Promoting Palliative Care for People With Heart Failure (P3HF)

Yale University

Status: Not yet enrolling

Conditions: Heart Failure; Palliative Care

Treatments: Behavioral: Clinical Decision Support Tool

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT06933875

2000038269

1R34HL174885-01 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This project will develop and test a novel clinical decision support tool (CDS) that encourages timely referral to palliative care for people hospitalized with heart failure. This intervention will incorporate an existing, validated 1-year mortality risk model into a CDS to deliver prognostic information and evidence-based decision support at the point of care. Thus, this research may lead to improved care-concordant and goal-directed care for people with heart failure.

Full description

Healthcare providers will encounter the tool during the routine care of their hospitalized patients. Providers randomized to the intervention arm will receive training on the use of the tool and complete one post-trial survey. Providers randomized to the intervention arm will also have the opportunity to participate in 1 post-trial interview. Level 2 providers will participate in one interview.

Enrollment: 1,485 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Healthcare providers must meet the following criteria:

• Are an attending physician, fellow, or resident, advanced practice nurse, or physician associate
• Has ordering privileges
• Are members of one of the hospitals' admitting teams (e.g., hospitalist service, cardiology service)
• Anticipate employment at one of the two study sites for the 15-month trial period.

Or

• Palliative care team member
• Hospital administrator/quality and safety personnel

Patients of providers enrolled in the study must meet the following criteria for heart failure during hospitalization:

• N-terminal pro-B-type natriuretic peptide values of >500 pg/ml
• Not pregnant at the time of admission.
• Received intravenous diuretics within 24 hours of admission.

Exclusion criteria

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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1,485 participants in 3 patient groups

Clinical Decision Support (CDS) Tool

Experimental group

Description:

Providers will use the CDS tool to deliver prognostic information and evidence-based decision support at the point of care for timely referral to palliative care for participants hospitalized with heart failure.

Treatment:

Behavioral: Clinical Decision Support Tool

Standard of Care

No Intervention group

Description:

Providers will provide usual standard of care for participants hospitalized with heart failure.

Level 2 providers

Experimental group

Description:

Level 2 providers are providers potentially impacted by the tool. Level 2 providers will participate in one interview.

Treatment:

Behavioral: Clinical Decision Support Tool