Palliative Care for Heart Failure Patients

Study Overview
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Brief Summary
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The purpose of this study is to assess the impact of palliative care consultation on quality of life and symptom management for patients hospitalized with acute heart failure with a randomized control trial at Abbott Northwestern Hospital.

Detailed Description
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Research questions: Q1. Does the provision of palliative care to heart failure patients yield higher quality of life, increased symptom management, or reduced depression compared to heart failure patients not receiving palliative care? Q2. Does the provision of palliative care to heart failure patients result in differential use of medical services (lower hospital days and readmission) compared to heart failure patients not receiving systematic palliative care?

Official Title
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An Examination of Palliative Care as Standard Practice for Heart Failure Patients

Conditions
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Heart Failure

Intervention / Treatment
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* Other: Palliative Care Consultation
* Other: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Abbott Northwestern Hospital inpatient adults with a diagnosis of acute heart failure Exclusion Criteria: Are not an inpatient at Abbott Northwestern Hospital Are in the ICU On a ventilator Are pre-or post heart transplant Have a ventricular assist device (VAD) Determined to be actively dying Have cognitive impairments such that informed consent would not be possible, Are not proficient in the English language

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Palliative Care Consultation<br>Participant will get one palliative care consultation while in the hospital. The participants desire for subsequent palliative care visits will be determined and mutually agreed upon at the initial consultation. | Other: Palliative Care Consultation<br>* Intervention patient would receive an inpatient palliative care consultation to focus on comprehensive symptom assessment, create goals of care/treatment plan which include recommendations and referrals.<br>* Other names: palliative care medicine;|
| Active Comparator: Control<br>Usual care for HF patient which may include a palliative care consult if ordered by treating physician. | Other: Control<br>* The control group would receive usual care and could receive a palliative consult if ordered by the treating provider<br>* Other names: palliative care medicine;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Is there an impact on quality of life with the addition of palliative care intervention? | Assessment Tools: *Quality of Life-Minnesota Living with Heart Failure questionnaire (MLHF) | Change from baseline in quality of life score at 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Differential use of medical services- 30 day readmission | *Number of readmissions in 30 days of discharge from initial enrollment hospitalization. | 30 Days | 
| Is there an impact on Symptom Severity with the addition of palliative care | Assessment tool: *Symptom Severity - Edmonton Symptom Assessment scale (ESAS) | Change from baseline in symptom severity score at 3 months | 
| Is there an impact on depression with the addition of palliative care intervention? | Assessment Tool: *Depression- Patient Health Questionnaire (PHQ-9) | Change from baseline in depression score at 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Congestive Heart Failure, Heart Failure, Palliative Care, Palliative Medicine