• R K Moore, D Groves, S Bateson, P Barlow, C Hammond, A A Leach, and M R Chester.
• National Refractory Angina Centre, Royal Liverpool & Broadgreen University Hospital NHS Trust, UK.
• Eur J Pain. 2005 Jun 1; 9 (3): 305-10.

ObjectiveThis study was designed to assess the impact of a refractory angina programme on the health related quality of life for patients with chronic refractory angina (CRA) one year following enrolment.DesignA one year prospective audit.SettingSpecialist refractory angina clinic at a tertiary cardiac referral centre.Patients69 consecutive refractory angina patients referred to a regional refractory angina centre from 1/03/2001 to 1/09/2002.InterventionsPain treatment algorithm in accordance with the recommendations of the national refractory angina guideline committee.Main Outcome MeasuresImprovements in quality of life indices were assessed using Seattle angina questionnaire (SAQ), and short form-12 (SF-12) with changes in mood determined using the hospital anxiety and depression (HAD) questionnaire.ResultsAll dimensions of the SF-12 and SAQ were superior at one year with significant improvement seen with the mental component of SF-12 (p = 0.023), and four of the five SAQ domains, angina stability (p = 0.028), angina frequency (p=0.02), treatment satisfaction (p=0.001) and quality of life (p < 0.001). All the significant changes within the SAQ domains were large enough to be considered clinically relevant. At one year the anxiety and depression domains were significantly improved from baseline (p = 0.015, 0.018) with clinical anxiety levels falling significantly from 55% to 40%, a relative reduction of 28% (p = 0.008).ConclusionsImplementation of the national refractory angina guidelines in a prospective study of 69 consecutive CRA patients significantly improved health related quality of life status at one year.

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