Cardiac patients’ concerns and desire for information: a case for unmet needs

Tailoring healthcare provision to fulfil patients” needs is a principal objective of health services. Data on needs are sparse, especially in patients with coronary heart disease, who tend to have a high mortality rate, who often require admission to hospital and have an impaired health-related quality of life. A novel questionnaire was administered concomitantly with generic and specific quality of life tools in a cross-sectional study of a random sample of patients (n=242) aged 31–93 years (median 71 years) admitted with suspected acute coronary syndromes.
Patients with confirmed infarction had fewer healthcare needs and reported less need for information on heart disease compared to those with other manifestations of coronary disease (p<0.01). Those recently seen by a general practitioner were better informed about their current treatment (p<0.01). Coronary disease patients with low quality of life scores were more likely to be anxious about cardiac problems (p<0.001). They were more likely to spend more time thinking about these concerns (p<0.001) and to seek help from, and to have increased expectations of, the family doctor or cardiologist (p<0.001), particularly in seeking greater commitment to their care. Reported deficiencies in service included difficulty accessing healthcare services, especially for men < 65 years (p=0.01) and availability of repeat prescriptions for the over 75-year-olds (p<0.05). Patients with coronary disease had unmet healthcare needs and worse health-related quality of life. Further investigation of healthcare needs among patients with coronary disease could lead to simply improved services and major health improvement. Assessment of quality of life appeared to be a surrogate for formal healthcare needs assessment.