Supporting the Heterogeneous and Evolving Treatment Preferences of Patients With Heart Failure Through Collaborative Home‐Based Palliative Care

Campos, Erin; Isenberg, Sarina R.; Lovblom, Leif E.; Mak, Susanna; Steinberg, Leah; Bush, Shirley H.; Goldman, Russell; Graham, Caroline; Kavalieratos, Dio; Stukel, Thérèse A.; Tanuseputro, Peter; Quinn, Kieran L.

doi:10.1161/jaha.122.026319

Cited by 3 publications

(1 citation statement)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many patients in the palliative care group of the study were still actively pursuing treatment. The research team has also shown 2 evolving care preferences among patients with heart failure, with about half of those initially seeking active care shifting to a more comfort-based approach as their condition progressed.…”

Section: Barriers To Carementioning

confidence: 99%

Collaborative Care Model Helps Patients With Heart Failure Meet End-of-Life Goals

Kuehn¹

2023

Circulation

View full text Add to dashboard Cite

Section: Barriers To Carementioning

confidence: 99%

Collaborative Care Model Helps Patients With Heart Failure Meet End-of-Life Goals

Kuehn¹

2023

Circulation

View full text Add to dashboard Cite

Advance Care Planning (ACP) in Medicare Beneficiaries with Heart Failure

Bose Brill,

Riley,

Prater

et al. 2024

J GEN INTERN MED

View full text Add to dashboard Cite

Background Heart failure is a leading cause of death in the USA, contributing to high expenditures near the end of life. Evidence remains lacking on whether billed advance care planning changes patterns of end-of-life healthcare utilization among patients with heart failure. Large-scale claims evaluation assessing billed advance care planning and end-of-life hospitalizations among patients with heart failure can fill evidence gaps to inform health policy and clinical practice. Objective Assess the association between billed advance care planning delivered and Medicare beneficiaries with heart failure upon the type and quantity of healthcare utilization in the last 30 days of life. Design This retrospective cross-sectional cohort study used Medicare fee-for-service claims from 2016 to 2020. Participants A total of 48,466 deceased patients diagnosed with heart failure on Medicare. Main Measures Billed advance care planning services between the last 12 months and last 30 days of life will serve as the exposure. The outcomes are end-of-life healthcare utilization and total expenditure in inpatient, outpatient, hospice, skilled nursing facility, and home healthcare services. Key Results In the final cohort of 48,466 patients (median [IQR] age, 83 [76–89] years; 24,838 [51.2%] women; median [IQR] Charlson Comorbidity Index score, 4 [2–5]), 4406 patients had an advance care planning encounter. Total end-of-life expenditure among patients with billed advance care planning encounters was 19% lower (95% CI, 0.77–0.84) compared to patients without. Patients with billed advance care planning encounters had 2.65 times higher odds (95% CI, 2.47–2.83) of end-of-life outpatient utilization with a 33% higher expected total outpatient expenditure (95% CI, 1.24–1.42) compared with patients without a billed advance care planning encounter. Conclusions Billed advance care planning delivery to individuals with heart failure occurs infrequently. Prioritizing billed advance care planning delivery to these individuals may reduce total end-of-life expenditures and end-of-life inpatient expenditures through promoting use of outpatient end-of-life services, including home healthcare and hospice.

show abstract

Barriers and facilitators for place of death: A scoping review

Pedersen,

Raunkiær,

Graven

2024

Pall Supp Care

View full text Add to dashboard Cite

Objectives Many factors influence where people die, but most people prefer to die at home. Investigating the factors affecting death at different locations can enhance end-of-life care and enable more people to die at their preferred place. The aim was to investigate barriers and facilitators affecting place of death and compare facilitators and barriers across different places of death. Methods A scoping review registered on Open Science Framework was conducted in accordance with the guidelines for Scoping Reviews (PRISMA-ScR). An electronic search of literature was undertaken in MEDLINE, EMBASE, PUBMED, PsycINFO, and CINAHL covering the years January 2013–December 2023. Studies were included if they described barriers and/or facilitators for place of death among adults. Results This review identified 517 studies, and 95 of these were included in the review. The review identified the following themes. Illness factors: disease type, dying trajectory, treatment, symptoms, and safe environment. Individual factors: sex, age, ethnicity, preferences, and for environmental factors the following were identified: healthcare inputs, education and employment, social support, economy, and place of residence. Significance of results The factors influencing place of death are complex and some have a cumulative impact affecting where people die. These factors are mostly rooted in structural aspects and make hospital death more likely for vulnerable groups, who are also less likely to receive palliative care and advanced care planning. Disease type and social support further impact the location of death. Future research is needed regarding vulnerable groups and their preferences for place of death.

show abstract

Supporting the Heterogeneous and Evolving Treatment Preferences of Patients With Heart Failure Through Collaborative Home‐Based Palliative Care

Cited by 3 publications

References 40 publications

Collaborative Care Model Helps Patients With Heart Failure Meet End-of-Life Goals

Collaborative Care Model Helps Patients With Heart Failure Meet End-of-Life Goals

Advance Care Planning (ACP) in Medicare Beneficiaries with Heart Failure

Barriers and facilitators for place of death: A scoping review

Contact Info

Product

Resources

About