Convoy-Pal: A Digital Palliative Care Intervention for Older Adults with Heart Failure and their Caregivers (GP115)

Outcomes 1. Identify the importance of integrating caregivers into digital palliative care of older adults with heart failure. 2. Describe patient and caregiver outcomes following use of a digital palliative care self-management program. Key Message Digital health provides a modern opportunity to increase access and awareness of palliative care for older adults and their multiple informal caregivers. Importance Digital health systems (e.g., patient portals, mobile apps, etc.) are often designed for individual users rather than integrating caregivers to maximize benefit. As older adults with heart failure (HF) rely on the support of others to help manage their health, there is a critical need to foster approaches for effective integration of caregivers in digital palliative care. Objective(s) To test feasibility of the Social Convoy Palliative Care intervention (Convoy-Pal); a 3-month digital self-management program including assessment tools and resources related to clinical palliative care domains for both patients and their caregivers with shared, integrated features. Scientific Methods Utilized Randomized waitlist control pilot trial with patients 65 years and older who had been hospitalized twice or more for HF in the previous 2 years and their caregivers. We used descriptive statistics to describe recruitment, retention, missing data, and patient and caregiver self-report of social functioning, positive aspects of caregiving, and intervention acceptability. Results Our team mailed 503 patients recruitment invitations; 90 were ineligible,179 declined participation, and 31 patients and 15 of their caregivers (N=46) enrolled in the trial. Patients were 76.3 years of age, and caregivers 71.6, primarily White, but not all had access to a mobile device or computer. The study maintained a 67.4% retention rate, with 4.6% missing subscales on surveys, in part due to our established processes for providing technical support. Intervention patients reported improvements in social functioning (SF-36: 64.6±25.8 vs. 73.2±31.3) and caregivers reported increased perceptions of positive aspects of caregiving (29.5±5.28 vs. 35.0±5.35). Intervention acceptability was well-rated via the User Rated Mobile Application Scale, particularly related to the information provided (4.0±.43 out of 5). Conclusion(s) Convoy-Pal is feasible to deliver to both older patients and their caregivers. Because palliative care is a patient and caregiver approach to serious illness care, more research is needed to determine how to best design digital palliative care tools for multiple, varied age, and diverse simultaneous users. Impact The Convoy-Pal digital health palliative care intervention provides an innovative way to increase access and awareness of palliative care assessments and resources for older adults and their multiple informal caregivers.