Quality of life, care needs and priorities in atrial fibrillation: the impact of number and patterns of comorbidities

PURPOSE: Atrial fibrillation (AF) often coexists with multiple chronic conditions, worsening health-related quality of life (HRQoL) and increasing the burden on patients and caregivers. While multimorbidity is known to worsen clinical outcomes, the role of distinct comorbidity patterns in shaping patients' experience remains unclear. This cross-sectional study assessed whether the number and patterns of comorbidities differentially affect HRQoL, care needs, and priorities of AF patients and caregivers. METHODS: An online survey on living with AF and multimorbidity was disseminated between May 2022 and January 2023 in the UK, Italy, Spain, Romania, and Denmark. The analysis included 633 AF patients (46.9% females, median age 73 years) and 198 caregivers (26.8% females, median age 57 years). Exposure variables were the number and patterns (derived through latent class analysis) of comorbidities. Outcomes included HRQoL (measured with the EQ-5D-3L), perceived management problems and health priorities assessed through a structured questionnaire developed ad hoc for the survey. RESULTS: Three patterns emerged: unspecific (65.5%), diabetes-kidney-liver (18.2%), and complex (16.4%). More comorbidities and belonging to the complex pattern were associated with worse HRQoL, mainly due to limited mobility, dependency, and pain. Main issues were managing multiple diseases, medi ions, and appointments. The diabetes-kidney-liver group prioritized improving quality of life (OR=3.08, 95%CI:1.68-6.00) and living longer (OR=1.67, 95%CI:1.05-2.64), while pain relief was a distinct priority in the complex pattern (OR=2.32, 95%CI:1.38-3.86). CONCLUSION: Both number and combinations of AF comorbidities shape patients' and caregivers' experiences. Considering comorbidity profiles can help define targeted care plans and caregiver support initiatives.

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Journal
Quality of Life Research
Published
2026-04-01
DOI
https://doi.org/10.1007/s11136-025-04117-4
Primary Topic
Atrial Fibrillation Management and Outcomes
Type
article
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article

Quality of life, care needs and priorities in atrial fibrillation: the impact of number and patterns of comorbidities

Charlotte Stockton-Powdrell, Carrol L. Gamble, Iain Buchan, Cheïma Amrouch et al.
Quality of Life Research
Atrial Fibrillation Management and Outcomes
article

Quality of life, care needs and priorities in atrial fibrillation: the impact of number and patterns of comorbidities

Charlotte Stockton-Powdrell, Carrol L. Gamble, Iain Buchan, Cheïma Amrouch, Adele Ravelli, Stefanie De Buyser, Delphine De Smedt, Donato Giuseppe Leo, Lorenzo Palamenghi, José Miguel Rivera‐Caravaca, Vincenzo Rebba, Guendalina Graffigna, Jacek Marczyk, Andrea Lorimer, Serena Barello, Pia Cordsen, Benedetta Marcozzi, Trudie Lobban, Alessandra Buja, Nathan Lea, Elisabeta Bădilă, Georg Ruppe, Brendan Collins, Anca Rodica Dan, Chris Kypridemos, Donata Lucci, Caterina Bosio, Francisco Marín Ortuño, Roberto Da, Nadia Rosso, Alessandro Ferri, Laura Vivani, Dipak Kalra, Vanessa Roldán, Aldo Pietro Maggioni, Alam Sanaullah, Lu Dai, Marco Cicerone, Gehad Shehata, Silvia Anastasia, Davide Liborio Vetrano, Riccardo Proietti, Tatjana Potpara, Bruno Micael Zanforlini, Amaia Calderón-Larrañaga, Stefania Maggi, Søren Paaske Johnsen, Gregory Lip, John Ainsworth, Mariya Tokmakova, Cecilia Damiano, Martin O’Flaherty, Caterina Trevisan, Donato Leo, Federica Censi, Giuseppe Sergi, Mirko Petrovic, Nicola Ferri, Gheorghe-Andrei Dan, Deirdre A. Lane, Marianna Noale
article en

Abstract

PURPOSE: Atrial fibrillation (AF) often coexists with multiple chronic conditions, worsening health-related quality of life (HRQoL) and increasing the burden on patients and caregivers. While multimorbidity is known to worsen clinical outcomes, the role of distinct comorbidity patterns in shaping patients' experience remains unclear. This cross-sectional study assessed whether the number and patterns of comorbidities differentially affect HRQoL, care needs, and priorities of AF patients and caregivers. METHODS: An online survey on living with AF and multimorbidity was disseminated between May 2022 and January 2023 in the UK, Italy, Spain, Romania, and Denmark. The analysis included 633 AF patients (46.9% females, median age 73 years) and 198 caregivers (26.8% females, median age 57 years). Exposure variables were the number and patterns (derived through latent class analysis) of comorbidities. Outcomes included HRQoL (measured with the EQ-5D-3L), perceived management problems and health priorities assessed through a structured questionnaire developed ad hoc for the survey. RESULTS: Three patterns emerged: unspecific (65.5%), diabetes-kidney-liver (18.2%), and complex (16.4%). More comorbidities and belonging to the complex pattern were associated with worse HRQoL, mainly due to limited mobility, dependency, and pain. Main issues were managing multiple diseases, medi ions, and appointments. The diabetes-kidney-liver group prioritized improving quality of life (OR=3.08, 95%CI:1.68-6.00) and living longer (OR=1.67, 95%CI:1.05-2.64), while pain relief was a distinct priority in the complex pattern (OR=2.32, 95%CI:1.38-3.86). CONCLUSION: Both number and combinations of AF comorbidities shape patients' and caregivers' experiences. Considering comorbidity profiles can help define targeted care plans and caregiver support initiatives.

Quality of Life ResearchVol. 35(5)
University of Padua (IT), University of Liverpool (GB), Carol Davila University of Medicine and Pharmacy (RO), University of Ferrara (IT), Aalborg University Hospital (DK), Ghent University Hospital (BE), Karolinska Institutet (SE), Academia Oamenilor de Știință din România (RO), Liverpool Heart and Chest Hospital (GB), Instituto Murciano de Investigación Biosanitaria (ES), Stockholm Gerontology Research Center Foundation (SE), Spitalul Clinic Colentina (RO), Aalborg University (DK)
University of Liverpool, Aalborg Universitet, Karolinska Institutet, Universiteit Gent, Consiglio Nazionale delle Ricerche
Openalex Percentile: Top 36%
Atrial Fibrillation Management and Outcomes
DOIOpen Access PDFOpenAlex
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