Palliative Care Needs of Physically Frail Community-Dwelling Older Adults With Heart Failure.
- Publisher:
- Elsevier
- Publication Type:
- Journal Article
- Citation:
- J Pain Symptom Manage, 2023, 65, (6), pp. 500-509
- Issue Date:
- 2023-06
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1-s2.0-S0885392423000428-main.pdf | 478.43 kB | Adobe PDF |
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Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | DeGroot, L | |
dc.contributor.author | Pavlovic, N | |
dc.contributor.author | Perrin, N | |
dc.contributor.author | Gilotra, NA | |
dc.contributor.author | Dy, SM | |
dc.contributor.author | Davidson, PM | |
dc.contributor.author | Szanton, SL | |
dc.contributor.author | Saylor, MA | |
dc.date.accessioned | 2023-09-11T01:32:56Z | |
dc.date.available | 2023-01-13 | |
dc.date.available | 2023-09-11T01:32:56Z | |
dc.date.issued | 2023-06 | |
dc.identifier.citation | J Pain Symptom Manage, 2023, 65, (6), pp. 500-509 | |
dc.identifier.issn | 0885-3924 | |
dc.identifier.issn | 1873-6513 | |
dc.identifier.uri | http://hdl.handle.net/10453/172022 | |
dc.description.abstract | CONTEXT: Physical frailty is emerging as a potential "trigger" for palliative care (PC) consultation, but the PC needs of physically frail persons with heart failure (HF) in the outpatient setting have not been well described. OBJECTIVES: This study describes the PC needs of community dwelling, physically frail persons with HF. METHODS: We included persons with HF ≥50 years old who experienced ≥1 hospitalization in the prior year and excluded those with moderate/severe cognitive impairment, hospice patients, or non-English speaking persons. Measures included the FRAIL scale (0-5: 0 = robust, 1-2 = prefrail, 3-5 = frail) and the Integrated Palliative Outcome Scale (IPOS) (17 items, score 0-68; higher score = higher PC needs). Multiple linear regression tested the association between frailty group and palliative care needs. RESULTS: Participants (N = 286) had a mean age of 68 (range 50-92) were majority male (63%) and White (68%) and averaged two hospitalizations annually. Most were physically frail (44%) or prefrail (41%). Mean PC needs (IPOS) score was 19.7 (range 0-58). On average, participants reported 5.86 (SD 4.28) PC needs affecting them moderately, severely, or overwhelmingly in the last week. Patient-perceived family/friend anxiety (58%) weakness/lack of energy (58%), and shortness of breath (47%) were the most prevalent needs. Frail participants had higher mean PC needs score (26) than prefrail (16, P < 0.001) or robust participants (11, P < 0.001). Frail participants experienced an average of 8.32 (SD 3.72) moderate/severe/overwhelming needs compared to prefrail (4.56, SD 3.77) and robust (2.39, SD 2.91) participants (P < 0.001). Frail participants reported higher prevalence of weakness/lack of energy (83%), shortness of breath (66%), and family/friend anxiety (69%) than prefrail (48%, 39%, 54%) or robust (13%, 14%, 35%) participants (P < 0.001). CONCLUSION: Physically frail people with HF have higher unmet PC needs than those who are nonfrail. Implementing PC needs and frailty assessments may help identify vulnerable patients with unmet needs requiring further assessment and follow-up. | |
dc.format | Print-Electronic | |
dc.language | eng | |
dc.publisher | Elsevier | |
dc.relation.ispartof | J Pain Symptom Manage | |
dc.relation.isbasedon | 10.1016/j.jpainsymman.2023.01.016 | |
dc.rights | info:eu-repo/semantics/closedAccess | |
dc.subject | 11 Medical and Health Sciences | |
dc.subject.classification | Anesthesiology | |
dc.subject.classification | 32 Biomedical and clinical sciences | |
dc.subject.classification | 42 Health sciences | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Male | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Frail Elderly | |
dc.subject.mesh | Independent Living | |
dc.subject.mesh | Frailty | |
dc.subject.mesh | Palliative Care | |
dc.subject.mesh | Geriatric Assessment | |
dc.subject.mesh | Heart Failure | |
dc.subject.mesh | Dyspnea | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Dyspnea | |
dc.subject.mesh | Palliative Care | |
dc.subject.mesh | Geriatric Assessment | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Frail Elderly | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Male | |
dc.subject.mesh | Heart Failure | |
dc.subject.mesh | Independent Living | |
dc.subject.mesh | Frailty | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Male | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Frail Elderly | |
dc.subject.mesh | Independent Living | |
dc.subject.mesh | Frailty | |
dc.subject.mesh | Palliative Care | |
dc.subject.mesh | Geriatric Assessment | |
dc.subject.mesh | Heart Failure | |
dc.subject.mesh | Dyspnea | |
dc.title | Palliative Care Needs of Physically Frail Community-Dwelling Older Adults With Heart Failure. | |
dc.type | Journal Article | |
utslib.citation.volume | 65 | |
utslib.location.activity | United States | |
utslib.for | 11 Medical and Health Sciences | |
pubs.organisational-group | /University of Technology Sydney | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Health | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Health/IMPACCT | |
utslib.copyright.status | closed_access | * |
dc.date.updated | 2023-09-11T01:32:55Z | |
pubs.issue | 6 | |
pubs.publication-status | Published | |
pubs.volume | 65 | |
utslib.citation.issue | 6 |
Abstract:
CONTEXT: Physical frailty is emerging as a potential "trigger" for palliative care (PC) consultation, but the PC needs of physically frail persons with heart failure (HF) in the outpatient setting have not been well described. OBJECTIVES: This study describes the PC needs of community dwelling, physically frail persons with HF. METHODS: We included persons with HF ≥50 years old who experienced ≥1 hospitalization in the prior year and excluded those with moderate/severe cognitive impairment, hospice patients, or non-English speaking persons. Measures included the FRAIL scale (0-5: 0 = robust, 1-2 = prefrail, 3-5 = frail) and the Integrated Palliative Outcome Scale (IPOS) (17 items, score 0-68; higher score = higher PC needs). Multiple linear regression tested the association between frailty group and palliative care needs. RESULTS: Participants (N = 286) had a mean age of 68 (range 50-92) were majority male (63%) and White (68%) and averaged two hospitalizations annually. Most were physically frail (44%) or prefrail (41%). Mean PC needs (IPOS) score was 19.7 (range 0-58). On average, participants reported 5.86 (SD 4.28) PC needs affecting them moderately, severely, or overwhelmingly in the last week. Patient-perceived family/friend anxiety (58%) weakness/lack of energy (58%), and shortness of breath (47%) were the most prevalent needs. Frail participants had higher mean PC needs score (26) than prefrail (16, P < 0.001) or robust participants (11, P < 0.001). Frail participants experienced an average of 8.32 (SD 3.72) moderate/severe/overwhelming needs compared to prefrail (4.56, SD 3.77) and robust (2.39, SD 2.91) participants (P < 0.001). Frail participants reported higher prevalence of weakness/lack of energy (83%), shortness of breath (66%), and family/friend anxiety (69%) than prefrail (48%, 39%, 54%) or robust (13%, 14%, 35%) participants (P < 0.001). CONCLUSION: Physically frail people with HF have higher unmet PC needs than those who are nonfrail. Implementing PC needs and frailty assessments may help identify vulnerable patients with unmet needs requiring further assessment and follow-up.
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