Health Status in Heart Failure and Cancer: Analysis of the Medicare Health Outcomes Survey 2016-2020

JACC Heart Fail. 2024 Jul;12(7):1166-1178. doi: 10.1016/j.jchf.2023.10.003. Epub 2023 Nov 6.

Abstract

Background: People with heart failure (HF) and cancer experience impaired physical and mental health status. However, health-related quality of life (HRQOL) has not been directly compared between these conditions in a contemporary population of older people.

Objectives: The authors sought to compare HRQOL in people with HF vs those with lung, colorectal, breast, and prostate cancers.

Methods: The authors performed a pooled analysis of Medicare Health Outcomes Survey data from 2016 to 2020 in participants ≥65 years of age with a self-reported history of HF or active treatment for lung, colon, breast, or prostate cancer. They used the Veterans RAND-12 physical component score (PCS) and mental component score (MCS), which range from 0-100 with a mean score of 50 (based on the U.S. general population) and an SD of 10. The authors used pairwise Student's t-tests to evaluate for differences in PCS and MCS between groups.

Results: Among participants with HF (n = 71,025; 54% female, 16% Black), mean PCS was 29.5 and mean MCS 47.9. Mean PCS was lower in people with HF compared with lung (31.2; n = 4,165), colorectal (35.6; n = 4,270), breast (37.7; n = 14,542), and prostate (39.6; n = 17,670) cancer (all P < 0.001). Participants with HF had a significantly lower mean MCS than those with lung (31.2), colon (50.0), breast (52.0), and prostate (53.0) cancer (all P < 0.001).

Conclusions: People with HF experience worse HRQOL than those with cancer actively receiving treatment. The pervasiveness of low HRQOL in HF underscores the need to implement evidence-based interventions that target physical and mental health status and scale multidisciplinary clinics.

Keywords: comorbidities; heart failure; patient-reported outcomes; quality of life.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / psychology
  • Breast Neoplasms / therapy
  • Colorectal Neoplasms / psychology
  • Female
  • Health Status*
  • Health Surveys
  • Heart Failure* / epidemiology
  • Heart Failure* / psychology
  • Humans
  • Lung Neoplasms / psychology
  • Lung Neoplasms / therapy
  • Male
  • Medicare* / statistics & numerical data
  • Neoplasms*
  • Prostatic Neoplasms / therapy
  • Quality of Life*
  • United States / epidemiology