HealthDay News – Watching a video about end-of-life care options may help patients with advanced heart failure choose the approach best for them, according to a study published online June 29 in Circulation.

The study included 246 advanced heart failure patients (average age: 81), who were given verbal descriptions of 3 end-of-life care options. These options included: life-prolonging care; limited care such as intravenous therapy and hospitalization, but no cardiopulmonary resuscitation (CPR) or intubation; and comfort care. 

Half the patients also watched a 6-minute video that was narrated by a doctor and depicted the 3 levels of care. These patients were also encouraged to discuss end-of-life care with their doctor.


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Researchers found that, compared to those who did not see the video, patients who watched it were more likely to prefer comfort care (51% vs 30%), almost twice as likely to say they did not want CPR (68% vs 35%), and much more likely to say they did not want intubation (77% vs 48%). The video viewers were also 4 times more likely to discuss their end-of-life choices with their doctor within 3 months. Patients who watched the video also were much more knowledgeable about end-of-life care levels than the others.

“Because the course of heart failure is uncertain, in part because of improved therapies, doctors may be reluctant to initiate a conversation with their patients about advance care planning,” lead author Areej El-Jawahri, MD, director of the bone marrow transplant survivorship program at the Massachusetts General Hospital Cancer Center in Boston, and a member of the Video Images of Disease for Ethical Outcomes Consortium, said in a journal news release. “We found that when patients were better informed, it’s easier for them and their doctors to discuss end-of-life issues.”

Reference

El-Jawahri A, Passche-Orlow MK, Matlock D, et al. Randomized, controlled trial of an advance care planning video decision support tool for patients with advanced heart failure. Circulation. 2016. doi: 10.1161/CIRCULATIONAHA.116.021937.