Affiliation:
1. Tehran University of Medical Sciences
2. University of Alabama at Birmingham
3. Imam Khomeini Hospital, Tehran University of Medical Sciences
4. Birjand University of Medical Sciences
5. University of Alabama at Birmingham (UAB)
Abstract
Abstract
Background: While palliative care for patients with heart failure has gained global attention, in Iran most palliative care interventions have focused only on cancer patients. The purpose of this study is to determine the feasibility and acceptability of a telehealth palliative care intervention to improve the quality of life in patients with heart failure in Iran.
Methods: This single-site, pilot randomized clinical trial of a telehealth palliative care intervention versus usual care was conducted on patients with New York Heart Association class II/III heart failure recruited from a heart failure clinic in Iran. Under the supervision of a nurse interventionist, intervention participants received 6 weekly educational webinars and concurrent WhatsApp® group activities, with 6 weeks of follow-up. Feasibility was assessed by measuring recruitment, attrition, and questionnaire completion rates; acceptability was assessed via telephone interviews asking about satisfaction and attitudes. Secondary outcomes measured at baseline and 6 weeks included quality of life (PKCCQ and FACIT-Pal-14), anxiety and depression (HADS), and emergency department visits.
Results: We recruited and randomized 50 patients (mean age 47.5 years, 60% men). Among those approached for consent, 65% of patients agreed to participate and total study attrition was 10%. Also 68% of patients successfully completed at least 4 out of the 6 webinar sessions. Acceptability: 78% of patient participants expressed willingness to participate in the present study again or recommend other patients to participate. There was preliminary evidence for improvements in quality of life but not for anxiety, depression, and emergency department visits.
Conclusion: This nurse-led, early telehealth-palliative care intervention demonstrated evidence of acceptability and feasibility.
Trial registration: The study was registered at the Iranian Registry of Clinical Trials (IRCT) at 14 November, 2021, and can be found on the Iranian Registry of Clinical Trials Platform.
IRCT registration number: IRCT20100725004443N29
Publisher
Research Square Platform LLC
Reference65 articles.
1. Bragazzi NL, Zhong W, Shu J, Abu Much A, Lotan D, Grupper A et al. Burden of heart failure and underlying causes in 195 countries and territories from 1990 to 2017. Eur J Prev Cardiol [Internet]. 2021 Dec 29 [cited 2022 Jul 28];28(15):1682–90. Available from: https://pubmed.ncbi.nlm.nih.gov/33571994/.
2. Dietary diversity and food security status among heart failure patients in the north of Iran;Mahdavi-Roshan M;BMC Nutr,2021
3. Cardiovascular disease in Iran in the last 40 years: prevalence, mortality, morbidity, challenges and strategies for cardiovascular prevention;Sarrafzadegan N;Arch Iran Med,2019
4. Survival rate and predictors of mortality in patients hospitalised with heart failure: a cohort study on the data of Persian registry of cardiovascular disease (PROVE);Givi M;Postgrad Med J,2018
5. Fatigue in heart failure outpatients: levels, associated factors, and the impact on quality of life;Polikandrioti M;Arch Med Sci Atheroscler Dis,2019