Quality of life in patients with atrial fibrillation and multimorbidity, and their caregivers: results from the AFFIRMO international online survey

Patients with atrial fibrillation (AF) often have additional concomitant chronic conditions that affect their clinical management and quality of life (QoL). The AFFIRMO study aims to examine ways of optimising care and self-management for AF patients with multimorbidity.

An online survey open to AF patients and their caregivers was distributed to five countries (UK, Italy, Denmark, Romania and Spain) between June 2022 and January 2023. QoL among patients was assessed using the EQ-5D-3L questionnaire, while life changes for caregivers was assessed using the Bakas Caregiving Outcome Scale (BCOS).

659 patients (47.2% males, mean age: 70.9 [SD 10.2] years), and 201 caregivers (26.9% males, mean age 58.3 [SD 15.2] years) participated in the survey. Patients reported significant sex differences in health status (Table 1), with men reporting an overall higher QoL, while women reported greater impairment in mobility and usual activities, with higher levels of pain/discomfort. Patients aged >65 years reported greater impairment in QoL compared to the younger ones, with patients from Southern Europe reporting greater impairment in self-care than those from Eastern or Northern Europe. Patients with higher education reported better QoL.

Among caregivers (Table 2), men reported less negative life changes compared to women, with the latter also reporting more pain/discomfort. Caregivers aged <65 years reported greater impairment in mobility and usual activities than those aged ≥65 years, and those aged <50 years reported a higher level of anxiety/depression. Caregivers aged <75 years reported greater negative life changes than those aged ≥75 years. Caregivers from Spain reported less negative life changes compared to caregivers from other countries. Caregivers with further education level reported better overall quality of life and greater negative life changes compared to caregivers with lower levels of education.

The QoL of patients with AF and multimorbidity seems to be compromised especially in females and in the older ones. The caregivers of these patients also experience negative life changes, in particular those with younger age. The results of the AFFIRMO study will help in the development of better clinical and self-management strategies for AF patients with multimorbidity to reduce the negative impact on QoL.

Differences in patients' QoL