How the Elderly Live With Pain in Heart Failure

Study Events Patients admitted to TJUH with a HF diagnosis will be identified by intensive clinical research coordinator screening methods. The potential subjects will be approached in the acute care area for interview and consent to participate. At that visit, the variables of interest will be collected and the questionnaires completed. Following discharge, the subjects will be re-interviewed at follow-up clinic visits or by telephone, depending on whether the visit is to a Jefferson University Physician provider or to an outside provider or as circumstances allow.

Subjects will sign an informed consent to participate in HELP-HF. A selection of assessment questionnaires (listed below) and performance measures will be completed during the index hospitalization and at a subsequent follow up clinic visits or by telephone call. Some of these assessments involve data collection from standard of care encounters or tests and will be abstracted from the medical record.

The Kansas City Cardiomyopathy Questionnaire (KCCQ) The KCCQ is a valid, reliable and responsive health status measure for HF patients and serves as a clinically meaningful outcome assessment tool that is widely used in cardiovascular research, patient management, and quality of life self-assessment.12 The Brief Pain Inventory (BPI) The BPI is one of the most widely used measurement tools for assessing clinical pain. It allows patients to rate the severity of their pain and the degree to which their pain interferes with common dimensions of feeling and function. Initially developed to assess pain related to cancer, the BPI has validated as an appropriate measure for pain caused by a wide range of clinical conditions. , The Charlson Co-Morbidity Index (CCI) Comorbidity describes the effect of all other diseases an individual patient might have other than the primary disease of interest. The CCI is used to characterize comorbid medical conditions and allows inferences about the extent to which symptoms and other factors related to quality of life may be attributable to conditions other than HF. The CCI designates comorbid conditions in 19 categories and each category has an associated weight based on the adjusted risk of one-year mortality, and the overall comorbidity score reflects the cumulative increased likelihood of one-year mortality. Charlson scores can range between 0 and 35, with a higher score indicating increase in burden of comorbid disease.

OTC Medication Inventory A comprehensive list of any over the counter (OTC) medications will be collected and reconciled via review of the electronic medical records and by subject interview.

Brief Interventions Measures (BIM) The BIM questionnaire is a novel tool developed for use in the HELP-HF study. It is adapted from similar questionnaires used in palliative oncology care and incorporates an inventory of comfort measure identified in the literature. These include measures like application of heat or cold, massage, and other self-selected therapies.