
HRQOL significantly improved for both CAD and HF patients during DM program participation.
This trend is in contrast to historic controls, where no significant HRQOL improvement
occurred over time. (Disease Management 2007;10:164–178)
1Thomson