Examining Adherence and Dose Effect of an Early Palliative Care Intervention for Advanced Heart Failure Patients

Wells, Rachel; Dionne‐Odom, J. Nicholas; Azuero, Andres; Buck, Harleah G.; Ejem, Deborah; Burgio, Kathryn L.; Stockdill, Macy; Tucker, Rodney; Pamboukian, Salpy V.; Tallaj, José; Engler, Sally; Keebler, Konda; Tims, Sheri; Durant, Raegan W.; Swetz, Keith M.; Bakitas, Marie

doi:10.1016/j.jpainsymman.2021.01.136

Cited by 10 publications

(10 citation statements)

References 59 publications

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“…The applicability of telemedicine in the diagnosis and follow up of cardiovascular diseases is constantly increasing [ 1 , 26 ]. Several studies underline the advantages of telemedicine use in patents with HF in terms of clinical and psychological success [ 24 , 25 , 26 , 27 ]. Salzano et al demonstrated that telemedicine services expressly set up during the COVID-19 outbreak reduced the composite outcome of HF hospitalization and death when compared to the previous year without telemedicine [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Galinier et al demonstrated that some subgroups of patients in the selected population managed with telemonitoring may benefit in terms of clinical outcomes [ 26 ]. Wells et al demonstrated that telehealth sessions improved life quality in patients with advanced HF [ 27 ]. Telemonitoring through invasive devices represents a promising tool for the management and follow up of HF patients.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Support through Telemedicine in Heart Failure Outpatients during the COVID-19 Pandemic Period: Results of a 12-Months Follow Up

Severino

D’Amato

Prosperi

et al. 2022

JCM

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Background: Heart failure (HF) patients are predisposed to recurrences and disease destabilizations, especially during the COVID-19 outbreak period. In this scenario, telemedicine could be a proper way to ensure continuous care. The purpose of the study was to compare two modalities of HF outpatients’ follow up, the traditional in-person visits and telephone consultations, during the COVID-19 pandemic period in Italy. Methods: We conducted an observational study on consecutive HF outpatients. The follow up period was 12 months, starting from the beginning of the COVID-19 Italy lockdown. According to the follow up modality, and after the propensity matching score, patients were divided into two groups: those in G1 (n = 92) were managed with traditional in-person visits and those in G2 (n = 92) were managed with telephone consultation. Major adverse cardiovascular events (MACE) were the primary endpoints. Secondary endpoints were overall mortality, cardiovascular death, cardiovascular hospitalization, and hospitalization due to HF. Results: No significant differences between G1 and G2 have been observed regarding MACE (p = 0.65), cardiovascular death (p = 0.39), overall mortality (p = 0.85), hospitalization due to acute HF (p = 0.07), and cardiovascular hospitalization (p = 0.4). Survival analysis performed by the Kaplan–Meier method also did not show significant differences between G1 and G2. Conclusions: Telephone consultations represented a valid option to manage HF outpatients during COVID-19 pandemic, comparable to traditional in-person visits.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Support through Telemedicine in Heart Failure Outpatients during the COVID-19 Pandemic Period: Results of a 12-Months Follow Up

Severino

D’Amato

Prosperi

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…There are many cases of repeated rehospitalization and discharge after acute and chronic HF that require sudden hospitalization in the early stages [ 38 ]. Rehospitalization means that worsening of symptoms has occurred, so active early clinical testing, treatment, and self-care of the patient are vital [ 39 ]. Various tests can be performed as active initial treatment, and since this method is crucial for understanding the basic conditions of the patient for diagnosis and treatment, the reason for performing various tests should be clearly explained to the patient [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…Rehospitalization means that worsening of symptoms has occurred, so active early clinical testing, treatment, and self-care of the patient are vital [ 39 ]. Various tests can be performed as active initial treatment, and since this method is crucial for understanding the basic conditions of the patient for diagnosis and treatment, the reason for performing various tests should be clearly explained to the patient [ 39 ]. Treatment of HF patients can be broadly divided into medication treatment, medical procedure and surgical treatment, and lifestyle adjustment [ 23 , 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Development of Core Educational Content for Heart Failure Patients in Transition from Hospital to Home Care: A Delphi Study

Lee

Kim

2022

IJERPH

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Heart failure (HF) patients should be systematically educated before discharge on how to manage with standard written materials for patient self-management. However, because of the absence of readily available written materials to reinforce their learned knowledge, patients with HF feel inadequately informed in terms of the discharge information provided to them. This study aimed to develop core content to prepare patients with HF for transition from hospital to home care. The content was validated by expert panelists using Delphi methods. Nineteen draft items based on literature review were developed. We established a consensus on four core sections, including 47 categories and 128 subcategories through the Delphi survey: (1) understanding HF (five categories and 23 subcategories), (2) HF medication (19 categories and 45 subcategories), (3) HF management (20 categories and 47 subcategories), and (4) HF diary (three categories and 13 subcategories). Each section provided easy-to-understand educational contents using cartoon images and large or bold letters for older patients with HF. The developed core HF educational contents showed high consensus between the experts, along with clinical validity. The contents can be used as an educational booklet for both planning discharge education of patients with HF and for post-discharge management when transitioning from hospital to home. Based on this study, a booklet series for HF patients was first registered at the National Library of Korea. Future research should focus on delivering the core content to patients with HF in convenient and accessible format through various media.

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“…However, the characteristics of PC intervention contents and intervention measures and intervention dose comparisons were not presented. Secondary analysis of a recently published RCT 26 revealed that the dose of the PC intervention may affect the quality of life of patients with HF 32 . The recently published RCTs, as well as future reviews, should include intervention dose-effect to ensure the repeatability of interventions.…”

Section: Discussionmentioning

confidence: 99%

Palliative Care for Patients With Heart Failure

Kim¹,

Kim²,

Lee³

et al. 2022

J Hosp Palliat Nurs

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Palliative care should be integrated into routine disease management for all patients with serious illness, regardless of settings or prognosis. The purposes of this integrative review were to identify the features of randomized controlled trials for adult patients with heart failure and to provide basic references for the development of future trials. Using Whittemore and Knafl's integrative literature review method, comprehensive searches of the PubMed, Cochrane Library, CINAHL, EMBASE, and Korean databases were conducted, integrating keywords about heart failure and palliative care interventions. Quality appraisal was assessed using Cochrane risk-of-bias tools. In total, there were 6 trials providing palliative care interventions integrating team-based approaches between palliative care specialists and nonpalliative clinicians, such as a cardiologist, cardiac nurse, and advanced practice nurse across inpatient and outpatient settings. The different types of interventions included home visits, symptom management via phone calls or referral to a specialist team, and the establishment of treatment planning. Patient-reported outcome measures included positive effects of palliative interventions on symptom burden and quality of life. Given that most of the selected studies were conducted in Western countries, palliative care should be culturally tailored to assist heart failure patients worldwide. KEY WORDSadvance care planning, chronic disease, heart failure, palliative care, review T he prevalence of heart failure (HF) continues to increase with an increase in the aging population. 1 The American Heart Association has reported that 50% of patients diagnosed as having HF die within 5 years, and 5% are at the end of life with a condition refractory to medical treatment. 1 Patients with HF have a significant burden of symptom clusters, including pain, fatigue, dyspnea, depression, anxiety, insomnia, and loss of appetite, causing deterioration in overall quality of life. 2 This imposes an economic and structural burden on patients and their families, as well as the social health care delivery system caring for them. 3 The treatment and management of patients with HF require the consideration of combined physical, psychosocial, and environmental factors. 4 For instance, medical devices such as pacemakers and implantable defibrillators may be effective in the early stages of HF, but their benefits may gradually wane as the disease progresses. In addition to the unpredictable prognosis, patients vary in their illness experience and perception toward overall disease management. 5 As HF progresses, responsibility for end-of-life treatment decisions may change according to the patients' or their family's cultural norms and social context. 6 The National Consensus Project Clinical Practice Guidelines for Quality Palliative Care (NCP guidelines) defines palliative care (PC) as an interdisciplinary care delivery system designed to anticipate, prevent, and manage severe illness to optimize the quality of life for patients, the...

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Examining Adherence and Dose Effect of an Early Palliative Care Intervention for Advanced Heart Failure Patients

Cited by 10 publications

References 59 publications

Clinical Support through Telemedicine in Heart Failure Outpatients during the COVID-19 Pandemic Period: Results of a 12-Months Follow Up

Clinical Support through Telemedicine in Heart Failure Outpatients during the COVID-19 Pandemic Period: Results of a 12-Months Follow Up

Development of Core Educational Content for Heart Failure Patients in Transition from Hospital to Home Care: A Delphi Study

Palliative Care for Patients With Heart Failure

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