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HeartFull: Feasibility of an Integrated Program of Care for Patients with Advanced Stage of Heart Failure

Leah Steinberg1,2, Sarina R Isenberg1,2,3,4, Susanna Mak5,6

  • 1Temmy Latner Centre for Palliative Care, 518775Sinai Health System, Toronto, Ontario, Canada.

The American Journal of Hospice & Palliative Care
|February 7, 2022
PubMed

Insights

Implementing integrated palliative care for advanced heart failure (AHF) was feasible. This program facilitated more patients dying in non-acute settings, similar to palliative oncology care.

Area of Science:

  • Cardiology
  • Palliative Care
  • Health Services Research

Background:

  • Advanced heart failure (AHF) patients face high mortality and healthcare utilization.
  • Palliative care involvement is often limited in AHF cases.
  • Chronic severe symptomatic heart failure (NYHA III/IV) with prior hospitalization indicates a critical need for integrated care.

Purpose of the Study:

  • To assess the feasibility of recruiting AHF patients into an integrated care program (HeartFull).
  • To evaluate the engagement of cardiology and palliative care providers in this integrated model.
  • To determine the proportion of patients who died in non-acute care settings and analyze healthcare utilization and patient-reported outcomes.

Main Methods:

  • Recruitment of AHF patients from an urban academic hospital.
  • Integration with a 24/7 inpatient and home palliative care service.
  • Monthly collection of utilization, disposition, and survey data for up to 20 months.

Main Results:

  • 65% of referred patients (30/46) agreed to participate.
  • 70% of patients (19/27) died in non-acute care settings (home or palliative unit).
  • Hospitalization and emergency visit rates trended downward but did not reach statistical significance; no significant changes in patient-reported outcomes were observed.

Conclusions:

  • Integrated palliative care for AHF is feasible in an urban academic setting.
  • The HeartFull program enabled a higher proportion of AHF patients to die in non-acute settings, comparable to palliative oncology patients.
  • The HeartFull program has been integrated into routine clinical practice.
Abstract

Keywords:
communicationheart failurehomecareintegrated caremanagementpalliative care

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