Journal article
Examining Adherence and Dose Effect of an Early Palliative Care Intervention for Advanced Heart Failure Patients
Journal of pain and symptom management, Vol.62(3), pp.471-481
09/01/2021
DOI: 10.1016/j.jpainsymman.2021.01.136
PMCID: PMC8339177
PMID: 33556493
Abstract
Research priority guidelines highlight the need for examining the “dose” components of palliative care (PC) interventions, such as intervention adherence and completion rates, that contribute to optimal outcomes.
Examine the “dose” effect of PC intervention completion vs. noncompletion on quality of life (QoL) and healthcare use in patients with advanced heart failure (HF) over 32 weeks.
Secondary analysis of the ENABLE CHF-PC intervention trial for patients with New York Heart Association (NYHA) Class III/IV HF. “Completers” defined as completing a single, in-person outpatient palliative care consultation (OPCC) plus 6 weekly, PC nurse coach-led telehealth sessions. “Non-completers” were defined as either not attending the OPCC or completing <6 telehealth sessions. Outcome variables were QoL and healthcare resource use (hospital days; emergency department visits). Mixed models were used to model dose effects for “completers” vs “noncompleters” over 32 weeks.
Of 208 intervention group participants, 81 (38.9%) were classified as “completers” with a mean age of 64.6 years; 72.8% were urban-dwelling; 92.5% had NYHA Class III HF. ‘Completers’ vs. “non-completers”” groups were well-balanced at baseline; however “noncompleters” did report higher anxiety (6.0 vs 7.0, P < 0.05, d = 0.28). Moderate, clinically significant, improved QoL differences were found at 16 weeks in “completers” vs. “non-completers” (between-group difference: −9.71 (3.18), d = 0.47, P = 0.002) but not healthcare use.
Higher intervention completion rates of an early PC intervention was associated with QoL improvements in patients with advanced HF. Future work should focus on identifying the most efficacious “dose” of intervention components and increasing adherence to them.
ClinicalTrials.gov Identifier: NCT02505425
Details
- Title: Subtitle
- Examining Adherence and Dose Effect of an Early Palliative Care Intervention for Advanced Heart Failure Patients
- Creators
- Rachel Wells - University of Alabama at BirminghamJames Nicholas Dionne-Odom - University of Alabama at BirminghamAndres Azuero - University of Alabama at BirminghamHarleah Buck - University of IowaDeborah Ejem - University of Alabama at BirminghamKathryn L. Burgio - Birmingham VA Medical CenterMacy L. Stockdill - University of Alabama at BirminghamRodney Tucker - University of Alabama at BirminghamSalpy V. Pamboukian - University of Alabama at BirminghamJose Tallaj - University of Alabama at BirminghamSally Engler - University of Alabama at BirminghamKonda Keebler - University of Alabama at BirminghamSheri Tims - University of Alabama at BirminghamRaegan Durant - University of Alabama at BirminghamKeith M. Swetz - University of Alabama at BirminghamMarie Bakitas - University of Alabama at Birmingham
- Resource Type
- Journal article
- Publication Details
- Journal of pain and symptom management, Vol.62(3), pp.471-481
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jpainsymman.2021.01.136
- PMID
- 33556493
- PMCID
- PMC8339177
- ISSN
- 0885-3924
- eISSN
- 1873-6513
- Grant note
- DOI: 10.13039/100000867, name: Robert Wood Johnson Foundation; DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100000056, name: National Institute of Nursing Research, award: R01NR013665; DOI: 10.13039/100000133, name: Agency for Healthcare Research and Quality, award: T32 HS013852
- Language
- English
- Date published
- 09/01/2021
- Academic Unit
- Nursing
- Record Identifier
- 9984370657602771
Metrics
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