- •The vast majority of patients hospitalized with acute decompensated heart failure say they have never discussed their wishes for end-of-life care with their doctor.
- •End-of-life discussions were not more common with patients with worse prognosis.
- •Patients who recall having discussions were more knowledgeable about end-of-life options and more likely to have completed an advance directive.
Methods and Results
- Executive summary: heart disease and stroke statistics—2016 update: a report from the American Heart Association.Circulation. 2016; 133: 447-454
- Executive summary: HFSA 2010 comprehensive heart failure practice guideline.J Card Fail. 2010; 16: 475-539
- 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines.Circulation. 2013; 128: e240-e327
- Advance directives among hospitalized patients with heart failure.JACC Heart Fail. 2015; 3: 112-121
- Advance directives in community patients with heart failure.Circ Cardiovasc Qual Outcomes. 2012; 5: 283-289
- A survey of clinician attitudes and self-reported practices regarding end-of-life care in heart failure.Palliat Med. 2015; 29: 260-267
- Predicting survival in heart failure: a risk score based on 39 372 patients from 30 studies.Eur Heart J. 2013; 34: 1404-1413
- Resuscitation preferences among patients with severe congestive heart failure: results from the SUPPORT project. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.Circulation. 1998; 98: 648-655
- Choices of seriously ill patients about cardiopulmonary resuscitation: correlates and outcomes. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.Am J Med. 1996; 100: 128-137
- Self-rated health predicts healthcare utilization in heart failure.J Am Heart Assoc. 2014; 3: e000931
- Brief questions to identify patients with inadequate health literacy.Fam Med. 2004; 36: 588-594
- Psychometric characteristics of a quality of communication questionnaire assessing communication about end-of-life care.J Palliat Med. 2006; 9: 1086-1098
- Development and testing of a short form of the patient activation measure.Health Serv Res. 2005; 40: 1918-1930
- Perceptions and attitudes about hospice and palliative care among community-dwelling older adults.Am J Hosp Palliat Care. 2013; 30: 153-161
- Health literacy and outcomes among patients with heart failure.JAMA. 2011; 305: 1695-1701
- Predicting survival in heart failure: validation of the MAGGIC heart failure risk score in 51,043 patients from the Swedish heart failure registry.Eur J Heart Fail. 2014; 16: 173-179
- Decision making in advanced heart failure: a scientific statement from the American Heart Association.Circulation. 2012; 125: 1928-1952
- Accuracy of physician prognosis in heart failure and lung cancer: comparison between physician estimates and model predicted survival.Palliat Med. 2016; 30: 684-689
Funding: National Institutes of Health ( K23 HL 116643 , primary investigator Dunlay).