Skip to main content

Strategies to address the shortcomings of commonly used advanced chronic heart failure descriptors to improve recruitment in palliative care research: A parallel mixed-methods feasibility study

Kane, Pauline M.; Murtagh, Fliss E.M.; Ryan, Karen R.; Brice, Mary; Mahon, Niall G.; McAdam, Brendan; McQuillan, Regina; O’Gara, Geraldine; Raleigh, Caroline; Tracey, Cecelia; Howley, Christine; Higginson, Irene J.; Daveson, Barbara A.; on behalf of BuildCARE

Authors

Pauline M. Kane

Karen R. Ryan

Mary Brice

Niall G. Mahon

Brendan McAdam

Regina McQuillan

Geraldine O’Gara

Caroline Raleigh

Cecelia Tracey

Christine Howley

Irene J. Higginson

Barbara A. Daveson

on behalf of BuildCARE



Abstract

Background:
Recruitment challenges contribute to the paucity of palliative care research with advanced chronic heart failure patients.

Aim:
To describe the challenges and outline strategies of recruiting advanced chronic heart failure patients.

Design:
A feasibility study using a pre–post uncontrolled design.

Setting:
Advanced chronic heart failure patients were recruited at two nurse-led chronic heart failure disease management clinics in Ireland

Results:
Of 372 patients screened, 81 were approached, 38 were recruited (46.9% conversion to consent) and 25 completed the intervention. To identify the desired population, a modified version of the European Society of Cardiology definition was used together with modified New York Heart Association inclusion criteria to address inter-study site New York Heart Association classification subjectivity. These modifications substantially increased median monthly numbers of eligible patients approached (from 8 to 20) and median monthly numbers recruited (from 4 to 9). Analysis using a mortality risk calculator demonstrated that recruited patients had a median 1-year mortality risk of 22.7 and confirmed that the modified eligibility criteria successfully identified the population of interest. A statistically significant difference in New York Heart Association classification was found in recruited patients between study sites, but no statistically significant difference was found in selected clinical parameters between these patients.

Conclusion:
Clinically relevant modifications to the European Society of Cardiology definition and strategies to address New York Heart Association subjectivity may help to improve advanced chronic heart failure patient recruitment in clinical settings, thereby helping to address the paucity of palliative care research this population.

Journal Article Type Article
Publication Date Feb 1, 2018
Journal Palliative Medicine
Print ISSN 0269-2163
Electronic ISSN 1477-030X
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 32
Issue 2
Pages 517-524
APA6 Citation Kane, P. M., Murtagh, F. E., Ryan, K. R., Brice, M., Mahon, N. G., McAdam, B., …on behalf of BuildCARE, . (2018). Strategies to address the shortcomings of commonly used advanced chronic heart failure descriptors to improve recruitment in palliative care research: A parallel mixed-methods feasibility study. Palliative medicine, 32(2), 517-524. https://doi.org/10.1177/0269216317706426
DOI https://doi.org/10.1177/0269216317706426
Keywords Heart failure; Palliative care; Recruitment; Patient-reported outcome measures
Publisher URL http://journals.sagepub.com/doi/10.1177/0269216317706426
Copyright Statement ©The Author(s) 2017
;