Key result
Palliative care in end-stage HF is linked to ~219% higher odds of end-of-life opioid use.
Why the study?
Patients with end-stage heart failure carry a heavy disease burden, but evidence evaluating the effects of palliative care consultation services during end of life remains scarce.
Does palliative care consultation service (PCCS) alter opioid use and aggressive treatments during end of life in patients with end-stage heart failure?
Observational (n=120)
No
Does palliative care consultation service (PCCS) alter opioid use and aggressive treatments during end of life in patients with end-stage heart failure?
Effect estimate: OR 3.192 (95% CI 1.311-7.768)
Absolute Event Rate: 76.67% vs 53.33%
p-value: p=0.0105
Palliative care consultation for end-stage heart failure patients significantly increases opioid use for symptom management and DNR orders, though it may also increase the length of terminal hospitalizations.
PCCS was associated with increased opioid use and prolonged terminal hospitalization in end-stage HF; leaves open net effects on EOL care quality.
BACKGROUND: Patients experiencing end-stage heart failure are a particularly important population who carry with them a heavy disease burden. However, evidence related to palliative care for patients with end-stage heart failure remains scarce, particularly when it comes to the issue of palliative care consultation service (PCCS). This 4-year observational study aimed to evaluate the effects of PCCS on opioid use and aggressive treatment during end of life (EOL) among patients diagnosed with end-stage heart failure. METHODS: This observational study used the hospice palliative care database of a tertiary medical center in Taiwan. We enrolled all decedents who were diagnosed with end-stage heart failure from the period January 1, 2018 to December 31, 2021. PCCS prior to death was documented with the relationship between PCCS and opioid use and treatment aggressiveness during EOL then analyzed through use of multivariable logistic regression. RESULTS: A total of 120 patients were enrolled, which included 60 (50.0%) patients with end-stage heart failure who received PCCS prior to death. Compared with patients who did not receive PCCS, patients with PCCS during EOL were found to have had significantly more opioids use (odds ratio and 95% confidence interval: 3.192, 1.311-7.768) as well as a greater likelihood of their hospitalization extending for more than 14 days (odds ratio and 95% confidence interval: 4.454, 1.863-10.651) during EOL. Even though patients who received PCCS did not experience significantly different combined treatment aggressiveness during EOL, they received less CPR and had more DNR consent orders. Moreover, the promotion of PCCS increased disease awareness in both patients and their families. CONCLUSION: PCCS in patients diagnosed with end-stage heart failure during EOL could significantly increase their opioid use and reduce some forms of aggressive treatments during EOL.
No takes yet. Share an insight, caveat, or question.
Chen et al. (2025) conducted an observational in End-stage heart failure (n=120). Palliative care consultation service (PCCS) vs. No PCCS (regular care) was evaluated on Opioid use during end of life (OR 3.192, 95% CI 1.311-7.768, p=0.0105). Palliative care consultation service significantly increased opioid use (OR 3.192) and the likelihood of hospitalization extending for more than 14 days (OR 4.454) during the end of life in patients with end-stage heart failure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: