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Observational Study
. 2025 Apr 9;24(1):97.
doi: 10.1186/s12904-025-01686-6.

Effects of palliative care consultation service on decedents experiencing end-stage heart failure: a 4-year observational study

Pei-Yu Chen  1 , Lian-Shin Lin  2 , Ling-Hui Huang  2 , Szu-Pei Chien  3 , Chin-Yi Chao  2 , Jia-Jyun Wu  1   4 , Chun-Li Wang  1   5   6 , Lung-Chun Lee  1 , Pi-Shan Hsu  1 , Wei-Min Chu  7   8   9   10
Affiliations
Observational Study

Effects of palliative care consultation service on decedents experiencing end-stage heart failure: a 4-year observational study

Pei-Yu Chen et al. BMC Palliat Care. .

Abstract

Background: Patients experiencing end-stage heart failure are a particularly important population who carry with them a heavy disease burden. However, evidence related to palliative care for patients with end-stage heart failure remains scarce, particularly when it comes to the issue of palliative care consultation service (PCCS). This 4-year observational study aimed to evaluate the effects of PCCS on opioid use and aggressive treatment during end of life (EOL) among patients diagnosed with end-stage heart failure.

Methods: This observational study used the hospice palliative care database of a tertiary medical center in Taiwan. We enrolled all decedents who were diagnosed with end-stage heart failure from the period January 1, 2018 to December 31, 2021. PCCS prior to death was documented with the relationship between PCCS and opioid use and treatment aggressiveness during EOL then analyzed through use of multivariable logistic regression.

Results: A total of 120 patients were enrolled, which included 60 (50.0%) patients with end-stage heart failure who received PCCS prior to death. Compared with patients who did not receive PCCS, patients with PCCS during EOL were found to have had significantly more opioids use (odds ratio and 95% confidence interval: 3.192, 1.311-7.768) as well as a greater likelihood of their hospitalization extending for more than 14 days (odds ratio and 95% confidence interval: 4.454, 1.863-10.651) during EOL. Even though patients who received PCCS did not experience significantly different combined treatment aggressiveness during EOL, they received less CPR and had more DNR consent orders. Moreover, the promotion of PCCS increased disease awareness in both patients and their families.

Conclusion: PCCS in patients diagnosed with end-stage heart failure during EOL could significantly increase their opioid use and reduce some forms of aggressive treatments during EOL.

Keywords: Aggressiveness; End-of-life; Heart failure; Palliative care consultation service.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Taichung Veterans General Hospital (Protocol code: TCVGH-IRB CE20362A, Date of approval: December 2, 2020). Consent to participate was waived by the Institutional Review Board Taichung Veterans General Hospital due to the retrospective design of study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the study
See this image and copyright information in PMC

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