Which patients with heart failure should receive specialist palliative care?

Campbell, RT; Petrie, MC; Jackson, CE; Jhund, PS; Wright, A; Gardner, RS; Sonecki, P; Pozzi, A; McSkimming, P; McConnachie, A; Finlay, F; Davidson, P; Denvir, MA; Johnson, MJ; Hogg, KJ; McMurray, JJV

Which patients with heart failure should receive specialist palliative care?

Campbell, RT Petrie, MC Jackson, CE Jhund, PS Wright, A Gardner, RS Sonecki, P Pozzi, A McSkimming, P McConnachie, A Finlay, F Davidson, P

Denvir, MA Johnson, MJ Hogg, KJ McMurray, JJV

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Publisher:: WILEY
Publication Type:: Journal Article
Citation:: Eur J Heart Fail, 2018, 20, (9), pp. 1338-1347
Issue Date:: 2018-09

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Field	Value	Language
dc.contributor.author	Campbell, RT
dc.contributor.author	Petrie, MC
dc.contributor.author	Jackson, CE
dc.contributor.author	Jhund, PS
dc.contributor.author	Wright, A
dc.contributor.author	Gardner, RS
dc.contributor.author	Sonecki, P
dc.contributor.author	Pozzi, A
dc.contributor.author	McSkimming, P
dc.contributor.author	McConnachie, A
dc.contributor.author	Finlay, F
dc.contributor.author	Davidson, P https://orcid.org/0000-0003-2050-1534
dc.contributor.author	Denvir, MA
dc.contributor.author	Johnson, MJ
dc.contributor.author	Hogg, KJ
dc.contributor.author	McMurray, JJV
dc.date.accessioned	2022-09-10T22:09:38Z
dc.date.available	2018-05-21
dc.date.available	2022-09-10T22:09:38Z
dc.date.issued	2018-09
dc.identifier.citation	Eur J Heart Fail, 2018, 20, (9), pp. 1338-1347
dc.identifier.issn	1388-9842
dc.identifier.issn	1879-0844
dc.identifier.uri	http://hdl.handle.net/10453/161621
dc.description.abstract	AIMS: We investigated which patients with heart failure (HF) should receive specialist palliative care (SPC) by first creating a definition of need for SPC in patients hospitalised with HF using patient-reported outcome measures (PROMs) and then testing this definition using the outcome of days alive and out of hospital (DAOH). We also evaluated which baseline variables predicted need for SPC and whether those with this need received SPC. METHODS AND RESULTS: PROMs assessing quality of life (QoL), symptoms, and mood were administered at baseline and every 4 months. SPC need was defined as persistently severe impairment of any PROM without improvement (or severe impairment immediately preceding death). We then tested whether need for SPC, so defined, was reflected in DAOH, a measure which combines length of stay, days of hospital re-admission, and days lost due to death. Of 272 patients recruited, 74 (27%) met the definition of SPC needs. These patients lived one third fewer DAOH than those without SPC need (and less than a quarter of QoL-adjusted DAOH). A Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score of <29 identified patients who subsequently had SPC needs (area under receiver operating characteristic curve 0.78). Twenty-four per cent of patients with SPC needs actually received SPC (n = 18). CONCLUSIONS: A quarter of patients hospitalised with HF had a need for SPC and were identified by a low KCCQ score on admission. Those with SPC need spent many fewer DAOH and their DAOH were of significantly worse quality. Very few patients with SPC needs accessed SPC services.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	WILEY
dc.relation.ispartof	Eur J Heart Fail
dc.relation.isbasedon	10.1002/ejhf.1240
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology
dc.subject.classification	Cardiovascular System & Hematology
dc.subject.mesh	Aged
dc.subject.mesh	Aged, 80 and over
dc.subject.mesh	Female
dc.subject.mesh	Follow-Up Studies
dc.subject.mesh	Heart Failure
dc.subject.mesh	Hospitalization
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Palliative Care
dc.subject.mesh	Patient Reported Outcome Measures
dc.subject.mesh	Patient Selection
dc.subject.mesh	Prevalence
dc.subject.mesh	Quality of Life
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Specialization
dc.subject.mesh	United Kingdom
dc.subject.mesh	Humans
dc.subject.mesh	Hospitalization
dc.subject.mesh	Palliative Care
dc.subject.mesh	Prevalence
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Follow-Up Studies
dc.subject.mesh	Patient Selection
dc.subject.mesh	Quality of Life
dc.subject.mesh	Aged
dc.subject.mesh	Aged, 80 and over
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Heart Failure
dc.subject.mesh	Specialization
dc.subject.mesh	United Kingdom
dc.subject.mesh	Patient Reported Outcome Measures
dc.title	Which patients with heart failure should receive specialist palliative care?
dc.type	Journal Article
utslib.citation.volume	20
utslib.location.activity	England
utslib.for	1102 Cardiorespiratory Medicine and Haematology
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.date.updated	2022-09-10T22:09:36Z
pubs.issue	9
pubs.publication-status	Published
pubs.volume	20
utslib.citation.issue	9

Abstract:

AIMS: We investigated which patients with heart failure (HF) should receive specialist palliative care (SPC) by first creating a definition of need for SPC in patients hospitalised with HF using patient-reported outcome measures (PROMs) and then testing this definition using the outcome of days alive and out of hospital (DAOH). We also evaluated which baseline variables predicted need for SPC and whether those with this need received SPC. METHODS AND RESULTS: PROMs assessing quality of life (QoL), symptoms, and mood were administered at baseline and every 4 months. SPC need was defined as persistently severe impairment of any PROM without improvement (or severe impairment immediately preceding death). We then tested whether need for SPC, so defined, was reflected in DAOH, a measure which combines length of stay, days of hospital re-admission, and days lost due to death. Of 272 patients recruited, 74 (27%) met the definition of SPC needs. These patients lived one third fewer DAOH than those without SPC need (and less than a quarter of QoL-adjusted DAOH). A Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score of <29 identified patients who subsequently had SPC needs (area under receiver operating characteristic curve 0.78). Twenty-four per cent of patients with SPC needs actually received SPC (n = 18). CONCLUSIONS: A quarter of patients hospitalised with HF had a need for SPC and were identified by a low KCCQ score on admission. Those with SPC need spent many fewer DAOH and their DAOH were of significantly worse quality. Very few patients with SPC needs accessed SPC services.

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http://hdl.handle.net/10453/161621