Effects of a transitional palliative care model on patients with end-stage heart failure: study protocol for a randomized controlled trial
Effects of a transitional palliative care model on patients with end-stage heart failure: study protocol for a randomized controlled trial
Background: Heart failure (HF) is characterized by high rates of readmission after hospitalization, and readmission is a major contributor to healthcare costs. The transitional care model has proven efficacy in reducing the readmission rate and economic outcomes, and increasing satisfaction with care. However, the effectiveness of the transitional care model has not been evaluated in patients with end-stage HF. This study was designed to compare the customary hospital-based care and a comprehensive transitional care model, namely the Home-based Palliative HF Program (HPHP), in terms of readmission rate, quality of life, and satisfaction with care among end-stage HF patients under palliative care. Methods/design: This is a randomized controlled trial taking place in hospitals in Hong Kong. We have been recruiting patients with end-stage HF who are identified as appropriate for palliative care during hospitalization, on referral by their physicians. A set of questionnaires is collected from each participant upon discharge. Participants are randomized to receive usual care (customary hospital-based care) or the intervention (HPHP). The HPHP will be implemented for up to 12 months. Outcome measures will be performed at 1, 3, 6, and 12 months post-discharge. The primary outcome of this study is quality of life measured by the Chronic Heart Failure Questionnaire - Chinese version; secondary outcomes include readmission rate, symptom intensity, functional status, and satisfaction with care. Discussion: This study is original and will provide important information for service development in the area of palliative care. The introduction of palliative care to end-stage organ failure patients is new and has received increasing attention worldwide in the last decade. This study adopts the randomized controlled trial, a vigorous research design, to establish scientific evidence in exploring the best model for end-stage HF patients receiving palliative care.
End-stage heart failure, Health services utilization, Palliative care, Quality of life, Transitional care
Ng, Alina Yee Man
287fbac8-4b1f-41b6-9099-c45aa80ba112
Wong, Frances Kam Yuet
16ef04f5-c554-4606-9b2f-7f604b2495c3
Lee, Paul Hong
02620eab-ae7f-4a1c-bad1-8a50e7e48951
31 March 2016
Ng, Alina Yee Man
287fbac8-4b1f-41b6-9099-c45aa80ba112
Wong, Frances Kam Yuet
16ef04f5-c554-4606-9b2f-7f604b2495c3
Lee, Paul Hong
02620eab-ae7f-4a1c-bad1-8a50e7e48951
Ng, Alina Yee Man, Wong, Frances Kam Yuet and Lee, Paul Hong
(2016)
Effects of a transitional palliative care model on patients with end-stage heart failure: study protocol for a randomized controlled trial.
Trials, 17 (1), [173].
(doi:10.1186/S13063-016-1303-7).
Abstract
Background: Heart failure (HF) is characterized by high rates of readmission after hospitalization, and readmission is a major contributor to healthcare costs. The transitional care model has proven efficacy in reducing the readmission rate and economic outcomes, and increasing satisfaction with care. However, the effectiveness of the transitional care model has not been evaluated in patients with end-stage HF. This study was designed to compare the customary hospital-based care and a comprehensive transitional care model, namely the Home-based Palliative HF Program (HPHP), in terms of readmission rate, quality of life, and satisfaction with care among end-stage HF patients under palliative care. Methods/design: This is a randomized controlled trial taking place in hospitals in Hong Kong. We have been recruiting patients with end-stage HF who are identified as appropriate for palliative care during hospitalization, on referral by their physicians. A set of questionnaires is collected from each participant upon discharge. Participants are randomized to receive usual care (customary hospital-based care) or the intervention (HPHP). The HPHP will be implemented for up to 12 months. Outcome measures will be performed at 1, 3, 6, and 12 months post-discharge. The primary outcome of this study is quality of life measured by the Chronic Heart Failure Questionnaire - Chinese version; secondary outcomes include readmission rate, symptom intensity, functional status, and satisfaction with care. Discussion: This study is original and will provide important information for service development in the area of palliative care. The introduction of palliative care to end-stage organ failure patients is new and has received increasing attention worldwide in the last decade. This study adopts the randomized controlled trial, a vigorous research design, to establish scientific evidence in exploring the best model for end-stage HF patients receiving palliative care.
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More information
Accepted/In Press date: 18 March 2016
Published date: 31 March 2016
Additional Information:
Funding Information:
This study is funded by the Hong Kong University Grants Committee, General Research Fund, Research Grants Council (PolyU 5492/12H), and a Postgraduate Research Student Grant from the Hong Kong Polytechnic University (Ref. RPBS). We thank the palliative care teams of the study hospitals for their clinical advice on this study. We are grateful to the volunteers and participants of the study.
Publisher Copyright:
© 2016 Ng et al.
Keywords:
End-stage heart failure, Health services utilization, Palliative care, Quality of life, Transitional care
Identifiers
Local EPrints ID: 475345
URI: http://eprints.soton.ac.uk/id/eprint/475345
ISSN: 1745-6215
PURE UUID: 63fc4446-5b7f-4256-92e7-cbec040faad5
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Date deposited: 15 Mar 2023 17:48
Last modified: 18 Mar 2024 04:09
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Contributors
Author:
Alina Yee Man Ng
Author:
Frances Kam Yuet Wong
Author:
Paul Hong Lee
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