The Associations of Diagnoses of Fatigue and Depression With Use of Medical Services in Patients With Heart Failure.
Seongkum Heo, Jean McSweeney, Pao-Feng Tsai and 3 others
PMID 31094761WHAT IT FOUND
In heart failure patients, a recorded fatigue diagnosis was associated with more medical services.
Patients with that diagnosis also had more hospitalizations, ED visits, and longer stays. A depression diagnosis was not associated with medical services. The study cannot show fatigue caused them.
Key findings
0145.4% of patients had a recorded fatigue diagnosis and 26.3% had a recorded depression diagnosis.
02A recorded fatigue diagnosis was associated with more use of medical services in the total sample and in both reduced LVEF and preserved LVEF subgroups.
03A recorded depression diagnosis was not associated with more use of medical services.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary analysis of medical records, not an intervention study, so it cannot show that fatigue caused higher service use. Fatigue and depression diagnoses depended on documentation in the records, so actual symptoms may have been missed or misclassified. Medical service use was counted from CPT codes without weighting and did not include hospitalizations, ED visits, or length of stay, although those were analysed separately. The study did not collect self-reported fatigue, so a diagnosis of fatigue may not match what patients experience. Depression and fatigue can overlap, and diagnosis-based rates may differ from questionnaire-based rates. The supplied text does not state the total number of patients analysed, so the size and precision of the findings cannot be judged.
Declared interests
The supplied text lists NIH extramural research support. It does not provide an author conflict of interest statement or details about who designed, collected, analysed, or wrote the study.
The easy way to misread this
Do not conclude that treating fatigue will reduce medical service use. This was a record-based association study, and it showed only that a documented fatigue diagnosis occurred with more service use; it did not test any treatment.