Featured Research

from universities, journals, and other organizations

Heart Failure Patients Often Overestimate Their Own Life Expectancy

Date:
June 4, 2008
Source:
Duke University Medical Center
Summary:
Many patients with heart failure -- especially younger ones and those with more severe disease -- significantly overestimate how long they going to live, say Duke University Medical Center researchers.

Many patients with heart failure -- especially younger ones and those with more severe disease -- significantly overestimate how long they going to live, say Duke University Medical Center researchers.

"It's a bit of a puzzle," says Dr. Larry Allen, a cardiologist at Duke and the lead author of the study. "As physicians, we know how important it is to talk with our patients about end of life issues, but this study suggests we may need to take another look at how we might do that better."

The research showed that among 122 patients with heart failure enrolled in the Duke University Heart Failure Disease Management Program, the patients, on average, believed the would live about 40 percent longer than what accepted survival models predicted.

While the reasons underlying the phenomenon aren't clear, scientists say the finding may hold important implications about options such as high-end medical devices, transplantation or palliative care -- important decisions that have enormous impact on patients' quality of life and clinical outcomes.

According to the American Heart Association, about five million people in the United States have heart failure, a condition in which the heart becomes weak and is no longer able to pump as much blood as the body needs. Despite advances in treatment options, the prognosis for patients with symptomatic heart failure is grim: Median life expectancy is less than five years.

Michael Felker, M.D., the senior investigator of the study and a member of the Duke Clinical Research Institute, says the finding is important on many levels.

"With the increasing availability of potentially life-saving but costly therapies, patients need to be fully aware of their prognosis in order to make appropriate decisions about their care. Our data suggest that is not happening, and that many heart failure patients do not have an accurate understanding of their likely survival," says Felker.

When researchers asked the patients to address the eventual outcome of their disease, 9 percent said they thought they would be cured, 51 percent said they thought they would have normal life expectancy and 36 percent said they thought heart failure would shorten their lives.

On average, the patients said they thought they would live an additional 13 years. But the widely accepted Seattle Heart Failure Model suggested that the patients would only live an additional 10 years, on average. Patient predictions were highly variable, ranging from 1 to 54 years, and had almost no correlation with individual model predictions.

The data showed that patients appeared to predict their life expectancy without regard to the severity of their illness; those with advanced disease were just as likely to predict a longer than expected life as those with less severe disease. The researchers also found that prior discussions with their clinicians (only about a third of them had talked with a clinician about their prognosis) didn't seem to make any difference in the degree to which they were able to realistically predict outcomes. They also discovered that there was no relationship between a higher estimate of longevity and improved survival.

"Even though we didn't find any difference between patients who had spoken with their caregivers about end of life and those that had not, that doesn't mean that better communication wouldn't help change things," says Allen. "Patients are only able to take in so much information at one time. Maybe we need to revisit end of life issues several times over and check in to make sure important messages are not just stated, but understood, as well. It's a very complex issue, and one that needs more study."

Researchers from Duke who contributed to the study include James Tulsky, Christopher O'Connor, Margaret Bowers and Gwen Dodson. Additional co-authors include Wayne Levy, of the University of Washington, who developed the Seattle Heart Failure Model; Jonathan Yager, from Cardiac Care Associates in Fairfax, Va.; and Michele Jonsson Funk from the University of North Carolina at Chapel Hill.


Story Source:

The above story is based on materials provided by Duke University Medical Center. Note: Materials may be edited for content and length.


Journal Reference:

  1. Larry A. Allen, MD, MHS; Jonathan E. Yager, MD; Michele Jonsson Funk, PhD; Wayne C. Levy, MD; James A. Tulsky, MD; Margaret T. Bowers, RN, MSN; Gwen C. Dodson, RN, MSN; Christopher M. O%u2019Connor, MD; G. Michael Felker, MD, MHS. Discordance Between Patient-Predicted and Model-Predicted Life Expectancy Among Ambulatory Patients With Heart Failure. JAMA, 2008;299(21):2533-2542 [link]

Cite This Page:

Duke University Medical Center. "Heart Failure Patients Often Overestimate Their Own Life Expectancy." ScienceDaily. ScienceDaily, 4 June 2008. <www.sciencedaily.com/releases/2008/06/080603164404.htm>.
Duke University Medical Center. (2008, June 4). Heart Failure Patients Often Overestimate Their Own Life Expectancy. ScienceDaily. Retrieved July 22, 2014 from www.sciencedaily.com/releases/2008/06/080603164404.htm
Duke University Medical Center. "Heart Failure Patients Often Overestimate Their Own Life Expectancy." ScienceDaily. www.sciencedaily.com/releases/2008/06/080603164404.htm (accessed July 22, 2014).

Share This




More Health & Medicine News

Tuesday, July 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com
$23.6 Billion Awarded To Widow In Smoking Lawsuit

$23.6 Billion Awarded To Widow In Smoking Lawsuit

Newsy (July 20, 2014) Cynthia Robinson claims R.J. Reynolds Tobacco Company hid the health and addiction risks of its products, leading to the death of her husband in 1996. Video provided by Newsy
Powered by NewsLook.com
Tooth Plaque Provides Insight Into Diets Of Ancient People

Tooth Plaque Provides Insight Into Diets Of Ancient People

Newsy (July 19, 2014) Research on plaque from ancient teeth shows that our prehistoric ancestor's had a detailed understanding of plants long before developing agriculture. Video provided by Newsy
Powered by NewsLook.com
Contaminated Water Kills 3 Babies in South African Town

Contaminated Water Kills 3 Babies in South African Town

AFP (July 18, 2014) Contaminated water in South Africa's northwestern town of Bloemhof kills three babies and hospitalises over 500 people. The incident highlights growing fears over water safety in South Africa. Duration: 02:22 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins