Effects of palliative care consultation service on decedents experiencing end-stage heart failure: a 4-year observational study
Abstract Background Patients experiencing end-stage heart failure are a particularly important population who carry with them a heavy disease burden. However, evidence related to palliative care for patients with end-stage heart failure remains scarce, particularly when it comes to the issue of pall...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-04-01
|
| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-025-01686-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850202576002220032 |
|---|---|
| author | Pei-Yu Chen Lian-Shin Lin Ling-Hui Huang Szu-Pei Chien Chin-Yi Chao Jia-Jyun Wu Chun-Li Wang Lung-Chun Lee Pi-Shan Hsu Wei-Min Chu |
| author_facet | Pei-Yu Chen Lian-Shin Lin Ling-Hui Huang Szu-Pei Chien Chin-Yi Chao Jia-Jyun Wu Chun-Li Wang Lung-Chun Lee Pi-Shan Hsu Wei-Min Chu |
| author_sort | Pei-Yu Chen |
| collection | DOAJ |
| description | Abstract Background Patients experiencing end-stage heart failure are a particularly important population who carry with them a heavy disease burden. However, evidence related to palliative care for patients with end-stage heart failure remains scarce, particularly when it comes to the issue of palliative care consultation service (PCCS). This 4-year observational study aimed to evaluate the effects of PCCS on opioid use and aggressive treatment during end of life (EOL) among patients diagnosed with end-stage heart failure. Methods This observational study used the hospice palliative care database of a tertiary medical center in Taiwan. We enrolled all decedents who were diagnosed with end-stage heart failure from the period January 1, 2018 to December 31, 2021. PCCS prior to death was documented with the relationship between PCCS and opioid use and treatment aggressiveness during EOL then analyzed through use of multivariable logistic regression. Results A total of 120 patients were enrolled, which included 60 (50.0%) patients with end-stage heart failure who received PCCS prior to death. Compared with patients who did not receive PCCS, patients with PCCS during EOL were found to have had significantly more opioids use (odds ratio and 95% confidence interval: 3.192, 1.311–7.768) as well as a greater likelihood of their hospitalization extending for more than 14 days (odds ratio and 95% confidence interval: 4.454, 1.863–10.651) during EOL. Even though patients who received PCCS did not experience significantly different combined treatment aggressiveness during EOL, they received less CPR and had more DNR consent orders. Moreover, the promotion of PCCS increased disease awareness in both patients and their families. Conclusion PCCS in patients diagnosed with end-stage heart failure during EOL could significantly increase their opioid use and reduce some forms of aggressive treatments during EOL. |
| format | Article |
| id | doaj-art-9662ed0becd145b4a4e01acdf7b65c1a |
| institution | OA Journals |
| issn | 1472-684X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj-art-9662ed0becd145b4a4e01acdf7b65c1a2025-08-20T02:11:43ZengBMCBMC Palliative Care1472-684X2025-04-0124111110.1186/s12904-025-01686-6Effects of palliative care consultation service on decedents experiencing end-stage heart failure: a 4-year observational studyPei-Yu Chen0Lian-Shin Lin1Ling-Hui Huang2Szu-Pei Chien3Chin-Yi Chao4Jia-Jyun Wu5Chun-Li Wang6Lung-Chun Lee7Pi-Shan Hsu8Wei-Min Chu9Department of Family Medicine, Taichung Veterans General HospitalDepartment of Nursing, Taichung Veterans General HospitalDepartment of Nursing, Taichung Veterans General HospitalSchool of Medicine, Kaohsiung Medical UniversityDepartment of Nursing, Taichung Veterans General HospitalDepartment of Family Medicine, Taichung Veterans General HospitalDepartment of Family Medicine, Taichung Veterans General HospitalDepartment of Family Medicine, Taichung Veterans General HospitalDepartment of Family Medicine, Taichung Veterans General HospitalDepartment of Family Medicine, Taichung Veterans General HospitalAbstract Background Patients experiencing end-stage heart failure are a particularly important population who carry with them a heavy disease burden. However, evidence related to palliative care for patients with end-stage heart failure remains scarce, particularly when it comes to the issue of palliative care consultation service (PCCS). This 4-year observational study aimed to evaluate the effects of PCCS on opioid use and aggressive treatment during end of life (EOL) among patients diagnosed with end-stage heart failure. Methods This observational study used the hospice palliative care database of a tertiary medical center in Taiwan. We enrolled all decedents who were diagnosed with end-stage heart failure from the period January 1, 2018 to December 31, 2021. PCCS prior to death was documented with the relationship between PCCS and opioid use and treatment aggressiveness during EOL then analyzed through use of multivariable logistic regression. Results A total of 120 patients were enrolled, which included 60 (50.0%) patients with end-stage heart failure who received PCCS prior to death. Compared with patients who did not receive PCCS, patients with PCCS during EOL were found to have had significantly more opioids use (odds ratio and 95% confidence interval: 3.192, 1.311–7.768) as well as a greater likelihood of their hospitalization extending for more than 14 days (odds ratio and 95% confidence interval: 4.454, 1.863–10.651) during EOL. Even though patients who received PCCS did not experience significantly different combined treatment aggressiveness during EOL, they received less CPR and had more DNR consent orders. Moreover, the promotion of PCCS increased disease awareness in both patients and their families. Conclusion PCCS in patients diagnosed with end-stage heart failure during EOL could significantly increase their opioid use and reduce some forms of aggressive treatments during EOL.https://doi.org/10.1186/s12904-025-01686-6Heart failureEnd-of-lifePalliative care consultation serviceAggressiveness |
| spellingShingle | Pei-Yu Chen Lian-Shin Lin Ling-Hui Huang Szu-Pei Chien Chin-Yi Chao Jia-Jyun Wu Chun-Li Wang Lung-Chun Lee Pi-Shan Hsu Wei-Min Chu Effects of palliative care consultation service on decedents experiencing end-stage heart failure: a 4-year observational study BMC Palliative Care Heart failure End-of-life Palliative care consultation service Aggressiveness |
| title | Effects of palliative care consultation service on decedents experiencing end-stage heart failure: a 4-year observational study |
| title_full | Effects of palliative care consultation service on decedents experiencing end-stage heart failure: a 4-year observational study |
| title_fullStr | Effects of palliative care consultation service on decedents experiencing end-stage heart failure: a 4-year observational study |
| title_full_unstemmed | Effects of palliative care consultation service on decedents experiencing end-stage heart failure: a 4-year observational study |
| title_short | Effects of palliative care consultation service on decedents experiencing end-stage heart failure: a 4-year observational study |
| title_sort | effects of palliative care consultation service on decedents experiencing end stage heart failure a 4 year observational study |
| topic | Heart failure End-of-life Palliative care consultation service Aggressiveness |
| url | https://doi.org/10.1186/s12904-025-01686-6 |
| work_keys_str_mv | AT peiyuchen effectsofpalliativecareconsultationserviceondecedentsexperiencingendstageheartfailurea4yearobservationalstudy AT lianshinlin effectsofpalliativecareconsultationserviceondecedentsexperiencingendstageheartfailurea4yearobservationalstudy AT linghuihuang effectsofpalliativecareconsultationserviceondecedentsexperiencingendstageheartfailurea4yearobservationalstudy AT szupeichien effectsofpalliativecareconsultationserviceondecedentsexperiencingendstageheartfailurea4yearobservationalstudy AT chinyichao effectsofpalliativecareconsultationserviceondecedentsexperiencingendstageheartfailurea4yearobservationalstudy AT jiajyunwu effectsofpalliativecareconsultationserviceondecedentsexperiencingendstageheartfailurea4yearobservationalstudy AT chunliwang effectsofpalliativecareconsultationserviceondecedentsexperiencingendstageheartfailurea4yearobservationalstudy AT lungchunlee effectsofpalliativecareconsultationserviceondecedentsexperiencingendstageheartfailurea4yearobservationalstudy AT pishanhsu effectsofpalliativecareconsultationserviceondecedentsexperiencingendstageheartfailurea4yearobservationalstudy AT weiminchu effectsofpalliativecareconsultationserviceondecedentsexperiencingendstageheartfailurea4yearobservationalstudy |