Evidence map›Paper›PMID 27401505›Full record

Trial reportJournal of pain and symptom management2016

An Intervention to Enhance Goals-of-Care Communication Between Heart Failure Patients and Heart Failure Providers.

Ardith Z Doorenbos, Wayne C Levy, J Randall Curtis, Cynthia M Dougherty

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of pain and symptom management, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 4 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  4. Advance care planning for adults with heart failure.The Cochrane database of systematic reviews · 2020
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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

4 authors.

Ardith Z DoorenbosSchool of Nursing, University of Washington, Seattle, Washington, USA; School of Medicine, University of Washington, Seattle, Washington, USA. Electronic address: doorenbo@uw.edu.
Wayne C LevySchool of Medicine, University of Washington, Seattle, Washington, USA.
J Randall CurtisSchool of Medicine, University of Washington, Seattle, Washington, USA.
Cynthia M DoughertySchool of Nursing, University of Washington, Seattle, Washington, USA; School of Medicine, University of Washington, Seattle, Washington, USA.

Funding

Applying Technology to Problems in Pain and Symptom ManagementK24NR015340 · NINR · UNIVERSITY OF WASHINGTON · PI DOORENBOS, ARDITH Z · 2014 to 2018
$842k
NINR NIH HHS K24 NR015340
6 · The paper itself

Abstract

contextHeart failure patients contend with a markedly impaired quality of life, experiencing emotional distress and severe physical discomfort that increases in frequency in the last months of life. Improving communication between patients and providers about goals of care has the potential to improve patient-provider communication and patient outcomes.

objectivesTo determine the effects of a goals-of-care (GoC) intervention compared to usual care on the number of GoC conversations, quality of communication between patients and providers, referrals to palliative care services and completion of advance care directives.

methodsA two-group randomized study (n = 40/group) compared a GoC intervention to usual care, conducted in an academic heart failure (HF) clinic. The GoC intervention was a previsit patient activation-education, telephone-based intervention delivered by a nurse. The primary outcome of the study was number of GoC conversations between HF patients and HF providers. Secondary outcomes were quality of communication, number of referrals to palliative care, and completion of advance directives.

resultsPatients averaged 58.15 ± 11.26 years of age, with mean left ventricular ejection fraction = 30.31 ± 9.72% and Seattle Heart Failure Model scores = 95.1 ± 1.60. There was a significant increase in goals-of-care conversations (58% vs. 2.6%, P < 0.001) and quality of end-of-life communication (P = 0.03) in the GoC group compared to usual care after the intervention. There were no differences between groups on the other outcomes.

conclusionThe GoC intervention resulted in more GoC conversations and higher quality communication between HF patients and providers without increased anxiety or depression. Further studies are needed to assess impact on longer term quality of care and patient outcomes.

Indexed as

CommunicationPatient Care PlanningPatient Education as TopicTelemedicineAdvance DirectivesFemaleHeart FailureHumansMaleMiddle AgedNursesPalliative CareProfessional-Patient RelationsQuality of Health CareReferral and ConsultationTerminal Carecommunicationend of lifeGoals of careheart failurepalliative care

Identifiers

PMID27401505
PMCPMC5545129

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Registered trials

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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 OpenQuestion graph.