Instability in Preference for Place of Death Among Patients With Symptoms of Advanced Heart Failure.

Journal of the American Medical Directors Association
Chetna MalhotraEric A Finkelstein

Abstract

Patient preference for place of death is an important component of advance care planning (ACP). If patients' preference for place of death changes over time, this questions the value of their documented preference. We aimed to assess the extent and correlates of change in preference for place of death over time among patients with symptoms of advanced heart failure. We conducted a secondary analysis of data from a randomized controlled trial of a formal ACP program vs usual care. We interviewed 282 patients aged 21 years old and above with heart failure and New York Heart Association Classification III and IV symptoms in Singapore. Analytic sample included 200 patients interviewed at least twice. We assessed factors associated with patients' preference for place of death (home/institution/no preference) and change in their preference for place of death from previous time point (change toward home death/toward an institutional death/toward no preference/no change). These included patient demographics, quality of life (Kansas City Cardiomyopathy Questionnaire), and prognostic understanding. In our study, 66% of patients with heart failure changed their preference for place of death at least once during the study period with no co...Continue Reading

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Citations

Dec 31, 2020·Journal of the American Medical Directors Association·Christine E KistlerSheryl Zimmerman
Jan 6, 2021·International Journal of Environmental Research and Public Health·Jiaoli CaiPeter C Coyte

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