Table 2.
Summary of Existing Trials of Outpatient Specialty Palliative Care in Heart Failure
| Study (Country) | Patient Population* | Intervention (Participants Randomized) | Control (Participants Randomized) | Results | Risk of Bias | |
|---|---|---|---|---|---|---|
| Subjective | Objective | |||||
| Rogers et al, 2017 (USA) | Hospitalization for HF in past year and ESCAPE score >=4 indicating >50% risk of 6-mo. mortality. (Mean age: 71) | Interdisciplinary NP-led specialty palliative care intervention concomitant with usual HF management. Intervention foci included: physical and emotional symptom management, spiritual concerns, and advance care planning. (n=75) | Usual care (n=75) |
QOL [KCCQ]: Improved at 6 months, mean difference 9.49 points (95% CI: 0.94, 18.05; p=0.03) [FACIT-Pal]: Improved at 6 months, mean difference 11.77 points (95% CI: 0.84, 22.71; p=0.035) Mood [HADS depression]: Improved at 6 months, mean difference −1.94 points (95% CI: 3.57, −0.31; p=0.02) [HADS anxiety]: Improved at 6 months, mean difference −1.83 points (95% CI: −3.64, −0.02; p=0.048) Spiritual wellbeing [FACIT-Sp]: Improved @ 6 months, mean difference 3.98 points (95% CI: 0.46, 7.50; p=0.027) 6-month mortality: NS, 30.7% vs 26.7% (p value not reported). HF-related Rehospitalization: NS, 30.7% vs. 29.3% (p value not reported) |
Low | Low |
CI=Confidence Interval. ESCAPE=Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness. FACIT-Pal=Functional Assessment of Chronic Illness Therapy - Palliative care. FACIT-Sp=Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being. HADS= Hospital Anxiety and Depression Scale. HF=Heart Failure. KCCQ=Kansas City Cardiomyopathy Questionnaire. NP=Nurse Practitioner. NS=Not significant. QOL=Quality of Life. USA=United States of America.
*
Patient population details the indication for palliative care. All comparisons stated as intervention vs. control.