Quality of Life Assessment in Heart Failure Patients: Insights from a Low- to Middle-Income Country.

Background: Heart failure (HF) continues to have an immense impact, not only on tangible outcomes such as mortality, but also on patients' health-related quality of life (QoL). The aim of this study was to assess the QoL of patients living with HF using the Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Methods: The study considered consecutive patients of either gender, between 18 and 80 years of age, who had been diagnosed with HF with reduced ejection fraction for at least six months and who presented to the outpatient department for routine clinical follow-up. The QoL was assessed using KCCQ-12. Results: A total of 320 patients were included in this analysis; 257 (80.3%) were male, and the mean age was 54.9 ± 12.7 years, with 25 (7.8%) patients >70 years. The median time since HF was 24 (12-60) months. The median overall QoL score was 50.5 (32-75), with 81 (25.3%) categorized as good, 83 (25.9%) as moderate, 99 (30.9%) as poor, and 57 (17.8%) as having very poor QoL. In multivariable analysis, age >70 years, presence of diabetes, and non-adherence to medication were found to be independently associated with poor QoL, with adjusted odds ratios of 2.93 [1.06-8.06], 2.76 [1.66-4.61], and 1.72 [1.07-2.77], respectively. Conclusion: We observed good QoL in only one-fourth of the patients living with HF. Further, we observed that older age (>70 years), presence of diabetes, and non-adherence to medication were significantly associated with poorer QoL. These results underscore the need for targeted interventions to improve medication adherence and manage comorbidities, particularly diabetes, in order to enhance the QoL of HF patients.