Adverse psychological effects and costs associated with waiting for radiofrequency ablation

Justin L. Barclay, Patrick H. Gibson, Adele Lewis, Claire Wilson, Jonathan T. Affolter, Jitendra C. Patel, Neil W. Scott, David A. Alexander, Anna Maria Choy, Paul A. Broadhurst

Research output: Contribution to journalArticle

Abstract

Background
Radiofrequency ablation (RFA) is undertaken as a potentially curative treatment for a variety of heart rhythm disturbances. Previous studies have demonstrated improved quality of life and reduced symptoms after ablation. In many health care environments waiting lists exist for scheduling of procedures. However, the psychological effects of waiting for radiofrequency ablation have not previously been assessed. We hypothesized that waiting for this intervention may be associated with increased psychological morbidity and health care costs.

Methods
Ninety-two patients scheduled for elective RFA completed repeated questionnaires comprising the Medical Outcomes Short Form 36, Hospital Anxiety and Depression Scale, and an in-house questionnaire designed to assess the burden of symptoms related to arrhythmia (arrhythmia-related burden score). Mean scores were generated and compared at time points while waiting, before and after the procedure. Regression analyses were carried out to identify predictors of increased psychological morbidity while waiting and immediately prior to the procedure. Health care costs during the waiting period as a consequence of arrhythmia were quantified.

Results
Mean scores for parameters of psychological morbidity worsened during the period of waiting and improved after the procedure. Predictors of adverse effects within the cohort varied according to the time point assessed for each of the measures of psychological morbidity. A conservative estimate of the health care cost incurred while waiting exceeds £181 per patient.

Conclusions
Waiting for radiofrequency ablation appears to be associated with adverse psychological effects and health care costs. These results may support strategies to reduce waiting times and prioritize resource allocation.
Original languageEnglish
Pages (from-to)719-726
Number of pages8
JournalPACE
Volume36
Issue number6
Early online date25 Feb 2013
DOIs
Publication statusPublished - Jun 2013

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Psychology
Costs and Cost Analysis
Health Care Costs
Morbidity
Cardiac Arrhythmias
Cohort Effect
Waiting Lists
Resource Allocation
Anxiety
Regression Analysis
Quality of Life
Depression
Delivery of Health Care
Surveys and Questionnaires
Therapeutics

Keywords

  • radiofrequency ablation
  • quality of life
  • psychological effects
  • health economics

Cite this

Adverse psychological effects and costs associated with waiting for radiofrequency ablation. / Barclay, Justin L.; Gibson, Patrick H.; Lewis, Adele; Wilson, Claire; Affolter, Jonathan T.; Patel, Jitendra C.; Scott, Neil W.; Alexander, David A.; Choy, Anna Maria; Broadhurst, Paul A.

In: PACE, Vol. 36, No. 6, 06.2013, p. 719-726.

Research output: Contribution to journalArticle

Barclay, JL, Gibson, PH, Lewis, A, Wilson, C, Affolter, JT, Patel, JC, Scott, NW, Alexander, DA, Choy, AM & Broadhurst, PA 2013, 'Adverse psychological effects and costs associated with waiting for radiofrequency ablation', PACE, vol. 36, no. 6, pp. 719-726. https://doi.org/10.1111/pace.12099
Barclay, Justin L. ; Gibson, Patrick H. ; Lewis, Adele ; Wilson, Claire ; Affolter, Jonathan T. ; Patel, Jitendra C. ; Scott, Neil W. ; Alexander, David A. ; Choy, Anna Maria ; Broadhurst, Paul A. / Adverse psychological effects and costs associated with waiting for radiofrequency ablation. In: PACE. 2013 ; Vol. 36, No. 6. pp. 719-726.
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abstract = "BackgroundRadiofrequency ablation (RFA) is undertaken as a potentially curative treatment for a variety of heart rhythm disturbances. Previous studies have demonstrated improved quality of life and reduced symptoms after ablation. In many health care environments waiting lists exist for scheduling of procedures. However, the psychological effects of waiting for radiofrequency ablation have not previously been assessed. We hypothesized that waiting for this intervention may be associated with increased psychological morbidity and health care costs.MethodsNinety-two patients scheduled for elective RFA completed repeated questionnaires comprising the Medical Outcomes Short Form 36, Hospital Anxiety and Depression Scale, and an in-house questionnaire designed to assess the burden of symptoms related to arrhythmia (arrhythmia-related burden score). Mean scores were generated and compared at time points while waiting, before and after the procedure. Regression analyses were carried out to identify predictors of increased psychological morbidity while waiting and immediately prior to the procedure. Health care costs during the waiting period as a consequence of arrhythmia were quantified.ResultsMean scores for parameters of psychological morbidity worsened during the period of waiting and improved after the procedure. Predictors of adverse effects within the cohort varied according to the time point assessed for each of the measures of psychological morbidity. A conservative estimate of the health care cost incurred while waiting exceeds £181 per patient.ConclusionsWaiting for radiofrequency ablation appears to be associated with adverse psychological effects and health care costs. These results may support strategies to reduce waiting times and prioritize resource allocation.",
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AU - Patel, Jitendra C.

AU - Scott, Neil W.

AU - Alexander, David A.

AU - Choy, Anna Maria

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N2 - BackgroundRadiofrequency ablation (RFA) is undertaken as a potentially curative treatment for a variety of heart rhythm disturbances. Previous studies have demonstrated improved quality of life and reduced symptoms after ablation. In many health care environments waiting lists exist for scheduling of procedures. However, the psychological effects of waiting for radiofrequency ablation have not previously been assessed. We hypothesized that waiting for this intervention may be associated with increased psychological morbidity and health care costs.MethodsNinety-two patients scheduled for elective RFA completed repeated questionnaires comprising the Medical Outcomes Short Form 36, Hospital Anxiety and Depression Scale, and an in-house questionnaire designed to assess the burden of symptoms related to arrhythmia (arrhythmia-related burden score). Mean scores were generated and compared at time points while waiting, before and after the procedure. Regression analyses were carried out to identify predictors of increased psychological morbidity while waiting and immediately prior to the procedure. Health care costs during the waiting period as a consequence of arrhythmia were quantified.ResultsMean scores for parameters of psychological morbidity worsened during the period of waiting and improved after the procedure. Predictors of adverse effects within the cohort varied according to the time point assessed for each of the measures of psychological morbidity. A conservative estimate of the health care cost incurred while waiting exceeds £181 per patient.ConclusionsWaiting for radiofrequency ablation appears to be associated with adverse psychological effects and health care costs. These results may support strategies to reduce waiting times and prioritize resource allocation.

AB - BackgroundRadiofrequency ablation (RFA) is undertaken as a potentially curative treatment for a variety of heart rhythm disturbances. Previous studies have demonstrated improved quality of life and reduced symptoms after ablation. In many health care environments waiting lists exist for scheduling of procedures. However, the psychological effects of waiting for radiofrequency ablation have not previously been assessed. We hypothesized that waiting for this intervention may be associated with increased psychological morbidity and health care costs.MethodsNinety-two patients scheduled for elective RFA completed repeated questionnaires comprising the Medical Outcomes Short Form 36, Hospital Anxiety and Depression Scale, and an in-house questionnaire designed to assess the burden of symptoms related to arrhythmia (arrhythmia-related burden score). Mean scores were generated and compared at time points while waiting, before and after the procedure. Regression analyses were carried out to identify predictors of increased psychological morbidity while waiting and immediately prior to the procedure. Health care costs during the waiting period as a consequence of arrhythmia were quantified.ResultsMean scores for parameters of psychological morbidity worsened during the period of waiting and improved after the procedure. Predictors of adverse effects within the cohort varied according to the time point assessed for each of the measures of psychological morbidity. A conservative estimate of the health care cost incurred while waiting exceeds £181 per patient.ConclusionsWaiting for radiofrequency ablation appears to be associated with adverse psychological effects and health care costs. These results may support strategies to reduce waiting times and prioritize resource allocation.

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KW - quality of life

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