Prognostic Understanding and Preference for the Communication Process with Physicians in Hospitalized Heart Failure Patients

Hiroki Kitakata, Takashi Kono, Shun Kohsaka, Daisuke Fujisawa, Naomi Nakano, Yasuyuki Shiraishi, Yoshinori Katsumata, Shinsuke Yuasa, Keiichi Fukuda

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Heart failure (HF) is a highly prevalent, heterogeneous, and life-threatening condition. Precise prognostic understanding is essential for effective decision making, but little is known about patients’ attitudes toward prognostic communication with their physicians. Methods and Results: We conducted a questionnaire survey, consisting of patients’ prognostic understanding, preferences for information disclosure, and depressive symptoms, among hospitalized patients with HF (92 items in total). Individual 2-year survival rates were calculated using the Seattle Heart Failure Model, and its agreement level with patient self-expectations of 2-year survival were assessed. A total of 113 patients completed the survey (male 65.5%, median age 75.0 years, interquartile range 66.0–81.0 years). Compared with the Seattle Heart Failure Model prediction, patient expectation of 2-year survival was matched only in 27.8% of patients; their agreement level was low (weighted kappa = 0.11). Notably, 50.9% wished to know “more,” although 27.7% felt that they did not have an adequate prognostic discussion. Compared with the known prognostic variables (eg, age and HF severity), logistic regression analysis demonstrated that female and less depressive patients were associated with patients’ preference for “more” prognostic discussion. Conclusions: Patients’ overall prognostic understanding was suboptimal. The communication process requires further improvement for patients to accurately understand their HF prognosis and be involved in making a better informed decision.

Original languageEnglish
JournalJournal of Cardiac Failure
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • advance care planning
  • Heart failure
  • patient preference
  • prognosis
  • Seattle Heart Failure Model

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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