June 09, 2017

ACVIM 2017: Measuring Quality of Life in Owners of Dogs with Heart Disease

At ACVIM 2017, Dr. Lisa M. Freeman presented results of a study evaluating quality of life for owners of dogs with heart disease.
By JoAnna Pendergrass, DVM


At ACVIM 2017 in National Harbor, Maryland, Lisa M. Freeman, DVM, PhD, DACVN, discussed quality of life (QoL) for caregivers of human and veterinary patients with heart disease and presented results of a study evaluating QoL among owners of dogs with heart disease. Dr. Freeman is professor of clinical sciences at the Cummings School of Veterinary Medicine at Tufts University.
 
QoL, Dr. Freeman said, is a nebulous term. The World Health Organization defines QoL as “an individual’s perception of [his or her] position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns.” QoL has become increasingly important in human cardiovascular medicine; in veterinary medicine, it plays a major factor in the decision to euthanize.
 
Patient Quality of Life
QoL assessments can be tools for intervention and improving communication with patients and caregivers. A patient’s QoL is typically measured using health-related questionnaires, which can be either general or disease-specific. The Minnesota Living With Heart Failure questionnaire is commonly used to evaluate QoL in human patients with heart disease.
 
In 2005, Dr. Freeman and her team published a study in JAVMA on their development of the FETCH (functional evaluation of cardiac health) QoL questionnaire. This questionnaire, adapted from the Minnesota questionnaire, assesses the QoL in dogs with heart disease.
 
Caregiver Quality of Life
Caregiver QoL questionnaires have been more challenging to develop. Since 2011, several QoL questionnaires for caregivers of human patients with heart failure have been developed and include such domains as social support and physical well-being. However, Dr. Freeman noted, QoL questionnaires for pet owners have not yet been developed.
 
Study Design
Using caregiver-focused questions from the FETCH questionnaire, Dr. Freeman and her research team created a 7-item questionnaire to evaluate QoL in owners of dogs with heart disease. The self-administered questionnaire assessed how various factors, such as sleep, medication administration, and worry about dog’s condition affected owner QoL.
  
Questions were scored from 0 (lowest QoL) to 5 (highest QoL). Owners also completed the 17-question FETCH questionnaire (0–5 score/question) to provide dog QoL information.
 
Dogs were grouped according to heart disease type, with disease severity classified using International Small Animal Cardiac Health Council guidelines. Statistical analyses were performed to analyze QoL scores and determine questionnaire reliability, readability, and validity.
 
Study Results
Owner QoL scores ranged widely. All items significantly correlated with owner QoL scores, with the highest correlations being with sleep, reluctance to leave home, and worry. Owner QoL scores also significantly correlated with dog QoL scores. Median owner and dog QoL scores were similar. Statistical analysis indicated that the owner questionnaire was valid and reliable.
 
Dr. Freeman mentioned several study limitations. For example, questionnaire items were generated from experience and talking with owners. In addition, all dogs were from Tuft’s referral hospital, potentially introducing patient bias.
 
Taken together, the study results demonstrated that owner QoL is significantly influenced by a dog’s heart disease. Further testing, Dr. Freeman said, is needed to optimize the questionnaire for use in predicting outcomes like medication compliance and prognosis.
 
 
Dr. JoAnna Pendergrass received her Doctor of Veterinary Medicine degree from the Virginia-Maryland College of Veterinary Medicine. Following veterinary school, she completed a postdoctoral fellowship at Emory University’s Yerkes National Primate Research Center. Dr. Pendergrass is the founder and owner of JPen Communications, a medical communications company.

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