Symptom Interference Severity and Health-Related Quality of Life in Pulmonary Arterial Hypertension

Abstract Context While assessing symptom severity is an important component of evaluating symptoms, understanding those symptoms that interfere with patients' lives is also key. Pulmonary arterial hypertension (PAH) is a chronic disease resulting in right heart failure and increased mortality. Patients with PAH experience multiple symptoms but we do not know which symptoms and to what extent their symptoms interfere with daily life. Objectives To: 1) describe the prevalence of those symptoms that interfere with life; 2) describe the severity of symptom interference; and 3) determine those sociodemographic and clinical characteristics and interfering symptoms associated with health-related quality of life (HRQOL) in patients with PAH. Methods A convenience sample of 191 patients with PAH completed a sociodemographic form, the Pulmonary Arterial Hypertension Symptom Interference Scale (PAHSIS) and the Medical Outcomes Survey Short Form-36 to measure HRQOL. Hierarchical multiple linear regression was used to analyze demographic and medical characteristics along with symptom interference from the PAHSIS as predictors of HRQOL from the composite mental and physical health summary scores of the Short Form-36. Results The most interfering symptoms reported were fatigue, shortness of breath with exertion, and difficulty sleeping. Age, gender, functional class, oxygen use, fatigue, dizziness, and Raynaud phenomenon were associated with the HRQOL physical health summary scores. The symptoms fatigue and SOB while lying down were associated with the HRQOL mental health summary scores. Conclusion Patients with PAH are experiencing multiple symptoms that are interfering with their HRQOL and ability to function.