Race Differences in Quality of Life following a Palliative Care Intervention in Patients with Advanced Heart Failure: Insights from the Palliative Care in Heart Failure Trial.

Introduction: Black patients have a higher incidence of heart failure (HF) and worse outcomes than white patients. Guidelines recommend palliative care for patients with advanced HF, but no studies have examined outcomes in a black patient cohort. Methods: This is a post hoc analysis of the Palliative Care in Heart Failure trial, which randomized patients to usual care plus a palliative care intervention (UC+PAL) or usual care (UC). Quality of life (QoL) was measured using Kansas City Cardiomyopathy Questionnaire (KCCQ) and Functional Assessment of Chronic Illness Therapy-Palliative Care scale (FACIT-Pal). Results: Black patients represented 41% of the 148 patients. At six months, QoL improved more in UC+PAL than UC for both racial subgroups. The difference was greater for black than white patients (difference: KCCQ 10.8 vs. 2.5; FACIT-Pal: 14.8 vs. 3.9). However, the findings were not statistically significant. Conclusions: Larger studies are needed to assess the benefits of palliative care for black patients with HF. ClinicalTrials.gov Identifier: NCT01589601.

Duke Scholars

Author Maragatha Kuchibhatla Biostatistics & Bioinformatics, Division of Biostatistics

Author Christopher Michael O'Connor Medicine, Clinical Pharmacology

Author Mona Fiuzat Medicine, Clinical Pharmacology

Author Bradi Bartrug Granger School of Nursing

Author Daniel Benjamin Mark Medicine, Cardiology

Author Robert John Mentz Medicine, Cardiology

Author Kimberly Sherell Johnson Medicine, Geriatrics and Palliative Care