Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
349 participants
OBSERVATIONAL
2006-06-30
2007-12-31
Brief Summary
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The cause of pain for these persons is not clear. PAIN-HF (Pain Assessment, Incidence \& Nature in Heart Failure), conducted through the Palliative Care-Heart Failure Education And Research Trials (PC-HEART) collaborative will identify the prevalence of pain, its location, severity and impact on activities and the possible causes of pain in persons living with heart failure. The study will also try to understand relationships between other problems and pain, as well as what treatments are given to reduce pain.
Understanding sources of pain and its characteristics is the first step in helping health care providers better manage pain and related problems in persons with heart failure.
Detailed Description
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We will use standardized tools to survey patients, as follows:
Pain \& other symptoms (Assessed at enrollment and one-two weeks later):
Memorial Symptom Assessment Scale- HF (MSAS-HF) Short-form McGill pain questionnaire (SF-MPQ) Brief Pain Inventory (BPI)
Heart-failure specific measures (Assessed at Enrollment):
Kansas City Cardiomyopathy Questionnaire (KCCQ)
Psycho-social situation \& cognitive function (Assessed at Enrollment):
Physicians Health Questionnaire depression screen (PHQ-9) Mini-cog Social functioning: ENRICHD Social Support Inventory (ESSI) , The Short Physical Performance Battery (SPPB) will be collected on 1/2 of subjects Clinical Data (from medical record) Patient's medical condition: Charleson Comorbidity Scale, prior diagnosis of Diabetes Mellitus, Cancer, Chronic lung disease, Coronary Artery Disease, Cirrhosis.
Known painful conditions (osteoarthritis, chronic back pain, CAD with angina, neuropathy, others) Physical examination: Jugular Venous Pressure (as per NIH trial standards: base of neck, ½ way up, jaw level), edema (+1 (0-1/4" depression), +2 (1/4-1/2"), +3 (1/2-1"), +4 (\>1")), Blood pressure, Respiratory rate, Heart rate \& rhythm Echocardiogram data: Date of most recent Echocardiogram, LVEF, LVDD, LA dimension, presence of valvular disease \& measure of severity (for example, if aortic stenosis then valve area, if mitral regurgitation then 1+-4+) Laboratory data: BUN, CR, Na+, HgB, BNP, hemoglobin
Demographic Data Age, Sex, Race \& ethnic identification, Marital Status, Living situation (alone, with family, with other person), employment status (employed, self-employed, retired, unemployed due to disability), highest level of education, religious affiliation, annual household income, insurance (none, Medicare, Medicaid, Veterans Administration, Kaiser, other Health Maintenance Organization, private fee for service).
Medications \& Treatment (Assessed at Enrollment and 1-2 weeks later) Heart Failure medications: ACEI, ARB, β-blocker, digoxin, spironolactone, eplerenone, loop diuretics, nesiritide, inotropes, warfarin Analgesics: NSAIDs, Cox-2 inhibitors, Aspirin, Acetaminophen, Tramadol, Opioids Antidepressants: SSRI, Tricyclics, Psychostimulants, other Topical agents: acetylsalicylate acid creams, capsaicin Physical therapy, cold, heat, other modalities Statistical Evaluation We will report frequencies of pain in total, frequencies of levels of severity \& interference in activities of pain, by occasional versus frequent or constant pain, and by location with descriptive statistics. To the extent the etiology of pain is identified this will be reported with descriptive statistics. Pearson product-moment correlation coefficients, t-test and frequency statistics (Chi-square and Fisher's Exact test) will be used to evaluate associations between pain presence, severity and type and demographic and clinical variables. If possible, comparison will be made between patients without pain and those with pain using chi-square tests and t-test.
A multivariate analysis of variance will be used to assess relationship between pain and measures of heart failure severity, social support, depression and symptom distress other than pain.
Differences in Pain measures will be assessed between enrollment and the second assessment 1-2 weeks later, and changes will be correlated with changes in treatment for pain. Geographic locations of pain will be mapped using the body diagram on the BPI to identify areas of greatest frequency.
Conditions
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Keywords
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Study Design
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COHORT
PROSPECTIVE
Eligibility Criteria
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Inclusion Criteria
symptoms of dyspnea at rest or with minimal exertion systolic dysfunction or preserved systolic function ("diastolic heart failure") Outpatient care setting (office, clinic or home hospice).
2. Patient already receiving optimal medical therapy per ACC/AHA guidelines (ACEI or ARB + β-blocker +aldosterone antagonist) for at least 1 month or explanation of intolerance of specific medication. We will exclude those not on optimized medications with no notation of intolerance; however, we will keep a tally to quantify patients who are considered "advanced Heart Failure" but are not on recommended medications.
3. Can be awaiting LVAD, transplantation or other procedure
4. Age \> 18 years and able to sign informed consent to participate
Exclusion Criteria
2. Heart failure due to recent onset of acute viral myocarditis, peripartum myocarditis.
3. Patient on hemodialysis or receiving mechanical ventilation
4. Patients receiving investigational agents or devices.
5. Patients who have received heart transplant or a destination Left Ventricular Assist Device
18 Years
ALL
No
Sponsors
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Mayday Fund
OTHER
National Institute on Aging (NIA)
NIH
PC-HEART
OTHER
Responsible Party
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Patient-centered Education and Research
Principal Investigators
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Sarah J Goodlin, MD
Role: PRINCIPAL_INVESTIGATOR
Patient-centered Education and Research
Locations
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San Diego Hospice & Palliative Care
San Diego, California, United States
Washington DC VAMC Heart Failure Clinic
Washington D.C., District of Columbia, United States
Hospice of Palm Beach County
Palm Beach, Florida, United States
Lifepath Hospice & Palliative care
Tampa, Florida, United States
Bluhm Cardiovascular Institute
Chicago, Illinois, United States
Unniversity of Kentucky
Lexington, Kentucky, United States
Kaiser Mid-Atlantic States
Silver Spring, Maryland, United States
Singing River Hospital System
Pascagoula, Mississippi, United States
Strong Memorial Congestive Heart Failure Program
Rochester, New York, United States
Cleveland Clinic Foundation
Cleveland, Ohio, United States
Hospice of Lancaster County/The Heart Group
Lancaster, Pennsylvania, United States
Caris Health Care
Knoxville, Tennessee, United States
The Heart Center
Holladay, Utah, United States
Capital Hospice
Falls Church, Virginia, United States
Countries
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Related Links
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This is the PC-HEART website
Other Identifiers
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06-117PCER
Identifier Type: -
Identifier Source: org_study_id