Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Integrated Cardiac Care and Palliative Homecare for Patients With Severe Heart Failure
Brief Summary: Patients with severe heart failure have as many symptoms as many patients with cancer but yet do not have equal access to supportive and palliative care. They have an unpredictable course of illness, which makes difficult to judge when the palliative stage has been reached. The Heart failure and Palliative care Programme is a three-year project in Sweden financed by the Swedish Association of Local Authorities and Regions (SALAR). The overall aim is to develop, implement and evaluate a model that integrates cardiac care and palliative advanced home care for patients with severe chronic heart failure. The primary aim is to study the effects on patients' symptom burden, quality of life and activities of daily living. A randomized controlled clinical study is planned.

Patients (n=62) with a confirmed diagnosis in accordance with the criteria proposed by the European Society of Cardiology and with NYHA III-IV symptoms and at least one of following criteria will be included;

1. At least one episode of worsening heart failure that resolved with injection / infusion of diuretics or the addition of other heart failure treatment in the last 6 months and regarded optimally treated according to the responsible physician.
2. Need for infusions-treatment.
3. Chronic poor quality of life (VAS \< 50)
4. Signs of cardiac cachexia (involuntary non-oedematous weight loss ≥ 6% of total body weight within the last 6-12 months)
5. less than one year life expectancy The participants will be randomized to intervention or control group. The intervention consist of a multidisciplinary approach and collaboration between specialist palliative and heart failure (HF) caregivers, in a shared structured person-centred and identity-promoting care at home during six months. Usual care is performed for the control group.


Options:
A: Arm Label: Home-based Palliative Care; Type: EXPERIMENTAL; Interventions: Other: Home-based palliative care | Arm Label: Enhanced Usual Care; Type: ACTIVE_COMPARATOR; Interventions: Other: Enhanced usual care | Intervention Type: OTHER; Name: Home-based palliative care; Assigned to Arm(s): Home-based Palliative Care | Intervention Type: OTHER; Name: Enhanced usual care; Assigned to Arm(s): Enhanced Usual Care
B: Arm Label: Integrated care; Type: EXPERIMENTAL; Interventions: Other: Integrated care | Arm Label: control; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: OTHER; Name: Integrated care; Assigned to Arm(s): Integrated care | Intervention Type: OTHER; Name: Integrated care; Assigned to Arm(s): Integrated care
C: Arm Label: Early Palliative Care Referral; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Early Palliative Care Referral | Arm Label: Conventional Cancer Care; Type: PLACEBO_COMPARATOR; Interventions: Behavioral: Early Palliative Care Referral | Intervention Type: BEHAVIORAL; Name: Early Palliative Care Referral; Assigned to Arm(s): Conventional Cancer Care, Early Palliative Care Referral
D: Arm Label: Usual Care + Transitional Care Model; Type: EXPERIMENTAL; Interventions: Behavioral: Transitional Care Model, Behavioral: Usual care | Arm Label: Usual Care; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Usual care | Intervention Type: BEHAVIORAL; Name: Transitional Care Model; Assigned to Arm(s): Usual Care + Transitional Care Model | Intervention Type: BEHAVIORAL; Name: Usual care; Assigned to Arm(s): Usual Care, Usual Care + Transitional Care Model

Answer: B