Effectiveness of Timely Implementation of Palliative Care on the Well-Being of Patients With Chronic Heart Failure: A Randomized Case–Control Study

医学 心力衰竭 随机对照试验 射血分数 生活质量(医疗保健) 心功能曲线 缓和医疗 临床终点 内科学 介绍 干预(咨询) 利钠肽 物理疗法 心脏病学 护理部
作者
Lu Pan,Qiao Li,Yuzhe Zhang,Jianwei Zhang,Ling Yuan
出处
期刊:Journal of Palliative Care [SAGE Publishing]
卷期号:39 (4): 282-288 被引量:1
标识
DOI:10.1177/08258597231184798
摘要

Objectives: To date, there is a lack of consensus on the timely implementation of palliative care (PC) in patients with chronic heart failure (HF). We aimed to investigate the impact of primary PC intervention on chronic HF patients with different classes of cardiac function, and to determine a proper time point for the implementation of primary PC intervention. Methods: A consecutive series of 180 chronic HF patients with the New York Heart Association (NYHA) Cardiac function ranging from I to III were enrolled in this study. Patients with the same cardiac function class, they were randomized and equally assigned to the usual care (UC) group or to the PC intervention group. At the end of 24-week treatment, quality-of-life (QoL) measurements were evaluated. Left ventricular ejection fraction and N-terminal pro-B-type natriuretic peptide were measured for each group at baseline and the final follow-up, respectively. Results: Through the 6-month follow-up, patients randomized to the PC intervention group presented significantly better QoL and cardiac function as compared with patients randomized to the UC group alone. Subgroup analysis showed that for patients with NYHA class II or III, significantly improved cardiac function and QoL were observed in the PC intervention group as compared with the control group. As for patients with class I, no significant difference was found between the 2 groups. Conclusions: Palliative program can effectively improve the QoL and cardiac function of patients with chronic HF. Moreover, we provided evidence on timely referral of patients to PC intervention, which could be beneficial for patients with NYHA class II.
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