Quality of Life Outcomes in Patients with Pulmonary Hypertension Receiving Prostacyclin Therapy: Impact of Anxiety, Depression, Sociodemographic Characteristics, and Treatment-Related Factors

Objective: Despite advances in prostacyclin therapy, pulmonary hypertension (PH) continues to impair patients' quality of life (QoL). This study aimed to identify the clinical and psychological factors associated with QoL in patients receiving prostacyclin therapy.
Method: This cross-sectional study was conducted between July 2023 and September 2024 and included 58 patients with PH receiving prostacyclin therapy. Data were collected using a structured questionnaire assessing sociodemographic and disease-related characteristics. Symptom severity, anxiety, depression, and QoL were evaluated using the Pulmonary Arterial Hypertension Symptom Scale (PAHSS), the Hospital Anxiety and Depression Scale (HADS), and the EmPHasis-10 Questionnaire.
Results: The mean age of the patients was 48.89 ± 16.17 years, and 69% were female. Overall, 69% had at least one chronic comorbidity, 19% required continuous oxygen therapy, and the mean disease duration was 7.45 ± 6.84 years. The average duration of prostacyclin therapy was 28.03 ± 34.21 months. Mean scores were 71.52 ± 36.40 for PAHSS, 8.70 ± 5.23 for HADS-Anxiety, 7.82 ± 5.32 for HADS-Depression, and 30.05 ± 14.92 for EmPHasis-10. EmPHasis-10 scores showed moderate correlations with PAHSS, HADS-Anxiety, HADS-Depression, and 6-minute walk test (6MWT) scores. In multivariate analysis, age, PAHSS score, anxiety, depression, and vomiting explained 80% of the variance in EmPHasis-10 scores.
Conclusion: QoL was substantially impaired in patients with PH receiving prostacyclin therapy and was influenced by age, symptom severity, anxiety, depression, and vomiting.

Keywords: Depressive symptoms, prostacyclin therapy, pulmonary hypertension, quality of life, symptom burden