Evidence map›Paper›PMID 28705314›Full record

Trial reportJournal of the American College of Cardiology2017

Palliative Care in Heart Failure: The PAL-HF Randomized, Controlled Clinical Trial.

Joseph G Rogers, Chetan B Patel, Robert J Mentz, Bradi B Granger, Karen E Steinhauser, Mona Fiuzat, Patricia A Adams, Adam Speck, Kimberly S Johnson, Arun Krishnamoorthy and 8 more

6 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 6 registered trials, which are not on this map. Cited by 235 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
235citing papers in PubMed, 19 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.

NCT01589601 nacompletednot on this map

Palliative Care in Heart Failure (PAL-HF)

TypeinterventionalSponsorDuke UniversityRan2012 to 2016Enrolled150ConditionsHeart Failure, Heart Diseases, Cardiovascular DiseasesArmsUsual heart failure care, Interdisciplinary palliative care
NCT03724695 nacompletednot on this mapstarted 2018, after this paper: background citation

Advanced Heart Care at Home (AHCAH); a Pragmatic Randomized Trial for Clinicians Nudged to AHCAH, a Heart Failure Specific Home Palliative Care Services

TypeinterventionalSponsorUniversity of PennsylvaniaRan2018 to 2024Enrolled709ConditionsPalliative Care, Heart Failure, Health Care Utilization, Quality ImprovementArmsClinician nudge or opt out approach for AHCAH liaison visit
NCT04120857 nacompletednot on this mapstarted 2019, after this paper: background citation

A Tele-Health Symptom Management Program for Patients With Heart Failure: Pall-Heart

TypeinterventionalSponsorUniversity of VirginiaRan2019 to 2020Enrolled30ConditionsHeart FailureArmsGentle Stretching
NCT04994782 nacompletednot on this mapstarted 2021, after this paper: background citation

GAMification to Encourage End-Of-Life Discussions Between Implantable Cardioverter Defibrillator Recipients and Family Members

TypeinterventionalSponsorDebra MoserRan2021 to 2023Enrolled60ConditionsImplantable Defibrillator User, Terminal IllnessArmsGAME-EOL
NCT05284955 phase4unknown statusnot on this mapstarted 2023, after this paper: background citation

Efficacy of Pulmonary Pressure Guided Therapy in Stable Outpatients With Advanced Heart Failure - A Randomized Controlled Clinical Trial

TypeinterventionalSponsorFinn GustafssonRan2023 to 2025Enrolled60ConditionsAdvanced Heart Failure, Heart Failure With Reduced Ejection FractionArmsCardioMEMS HF System, Standard heart failure medical therapy
NCT07445932 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

The PALL-VAD Study: Palliative Care Intervention to Improve Health Related Quality of Life for Patients With Heart Failure on Long-Term LVAD Support: A Pilot, Prospective, Randomized Trial

TypeinterventionalSponsorMedstar Health Research InstituteRan2026 to 2027Enrolled90ConditionsAdvanced Heart Failure, Mechanical Circulatory Support, Left Ventricular Assist Device, Palliative CareArmsPalliative care intervention
3 · Its place in the literature

Who cites it

235 citing papers in PubMed, 19 syntheses or guidelines pooled it.

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  17. Advance care planning for adults with heart failure.The Cochrane database of systematic reviews · 2020
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  18. Guideline
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  20. Early palliative care in heart failure shows neutral effects across EF subtypes: an exploratory EPCHF secondary analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Trial

175 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors.

Joseph G RogersDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina. Electronic address: joseph.rogers@duke.edu.
Chetan B PatelDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
Robert J MentzDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
Bradi B GrangerDuke School of Nursing, Duke University, Durham, North Carolina.
Karen E SteinhauserDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina; Center for Health Services Research and Development in Primary Care, Durham VA Medical Center, Durham, North Carolina.
Mona FiuzatDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina.
Patricia A AdamsDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina.
Adam SpeckDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina.
Kimberly S JohnsonDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
Arun KrishnamoorthyPiedmont HealthCare, Atlanta, Georgia.
Hongqiu YangDuke Clinical Research Institute, Durham, North Carolina.
Kevin J AnstromDuke Clinical Research Institute, Durham, North Carolina; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina.
Gwen C DodsonDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina.
Donald H TaylorDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina; Sanford School of Public Policy, Duke University, Durham, North Carolina; Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina.
Jerry L KirchnerDuke Clinical Research Institute, Durham, North Carolina.
Daniel B MarkDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
Christopher M O'ConnorDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina; Inova Heart & Vascular Institute, Falls Church, Virginia.
James A TulskyDepartment of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Funding

REHAB-HF: A Trial of Rehabilitation Therapy in Older Acute Heart Failure PatientsR01AG045551 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2014 to 2018
$6.8M
Heart Failure Clinical Research Network Regional Clinical Center (U10)U10HL110312 · NHLBI · DUKE UNIVERSITY · PI FELKER, GARY M · 2012 to 2018
$3.5M
Palliative Care in Heart Failure (PAL-HF)R01NR013428 · NINR · DUKE UNIVERSITY · PI ROGERS, JOSEPH G., TULSKY, JAMES A. · 2011 to 2014
$1.8M
Increasing Access to Hospice Care for Older African Americans: A National StudyR01AG042130 · NIA · DUKE UNIVERSITY · PI JOHNSON, KIMBERLY S. · 2012 to 2014
$1.0M
Organizational Variability and Racial Disparities in Hospice UseK08AG028975 · NIA · DUKE UNIVERSITY · PI JOHNSON, KIMBERLY S. · 2007 to 2011
$863k
NHLBI NIH HHS U10 HL110312NIA NIH HHS K08 AG028975NIA NIH HHS R01 AG042130NIA NIH HHS R01 AG045551NINR NIH HHS R01 NR013428
6 · The paper itself

Abstract

backgroundAdvanced heart failure (HF) is characterized by high morbidity and mortality. Conventional therapy may not sufficiently reduce patient suffering and maximize quality of life.

objectivesThe authors investigated whether an interdisciplinary palliative care intervention in addition to evidence-based HF care improves certain outcomes.

methodsThe authors randomized 150 patients with advanced HF between August 15, 2012, and June 25, 2015, to usual care (UC) (n = 75) or UC plus a palliative care intervention (UC + PAL) (n = 75) at a single center. Primary endpoints were 2 quality-of-life measurements, the Kansas City Cardiomyopathy Questionnaire (KCCQ) overall summary and the Functional Assessment of Chronic Illness Therapy-Palliative Care scale (FACIT-Pal), assessed at 6 months. Secondary endpoints included assessments of depression and anxiety (measured via the Hospital Anxiety and Depression Scale [HADS]), spiritual well-being (measured via the FACIT-Spiritual Well-Being scale [FACIT-Sp]), hospitalizations, and mortality.

resultsPatients randomized to UC + PAL versus UC alone had clinically significant incremental improvement in KCCQ and FACIT-Pal scores from randomization to 6 months (KCCQ difference = 9.49 points, 95% confidence interval [CI]: 0.94 to 18.05, p = 0.030; FACIT-Pal difference = 11.77 points, 95% CI: 0.84 to 22.71, p = 0.035). Depression improved in UC + PAL patients (HADS-depression difference = -1.94 points; p = 0.020) versus UC-alone patients, with similar findings for anxiety (HADS-anxiety difference = -1.83 points; p = 0.048). Spiritual well-being was improved in UC + PAL versus UC-alone patients (FACIT-Sp difference = 3.98 points; p = 0.027). Randomization to UC + PAL did not affect rehospitalization or mortality.

conclusionsAn interdisciplinary palliative care intervention in advanced HF patients showed consistently greater benefits in quality of life, anxiety, depression, and spiritual well-being compared with UC alone. (Palliative Care in Heart Failure [PAL-HF]; NCT01589601).

Indexed as

Quality of LifeAgedFemaleFollow-Up StudiesHeart FailureHumansMalePalliative CareProspective StudiesSeverity of Illness IndexTreatment Outcomeheart failurepalliative carequality of life

Identifiers

PMID28705314
PMCPMC5664956

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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 OpenQuestion graph.