Evaluation of the effectiveness of the physician education program on primary palliative care in heart failure

PLoS One. 2022 Feb 4;17(2):e0263523. doi: 10.1371/journal.pone.0263523. eCollection 2022.

Abstract

Major cardiology societies' guidelines support integrating palliative care into heart failure (HF) care. This study aimed to identify the effectiveness of the HEart failure Palliative care Training program for comprehensive care providers (HEPT), a physician education program on primary palliative care in HF. We performed a pre- and post-test survey to evaluate HEPT outcomes. Physician-reported practices, difficulties and knowledge were evaluated using the Palliative Care Self-Reported Practices Scale in HF (PCPS-HF), Palliative Care Difficulties Scale in HF (PCDS-HF), and Palliative care knowledge Test in HF (PT-HF), respectively. Structural equation models (SEM) were used to estimate path coefficients for PCPS-HF, PCDS-HF, and PT-HF. A total of 207 physicians participated in the HEPT between February 2018 and July 2019, and 148 questionnaires were ultimately analyzed. The total PCPS-HF, PCDS-HF, and PT-HF scores were significantly improved 6 months after HEPT completion (61.1 vs 67.7, p<0.001, 54.9 vs 45.1, p<0.001, and 20.8 vs 25.7, p<0.001, respectively). SEM analysis showed that for pre-post difference (Dif) PCPS-HF, "clinical experience of more than 14 years" and pre-test score had significant negative effects (-2.31, p = 0.048, 0.52, p<0.001, respectively). For Dif PCDS-HF, ≥ "28 years old or older" had a significant positive direct effect (13.63, p<0.001), although the pre-test score had a negative direct effect (-0.56, p<0.001). For PT-HF, "involvement in more than 50 HF patients' treatment in the past year" showed a positive direct effect (0.72, p = 0.046), although the pre-test score showed a negative effect (-0.78, p<0.001). Physicians who completed the HEPT showed significant improvements in practice, difficulty, and knowledge scales in HF palliative care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cardiology / education*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Heart Failure / therapy*
  • Humans
  • Male
  • Middle Aged
  • Palliative Care / methods*
  • Palliative Care / organization & administration*
  • Physicians*
  • Quality of Health Care
  • Surveys and Questionnaires
  • Treatment Outcome

Grants and funding

This research was supported by grants from the Sasakawa Health Foundation (T.S.), the Cardiovascular Research Fund (T.S.), and AMED under Grant Number JP18ek0210072 (A.M.), Japan. The funders had no role in study design, data collection, and analysis, decision to publish, and preparation of the manuscript.