A review of health-related quality of life patient-reported outcome measures in cardiovascular nursing

Background: The traditional use of physically focused outcome measures fails to capture holistic, quality of life issues of importance to patients. The relatively recent, rapidly growing interest in patient-reported outcome measures (PROMs) attests to this and clinicians are faced with difficult decisions regarding their choice and use. Aims: The purpose of this review was to identify and synthesise the literature pertaining to the concept of quality of life and the main PROMs used to measure this in the cardiovascular field. Methods: A review of the recent literature was undertaken on commonly used cardiovascular health-related quality of life (HRQoL) PROMs. Results: Two types of HRQoL PROMs are available: disease-specific and generic. Both have limitations, and in many instances there is merit in using a combination, depending on the medical condition and treatment. In addition to psychometric considerations such as reliability, validity and responsiveness, the choice of a PROM will depend on factors such as the patient/investigator burden its use may impose, resources, costs, intellectual property and copyright issues. A new 'hybrid' HRQoL PROM for use in patients across the main cardiovascular disease presentations - angina, myocardial infarction and heart failure - appears to show promise. Conclusions: Cardiovascular HRQoL PROMs have a wide variety of uses and can help clinicians, researchers, managers and policy makers in decision making and provide indicators of clinical and institutional quality and outcomes. New HRQoL PROMs are emerging and their choice and use should be determined by a host of issues, including psychometric properties, acceptability, feasibility and cost.