Evidence‐based treatment and quality of life in heart failure

Objectives  To explore whether prescription of evidence‐based drug therapy is associated with better quality of life (QoL) in patients with heart failure (HF). Methods  Patients ( n  = 62) were recruited in the outpatient clinic of Groningen University Hospital. Inclusion criteria were previous diagnosis of HF, age 40–80 years; ejection fraction of less than 45%, free from other serious disease (such as cancer) and psychiatric problems in the last year. QoL was assessed with the RAND 36‐item health survey questionnaire, on five scales: physical functioning, mental health, social functioning, vitality and general health perception. Medication prescribed for 1 to 6 months before the QoL assessment was classified as either evidence‐based treatment or under‐treatment, according to the 2001 European guidelines on optimal HF treatment. The study had a cross‐sectional design. Results  QoL did not differ significantly between evidence‐based and under‐treated patients, unadjusted or after adjustment for significant patient imbalances. Conclusions  Conventional step‐up medication approach in HF may have a positive impact on survival or morbidity, but it seems not beneficial in relation to QoL. Other interventions should be designed to improve QoL of patients with HF.