Using a recent clinical trial conducted at Brigham and Women’s Hospital which tested the model of embedding a palliative care trained social worker in a heart failure outpatient clinic, this poster will explore the integration of palliative care into medical care of patients with advanced heart failure. It will focus on the integration of palliative care into medical care of patients with advanced heart failure, with an emphasis on the expertise, skill set and roles that social workers can offer in optimizing patients quality of life as these individuals are faced with the coping with the disease symptoms, defining their care goals, and building relationships with health care professionals.
Methods: This poster presents results from a randomized clinical trial of a social-work led communication intervention to increase patients’ understanding of the disease, promote physician-patient communication, and increase medical chart documentation of advanced care preferences. The study population (n=50) had mean age 72+ years and had been hospitalized for heart failure management within 1 year.
Results: At 6 months post-intervention, 65% of subjects in the intervention group compared with 33% of those in the usual-care control group had physician-level documentation of advanced care preferences in the electronic health record (p=0.02). Intervention patients were also more likely to revise their prognostic understanding of their illness in a direction consistent with the physician’s assessment (94% vs. 26%, p<0.001).
Conclusions and implications: This successful pilot trial exploring a new model of embedded palliative care social workers on clinical teams for heart failure patients shows significant promise and may offer a cost-effective solution to increasing patients understanding and enhancing shared decision making in patients with heart failure.