Protocol driven palliative care consultation: Outcomes of the ENABLE CHF-PC pilot study

Heart & Lung : the Journal of Critical Care
Rachel WellsMarie Bakitas

Abstract

Little has been reported about protocol-driven outpatient palliative care consultation (OPCC) for advanced heart failure (HF). To describe evaluation practices and treatment recommendations made during protocol-driven OPCCs for advanced HF. We performed content analysis of OPCCs completed as part of ENABLE CHF-PC, an early palliative care HF intervention, conducted at sites in the Northeast and Southeast. T-tests, Fisher's exact, and Chi-square tests were used to evaluate sociodemographic, outcome measures, and site content differences. Of 61 ENABLE CHF-PC participants, 39 (64%) had an OPCC (Northeast, n=27; Southeast, n=12). Social and medical history assessed most were close relationships (n=35, 90%), family support (n=33, 85%), advance directive status (n=33, 85%), functional status (n=30, 77%); and symptoms were mood (n= 35, 90%), breathlessness (n=28, 72%), and chest pain (n=24, 62%). Treatment recommendations focused on care coordination (n=13, 33%) and specialty referrals (n=12, 31%). Between-site OPCC differences included assessment of family support (Northeast vs. Southeast: 100% vs. 50%), code status (96% vs. 58%), goals of care discussions (89% vs. 41.7%), and prognosis understanding (85% vs. 33%). OPCCs for HF focus...Continue Reading

Citations

Jun 12, 2020·Journal of Palliative Medicine·Lyndsay DeGrootMartha Abshire

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