The impact of an advance care planning intervention for patients hospitalized with acute decompensated heart failure

Abstract

BackgroundMany patients with heart failure (HF) have not addressed end-of-life planning. ObjectiveEvaluate the impact of an advance care planning (ACP) intervention on patients hospitalized with acute decompensated HF. MethodsA convenience sample of patients hospitalized with HF completed the Advance Directive Attitude Survey (ADAS) before The Conversation Project intervention. Post-intervention scores were collected after 30 days. ResultsAll participants (n = 30) had positive pre-intervention ADAS scores. Post-intervention scores revealed no significant change (p = 0.53). Twenty eight percent completed an advance directive (AD), 64% discussed the AD with a significant other, 40% established a surrogate decision maker, and 12% discussed the AD with a provider. ConclusionsAdvance directive completion rates were low despite participants having positive attitudes regarding their value. Discussion of goals between the patient and significant other is an important factor in end-of-life planning. Further studies are needed on strategies to improve provider discussions and AD completion.