Abstract 9307: Does Preparedness Planning Improve Attitudes and Completion of Advance Directives in Patients with Symptomatic Heart Failure?

Abstract

BACKGROUND: Limited research exists to support the impact of preparedness planning on attitudes toward and completion of advance directives (ADs) in patients with symptomatic heart failure (HF). OBJECTIVE: We conducted this descriptive-correlational study to assess the impact of a palliative care (PC) intervention that facilitates preparedness planning on attitudes and completion of ADs in patients hospitalized for HF exacerbation. METHODS: Thirty-six patients (mean age 54 ± 8 years; predominantly male [72%]; White [61%]; married [69%]; New York Heart Association class II [69%]) from single tertiary care facility completed telephone interviews pre- and post-implementation of a PC consultation to facilitate preparedness planning and discussion of patient preferences. RESULTS: Mean attitude scores on the Advance Directive Attitude Scale (ADAS) improved from 57 ± 13 at baseline to 80 ± 7 at three months ( P < .001). Figure 1 illustrates changes in variables of interest over time. Completion of ADs was associated with race, marital status, higher ADAS scores, and better health perceptions at baseline; except for marital status, these associations were also observed post-intervention (Table 1). In addition, knowledge about ADs and discussions related to ADs with family and physicians were associated with completion of ADs post-intervention (all P s < 0.05). CONCLUSION: A PC consultation enhanced attitudes toward and increased the rate of completion of ADs in patients with symptomatic HF. However, larger scale randomized clinical trials to assess impact of preparedness planning on completion of ADs and outcomes are needed.