Abstract 19509: Palliative Care and Hospital Readmissions in Patients With Advanced Heart Failure: Insights From the PAL-HF Trial
Background: The PAL-HF trial intervention improved quality of life (QOL) compared to usual care in advanced heart failure (HF) patients. Patients with end-stage HF have a significant symptom burden that is often managed in the hospital despite patient preferences to reduce readmissions. Whether a palliative care intervention can reduce the burden of readmissions in advanced HF patients has not been well characterized.
Hypothesis: The PAL-HF intervention will be associated with a reduction in total readmissions and more days alive and out of the hospital (DAOH) over the 6 month follow-up period compared to usual care.
Methods: PAL-HF was a single center, randomized controlled trial of a multidisciplinary palliative care intervention compared to usual care in 150 patients with advanced HF (N=75 per study arm). We evaluated the total burden of all-cause readmissions and DAOH with the palliative care intervention compared to usual care.
Results: In PAL-HF, the median age was 72 (62-80) years, 47% were female, 41% were black, 48% had ischemic etiology and 55% had an EF</= 40%. Overall, 78 (52%) patients died and 73 (49%) were readmitted during the 6-month follow-up period without a significant between group difference by treatment assignment. The Table presents mortality and all-cause readmission data by treatment arm. Total readmissions were nominally lower in the intervention group than with usual care (61 vs. 69; p=0.135) with similar DAOH between groups (153 vs. 148; p=0.34).
Conclusion: A multidisciplinary, palliative care intervention that improved QOL resulted in a non-significant reduction in total readmissions and similar DAOH compared to usual care. Further work is needed to examine whether this intervention can be generalized to the broader population of advanced HF patients
Author Disclosures: R.J. Mentz: Research Grant; Modest; R01 NR013428/NR/NINR. B.B. Granger: Research Grant; Modest; R01 NR013428/NR/NINR. H. Yang: None. K.J. Anstrom: Research Grant; Modest; R01 NR013428/NR/NINR. C.M. O’Connor: Research Grant; Modest; R01 NR013428/NR/NINR. C.B. Patel: None. M. Fuzat: None. G. Dodson: None. P. Adams: None. J.A. Tulsky: Research Grant; Modest; R01 NR013428/NR/NINR. J.G. Rogers: Research Grant; Modest; R01 NR013428/NR/NINR.
- © 2016 by American Heart Association, Inc.