Gender Differences in Patients with Advanced Heart Failure: A Secondary Data Analysis of the ENABLE CHF-PC Randomized Clinical Trial.

Background: Women appear to be underrepresented in heart failure and palliative care research. Given this underrepresentation, their unique characteristics, needs, and outcomes require further investigation. Methods: A secondary analysis of baseline data of the Educate, Nurture, Advise, Before Life Ends Comprehensive Heartcare for Patients and Caregivers study, a randomized clinical trial of Deep South patients ≥50 years of age with advanced HF. Differences in sociodemographics and measures of quality of life and mood between female and male patients were examined using bivariate tests and effect-size measures. Results: Statistically significant gender differences were observed with females reporting poorer quality of life-The Kansas City Cardiomyopathy Measure (49.55 ± 20.04 vs. 55.37 ± 21.52, d = 0.28, p-adj = 0.01), Patient-Reported Outcome Measurement Information System (PROMIS) Global Mental Health (44 ± 8.02 vs. 46.53 ± 9.01, d = 0.30, p-adj = 0.007), and PROMIS Global Physical Health (37.37 ± 7.65 vs. 39.2 ± 8.20, d = 0.23, p-adj = 0.034) and Hospital Anxiety and Depression Scale anxiety (6.9 ± 4.38 vs. 4.72 ± 3.89, d = 0.53, p-adj = 0.003) compared with men at baseline. Conclusion: Further investigation of gender differences is necessary to improve outcomes and inform the refinement of PC-HF interventions for females.