Evidence map›Paper›PMID 33556493›Full record

ArticleJournal of pain and symptom management2021

Examining Adherence and Dose Effect of an Early Palliative Care Intervention for Advanced Heart Failure Patients.

Rachel Wells, James Nicholas Dionne-Odom, Andres Azuero, Harleah Buck, Deborah Ejem, Kathryn L Burgio, Macy L Stockdill, Rodney Tucker, Salpy V Pamboukian, Jose Tallaj and 6 more

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of pain and symptom management, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02505425 (Randomized Trial of ENABLE CHF-PC for Heart Failure Patients and Caregivers.), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02505425 nacompletednot on this map

Randomized Trial of ENABLE CHF-PC for Heart Failure Patients and Caregivers. (Comprehensive Heartcare For Patients and Caregivers)

TypeinterventionalSponsorUniversity of Alabama at BirminghamRan2015 to 2019Enrolled573ConditionsHeart FailureArmsBehavioral Support, Usual HF Care
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. A Qualitative Study of the Limits and Possibilities of Integrating Palliative Care in Heart Failure.Inquiry : a journal of medical care organization, provision and financing
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 1 institution in 1 country.

Rachel WellsSchool of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: raduncan@uab.edu.
James Nicholas Dionne-OdomSchool of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Medicine, Division of Gerontology, Geriatrics, Palliative Care, UAB Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, USA.
Andres AzueroSchool of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
Harleah BuckCsomay Center for Gerontological Excellence, College of Nursing, University of Iowa Iowa City, IA, USA.
Deborah EjemSchool of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
Kathryn L BurgioDepartment of Medicine, Division of Gerontology, Geriatrics, Palliative Care, UAB Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, USA; Birmingham VA Medical Center, Birmingham, AL, USA.
Macy L StockdillSchool of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
Rodney TuckerDepartment of Medicine, Division of Gerontology, Geriatrics, Palliative Care, UAB Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, USA.
Salpy V PamboukianDepartment of Medicine, Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
Jose TallajDepartment of Medicine, Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
Sally EnglerSchool of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
Konda KeeblerSchool of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
Sheri TimsSchool of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
Raegan DurantDepartment of Medicine, Division of Preventative Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Keith M SwetzDepartment of Medicine, Division of Gerontology, Geriatrics, Palliative Care, UAB Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, USA.
Marie BakitasSchool of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Medicine, Division of Gerontology, Geriatrics, Palliative Care, UAB Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, USA.
University of Alabama at Birmingham · US

Funding

UAB Health Services Research (HSR) Training ProgramT32HS013852 · AHRQ · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI LEVITAN, EMILY B, MUGAVERO, MICHAEL J · 2003 to 2024
$8.0M
NRSA Training CoreTL1TR003106 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SAAG, KENNETH G · 2019 to 2023
$3.7M
ENABLE: CHF-PC (Comprehensive Heartcare For Patients and Caregivers)R01NR013665 · NINR · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI BAKITAS, MARIE ANNE · 2015 to 2019
$3.6M
Optimizing an Early Palliative Care Intervention for Advanced HF PatientsK99NR019854 · NINR · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI WELLS, RACHEL D · 2021 to 2022
$174k
Influence of Race, Gender, Rurality, and Dyadic Health on Symptom Trajectories in Persons with Advanced Heart FailureF31NR018782 · NINR · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI STOCKDILL, MACY L · 2019 to 2021
$63k
AHRQ HHS T32 HS013852NCATS NIH HHS TL1 TR003106NINR NIH HHS F31 NR018782NINR NIH HHS K99 NR019854NINR NIH HHS R01 NR013665
6 · The paper itself

Abstract

contextResearch priority guidelines highlight the need for examining the "dose" components of palliative care (PC) interventions, such as intervention adherence and completion rates, that contribute to optimal outcomes.

objectivesExamine the "dose" effect of PC intervention completion vs. noncompletion on quality of life (QoL) and healthcare use in patients with advanced heart failure (HF) over 32 weeks.

methodsSecondary analysis of the ENABLE CHF-PC intervention trial for patients with New York Heart Association (NYHA) Class III/IV HF. "Completers" defined as completing a single, in-person outpatient palliative care consultation (OPCC) plus 6 weekly, PC nurse coach-led telehealth sessions. "Non-completers" were defined as either not attending the OPCC or completing <6 telehealth sessions. Outcome variables were QoL and healthcare resource use (hospital days; emergency department visits). Mixed models were used to model dose effects for "completers" vs "noncompleters" over 32 weeks.

resultsOf 208 intervention group participants, 81 (38.9%) were classified as "completers" with a mean age of 64.6 years; 72.8% were urban-dwelling; 92.5% had NYHA Class III HF. 'Completers' vs. "non-completers"" groups were well-balanced at baseline; however "noncompleters" did report higher anxiety (6.0 vs 7.0, P < 0.05, d = 0.28). Moderate, clinically significant, improved QoL differences were found at 16 weeks in "completers" vs. "non-completers" (between-group difference: -9.71 (3.18), d = 0.47, P = 0.002) but not healthcare use.

conclusionHigher intervention completion rates of an early PC intervention was associated with QoL improvements in patients with advanced HF. Future work should focus on identifying the most efficacious "dose" of intervention components and increasing adherence to them.

trial registrationClinicalTrials.gov Identifier: NCT02505425.

Indexed as

Heart FailureHospice and Palliative Care NursingTelemedicineHumansMiddle AgedPalliative CareQuality of Lifeheart failureintervention dose effectPalliative care

Identifiers

PMID33556493
PMCPMC8339177
OpenAlexW3127063016

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.