{"id":"e62ea2ee547f","type":"article","url":"https://hartvaat.nl/2017/07/18/palliatieve-zorg-bij-hartfalen-de-pal-hf-gerandomiseerde-trial/","title":"Palliatieve zorg bij hartfalen: de PAL-HF gerandomiseerde trial","title_en":"Palliative Care in Heart Failure: The PAL-HF Randomized, Controlled Clinical Trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts"],"tags":["acuut-hartfalen","emperor-trials","finearts-hf","pathfinder-trial","step-hfpef"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2017.05.030","source_url":"https://doi.org/10.1016/j.jacc.2017.05.030","authors":["Joseph G Rogers","Chetan B Patel","Robert J Mentz","Bradi B Granger","Karen E Steinhauser","Mona Fiuzat","Patricia A Adams","Adam Speck","Kimberly S Johnson","Arun Krishnamoorthy","Hongqiu Yang","Kevin J Anstrom","Gwen C Dodson","Donald H Taylor","Jerry L Kirchner","Daniel B Mark","Christopher M O'Connor","James A Tulsky"],"significance":8,"published":"2017-07-18","source_date":"2017-07-18","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/palliatief-hartfalen/"],"congress":"","summary_en":"The PAL-HF trial showed that specialized palliative care integrated with standard heart failure management improved quality of life, depression, anxiety, and spiritual well-being in patients with advanced heart failure. The results supported formal palliative care integration in heart failure programs.","created":"2026-07-03T10:26:48Z","updated":"2026-07-03T18:38:34Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde PAL-HF-trial die gespecialiseerde palliatieve zorg onderzocht bij gevorderd hartfalen. Toonde verbetering van kwaliteit van leven, depressie en angst. Onderbouwt integratie van palliatieve zorg.","abstract_original":"BACKGROUND: Advanced heart failure (HF) is characterized by high morbidity and mortality. Conventional therapy may not sufficiently reduce patient suffering and maximize quality of life. OBJECTIVES: The authors investigated whether an interdisciplinary palliative care intervention in addition to evidence-based HF care improves certain outcomes. METHODS: The authors randomized 150 patients with advanced HF between August 15, 2012, and June 25, 2015, to usual care (UC) (n = 75) or UC plus a palliative care intervention (UC + PAL) (n = 75) at a single center. Primary endpoints were 2 quality-of-life measurements, the Kansas City Cardiomyopathy Questionnaire (KCCQ) overall summary and the Functional Assessment of Chronic Illness Therapy-Palliative Care scale (FACIT-Pal), assessed at 6 months. Secondary endpoints included assessments of depression and anxiety (measured via the Hospital Anxiety and Depression Scale [HADS]), spiritual well-being (measured via the FACIT-Spiritual Well-Being scale [FACIT-Sp]), hospitalizations, and mortality. RESULTS: Patients randomized to UC + PAL versus UC alone had clinically significant incremental improvement in KCCQ and FACIT-Pal scores from randomization to 6 months (KCCQ difference = 9.49 points, 95% confidence interval [CI]: 0.94 to 18.05, p = 0.030; FACIT-Pal difference = 11.77 points, 95% CI: 0.84 to 22.71, p = 0.035). Depression improved in UC + PAL patients (HADS-depression difference = -1.94 points; p = 0.020) versus UC-alone patients, with similar findings for anxiety (HADS-anxiety difference = -1.83 points; p = 0.048). Spiritual well-being was improved in UC + PAL versus UC-alone patients (FACIT-Sp difference = 3.98 points; p = 0.027). Randomization to UC + PAL did not affect rehospitalization or mortality. CONCLUSIONS: An interdisciplinary palliative care intervention in advanced HF patients showed consistently greater benefits in quality of life, anxiety, depression, and spiritual well-being compared with UC alone. (Palliative Care in Heart Failure [PAL-HF]; NCT01589601)."}