Rachel S Tobin1, Marc D Samsky1,2, Maragatha Kuchibhatla3, Christopher M O'Connor4, Mona Fiuzat1, Haider J Warraich5, Kevin J Anstrom2,3, Bradi B Granger6, Daniel B Mark1,2, James A Tulsky7,8, Joseph G Rogers1,2, Robert J Mentz1,2, Kimberly S Johnson1,9. 1. Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA. 2. Division of Cardiology, Duke Clinical Research Institute, Durham, North Carolina, USA. 3. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina, USA. 4. Division of Cardiology, Inova Heart and Vascular Institute, Falls Church, Virginia, USA. 5. Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School and Cardiology Section, Boston, Massachusetts, USA. 6. Duke School of Nursing, Duke University, Durham, North Carolina, USA. 7. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA. 8. Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. 9. Division of Geriatrics, Geriatrics Research Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina, USA.
Abstract
Introduction: Black patients have a higher incidence of heart failure (HF) and worse outcomes than white patients. Guidelines recommend palliative care for patients with advanced HF, but no studies have examined outcomes in a black patient cohort. Methods: This is a post hoc analysis of the Palliative Care in Heart Failure trial, which randomized patients to usual care plus a palliative care intervention (UC+PAL) or usual care (UC). Quality of life (QoL) was measured using Kansas City Cardiomyopathy Questionnaire (KCCQ) and Functional Assessment of Chronic Illness Therapy-Palliative Care scale (FACIT-Pal). Results: Black patients represented 41% of the 148 patients. At six months, QoL improved more in UC+PAL than UC for both racial subgroups. The difference was greater for black than white patients (difference: KCCQ 10.8 vs. 2.5; FACIT-Pal: 14.8 vs. 3.9). However, the findings were not statistically significant. Conclusions: Larger studies are needed to assess the benefits of palliative care for black patients with HF. ClinicalTrials.gov Identifier: NCT01589601.
Introduction: Black patients have a higher incidence of heart failure (HF) and worse outcomes than white patients. Guidelines recommend palliative care for patients with advanced HF, but no studies have examined outcomes in a black patient cohort. Methods: This is a post hoc analysis of the Palliative Care in Heart Failure trial, which randomized patients to usual care plus a palliative care intervention (UC+PAL) or usual care (UC). Quality of life (QoL) was measured using Kansas City Cardiomyopathy Questionnaire (KCCQ) and Functional Assessment of Chronic Illness Therapy-Palliative Care scale (FACIT-Pal). Results: Black patients represented 41% of the 148 patients. At six months, QoL improved more in UC+PAL than UC for both racial subgroups. The difference was greater for black than white patients (difference: KCCQ 10.8 vs. 2.5; FACIT-Pal: 14.8 vs. 3.9). However, the findings were not statistically significant. Conclusions: Larger studies are needed to assess the benefits of palliative care for black patients with HF. ClinicalTrials.gov Identifier: NCT01589601.
Entities:
Keywords:
heart failure; palliative care; quality of life; race
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