Heart disease
A randomised controlled trial of care planning for patients with advanced heart disease (FLAME trial)
Patients with cancer have better developed palliative care services than people with heart disease. To address this we evaluated a care planning intervention with patients and families. This combined a holistic needs assessment by a cardiologist and cardiology nurse with the creation of a shared future care plan and nurse led care in the community, following a recent unscheduled hospital admission with acute coronary syndrome (ACS) or heart failure (HF). We explored whether such a complex intervention is acceptable to patients, their carers and health professionals, and if it is practical, deliverable and feasible.
The primary outcome measure was quality of life of patients and carers. Patients with a 12 month estimated mortality risk of 20% or greater were randomised to either early (upon discharge) or delayed (after 12 weeks) intervention. 50 patients were enrolled into the study (22% ACS, 68% HF, 10% valvular heart disease). Findings demonstrated that the intervention and outcome measures were acceptable, feasible and deliverable. A multi-centred clinical trial is being planned.
Funder
Marie Curie Cancer Care
Research team
Gill Highet, Martin Denvir, Sarah Cudmore, Shirley Robertson, Lisa Donald, Christopher Weir, Kirsty Boyd, Scott Murray