Key result
Among 8 patient-caregiver dyads, the ENABLE CHF-PC early palliative care intervention was unanimously found helpful and acceptable, yielding 4 themes including gaining perspective and planning.
Why the study?
Does the ENABLE CHF-PC early palliative care intervention provide a helpful and acceptable experience for patients with advanced heart failure and their caregivers?
Does the ENABLE CHF-PC early palliative care intervention provide a helpful and acceptable experience for patients with advanced heart failure and their caregivers?
The ENABLE CHF-PC early palliative care intervention is acceptable and helpful for patients with advanced heart failure and their caregivers, supporting its further evaluation in a randomized controlled trial.
Supports acceptability of early palliative care for advanced HF dyads; extends feasibility data and justifies larger efficacy RCTs.
OBJECTIVE:: Models of early, community-based palliative care for individuals with New York Heart Association (NYHA) class III/IV heart failure and their families are lacking. We used the Medical Research Council process of developing complex interventions to conduct a formative evaluation study to translate an early palliative care intervention from cancer to heart failure. METHOD:: One component of the parent formative evaluation pilot study was qualitative satisfaction interviews with 8 patient-caregiver dyad participants who completed Educate, Nurture, Advise, Before Life Ends Comprehensive Heartcare For Patient and Caregivers (ENABLE CHF-PC) intervention. The ENABLE CHF-PC consists of an in-person palliative care assessment, weekly telehealth coaching sessions, and monthly follow-up. Subsequent to completing the coaching sessions, patient and caregiver participants were interviewed to elicit their experiences with ENABLE CHF-PC. Digitally recorded interviews were transcribed and analyzed using a thematic approach. RESULTS:: Patients (n = 8) mean age was 67.3, 62.5% were female, 75% were married/living with a partner; caregivers (n = 8) mean age was 56.8, and 87.5% were female. Four themes related to experiences with ENABLE CHF-PC included "allowed me to vent," "gained perspective," "helped me plan," and "gained illness management and decision-making skills." Recommendations for intervention modification included (1) start program at diagnosis, (2) maintain phone-based approach, and (3) expand topics and modify format. CONCLUSION:: Patients and caregivers unanimously found the intervention to be helpful and acceptable. After incorporating modifications, ENABLE CHF-PC is currently undergoing efficacy testing in a large randomized controlled trial.
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Akyar et al. (2018) studied New York Heart Association (NYHA) class III/IV heart failure (n=16). ENABLE CHF-PC was evaluated on Experiences with ENABLE CHF-PC. Among 8 patient-caregiver dyads, the ENABLE CHF-PC early palliative care intervention was unanimously found helpful and acceptable, yielding 4 themes including gaining perspective and planning.
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