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- Title
Was it worth it? Benefits of transcatheter aortic valve implantation from a patient's perspective.
- Authors
Beishuizen, Sara J. E.; Festen, Suzanne; van der Werf, Hindrik W.; de Graeff, Pauline; van Munster, Barbara C.
- Abstract
Objectives: Transcatheter aortic valve implantation (TAVI) is an important treatment option for patients with severe aortic stenosis. To improve patient selection, shared decision‐making is recommended to elicit patients' treatment expectations and goals. We assessed patients' expectations and goals before TAVI treatment and whether these were met after treatment. Additionally, we evaluated how meeting these goals aligned with quality of life and functional recovery. Design A mixed method study. Setting: An academic medical center. Participants: Seventy‐four patients undergoing TAVI between 2015 and 2017. Measurements Patients' expectations and goals were assessed qualitatively before treatment. Six to twelve months post procedure, quality of life was measured with the EuroQuol‐5D and any change in the number of dependencies in (instrumental) activities of daily living was assessed. Results: Mean age of patients was 81.5 years, and 37.8% were male. Regaining the ability to engage in a specific hobby or activity was the most important treatment goal (33 patients, 54.1%), followed by reducing symptoms (19 patients 31.1%). 66.2% of patients stated that their treatment goal was met. Quality of life was higher in this group, as compared with patients who had not met their treatment goal. Twenty‐three patients (31.1%) showed functional improvement. Conclusion: TAVI patients were quite capable of eliciting treatment goals and a majority stated, after treatment, that these had been met patients' experience of treatment benefits regarding these goals had poor alignment with functional outcomes. This raises questions regarding relevant outcome measurements in this population, and could aid in improving shared decision‐making and patient selection for TAVI.
- Subjects
HEART valve prosthesis implantation; ACADEMIC medical centers; CONVALESCENCE; FUNCTIONAL status; RESEARCH methodology; SELF-management (Psychology); AORTIC stenosis; HEALTH outcome assessment; ACTIVITIES of daily living; PATIENT-centered care; PATIENTS' attitudes; TREATMENT effectiveness; PRE-tests &; post-tests; PHYSICAL activity; QUALITY of life; COST effectiveness; QUESTIONNAIRES; DESCRIPTIVE statistics; DECISION making; HOBBIES; GOAL (Psychology); DEPENDENCY (Psychology); EVALUATION
- Publication
Journal of the American Geriatrics Society, 2021, Vol 69, Issue 9, p2605
- ISSN
0002-8614
- Publication type
Article
- DOI
10.1111/jgs.17216