Identifying palliative care needs in chronic heart failure
Research type
Research Study
Full title
Identifying palliative care needs in chronic heart failure
IRAS ID
276605
Contact name
Sam Straw
Contact email
Sponsor organisation
University of Leeds
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
Chronic heart failure (CHF) is characterised by breathlessness, fatigue and fluid retention. CHF occurs when the heart is unable to meet the body’s needs. It is a progressive, incurable condition associated with significant impairments in quality of life and reduced life expectancy.
Patients are often hospitalised with worsening symptoms and this offers the opportunity for teams to discuss 'advance care planning', to establish patients' goals of care and, where appropriate, refer to palliative care services for the management of difficult symptoms. Patients with CHF are less likely to be referred to palliative care compared to other chronic diseases such as cancer, although the burden of psychological and physical symptoms are similar. The evidence suggests that more patients with CHF would welcome this, if only it were offered.
In the United Kingdom, it is recommended that treating teams use the Gold Standards Framework (GSF) Prognostic Identification Guidance to identify who might benefit from an integration of a palliative approach into their care. The GSF includes three prompts for healthcare professionals to consider: 1) the ‘Surprise Question’, 2) general indicators of decline, 3) disease specific clinical indictors of decline.
Previously, we showed the ‘Surprise Question’: “would you be surprised if this person died within the next year?”, is a simple, convenient and intuitive prompt which reliably identifies patients hospitalised with CHF who were within the last year of life (Straw S et al. EJHF. 2019). The Surprise Question can be used by different healthcare professionals with similar levels of accuracy. However, whether this prompt identifies palliative care needs or identifies patients with general and specific decline is unknown.
In this study we will assess whether the Surprise Question is able to identify palliative care needs for patients hospitalised with CHF and the effect of the prompt on clinical care.
REC name
London - Bloomsbury Research Ethics Committee
REC reference
24/LO/0743
Date of REC Opinion
19 Nov 2024
REC opinion
Further Information Favourable Opinion