The Associations of Diagnoses of Fatigue and Depression with Use of Medical Services in Patients with Heart Failure

Background: Fatigue and depression based on self-report and diagnosis are prevalent in patients with heart failure and adversely affect high rates of hospitalization and emergency department visits, which can impact use of medical services. The relationships of fatigue and depression to use of medical services in patients with preserved and reduced left ventricular ejection fraction (LVEF) may differ. Purpose: We examined the associations of diagnoses of fatigue and depression with use of medical services in patients with preserved and reduced LVEF, controlling for covariates. Methods: Data were collected on fatigue, depression, covariates, and use of medical services. Patients (N = 582) were divided into 2 groups based on LVEF (<40%, reduced LVEF; ≥40%, preserved LVEF). Multiple linear regression analyses were used to analyze the data. Results: A diagnosis of fatigue was a significant factor associated with more use of medical services in the total sample (β =.18, P <.001, R² = 54%) and patients with reduced LVEF (β =.13, P =.008, R² = 54%) and also preserved LVEF (β =.21, P <.001, R² = 54%), controlling for all covariates, but a diagnosis of depression was not. Conclusions: This study demonstrates the important roles of a diagnosis of fatigue in use of medical services. Thus, fatigue needs to be assessed, diagnosed, and managed effectively.