Palliative Care for Heart Failure Patients

• Improvements in quality of life [ Time Frame: Change from baseline in quality of life score at 6 months ] [ Designated as safety issue: No ]

  Assessment Tools:

  *Quality of Life-Minnesota Living with Heart Failure questionnaire (MLHF)

• Improvements in Symptom Severity [ Time Frame: Change from baseline in symptom severity score at 6 months ] [ Designated as safety issue: No ]

  Assessment tool:

  *Symptom Severity - Edmonton Symptom Assessment scale (ESAS)

• Improvements in depression [ Time Frame: Change from baseline in depression score at 6 months ] [ Designated as safety issue: No ]

  Assessment Tool:

  *Depression- PHQ-9

• Differential use of medical services- 30 day readmission [ Time Frame: 30 Days ] [ Designated as safety issue: No ]
  *Number of readmissions in 30 days of discharge from initial enrollment hospitalization.
• Is there an impact on Symptom Severity with the addition of palliative care [ Time Frame: Change from baseline in symptom severity score at 3 months ] [ Designated as safety issue: No ]

  Assessment tool:

  *Symptom Severity - Edmonton Symptom Assessment scale (ESAS)

• Is there an impact on depression with the addition of palliative care intervention? [ Time Frame: Change from baseline in depression score at 3 months ] [ Designated as safety issue: No ]

  Assessment Tool:

  *Depression- Patient Health Questionnaire (PHQ-9)

• Differential use of medical services- total number of hospital days [ Time Frame: 6 mo ] [ Designated as safety issue: No ]
  *Total number of hospital days
• Differential use of medical services- number of readmission [ Time Frame: 6 months ] [ Designated as safety issue: No ]
  *Number of readmissions to the hospital

The purpose of this study is to assess the impact of palliative care consultation on quality of life and symptom management for patients hospitalized with acute heart failure with a randomized control trial at Abbott Northwestern Hospital.

Research questions:

Q1. Does the provision of palliative care to heart failure patients yield higher quality of life, increased symptom management, or reduced depression compared to heart failure patients not receiving palliative care?

Q2. Does the provision of palliative care to heart failure patients result in differential use of medical services (lower hospital days and readmission) compared to heart failure patients not receiving systematic palliative care?

• Other: Palliative Care Consultation
  Intervention patient would receive an inpatient palliative care consultation to focus on comprehensive symptom assessment, create goals of care/treatment plan which include recommendations and referrals.
  Other Names:

  • palliative care consults
  • palliative care medicine
• Other: Control
  The control group would receive usual care and could receive a palliative consult if ordered by the treating provider
  Other Names:

  • palliative care consult
  • palliative care medicine

• Experimental: Palliative Care Consultation
  Participant will get one palliative care consultation while in the hospital. The participants desire for subsequent palliative care visits will be determined and mutually agreed upon at the initial consultation.
  Intervention: Other: Palliative Care Consultation
• Active Comparator: Control
  Usual care for HF patient which may include a palliative care consult if ordered by treating physician.
  Intervention: Other: Control

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Inclusion Criteria:

• Abbott Northwestern Hospital inpatient adults with a diagnosis of acute heart failure

Exclusion Criteria:

• Are not an inpatient at Abbott Northwestern Hospital
• Are in the ICU
• On a ventilator
• Are pre-or post heart transplant
• Have a ventricular assist device (VAD)
• Determined to be actively dying
• Have cognitive impairments such that informed consent would not be possible,
• Are not proficient in the English language