Effect of an Early Palliative Care Telehealth Intervention vs Usual Care on Patients With Heart Failure: The ENABLE CHF-PC Randomized Clinical Trial

Bakitas, Marie A.; Dionne-Odom, J. Nicholas; Ejem, Deborah B.; Wells, Rachel; Azuero, Andres; Stockdill, Macy L.; Keebler, Konda; Sockwell, Elizabeth; Tims, Sheri; Engler, Sally; Steinhauser, Karen; Kvale, Elizabeth; Durant, Raegan W.; Tucker, Rodney O.; Burgio, Kathryn L.; Tallaj, Jose; Swetz, Keith M.; Pamboukian, Salpy V.

doi:10.1001/jamainternmed.2020.2861

Cited by 170Palliative Care and End-of-Life IssuesTelemedicine and Telehealth ImplementationHeart Failure Treatment and Management

Effect of an Early Palliative Care Telehealth Intervention vs Usual Care on Patients With Heart Failure: The ENABLE CHF-PC Randomized Clinical Trial

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Bakitas, Marie A., Dionne-Odom, J. Nicholas, Ejem, Deborah B., Wells, Rachel, Azuero, Andres, Stockdill, Macy L., Keebler, Konda, Sockwell, Elizabeth +10 more·2020·JAMA Internal Medicine

DOI 10.1001/jamainternmed.2020.2861PMC PMC7385678

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Abstract

Importance: National guidelines recommend early palliative care for patients with advanced heart failure, which disproportionately affects rural and minority populations. Objective: To determine the effect of an early palliative care telehealth intervention over 16 weeks on the quality of life, mood, global health, pain, and resource use of patients with advanced heart failure. Design, Setting, and Participants: A single-blind, intervention vs usual care randomized clinical trial was conducted from October 1, 2015, to May 31, 2019, among 415 patients 50 years or older with New York Heart Association class III or IV heart failure or American College of Cardiology stage C or D heart failure at a large Southeastern US academic tertiary medical center and a Veterans Affairs medical center serving high proportions of rural dwellers and African American individuals. Interventions: The ENABLE CHF-PC (Educate, Nurture, Advise, Before Life Ends Comprehensive Heartcare for Patients and Caregivers) intervention comprises an in-person palliative care consultation and 6 weekly nurse-coach telephonic sessions (20-40 minutes) and monthly follow-up for 48 weeks. Main Outcomes and Measures: Primary outcomes were quality of life (as measured by the Kansas City Cardiomyopathy Questionnaire [KCCQ]: score range, 0-100; higher scores indicate better perceived health status and clinical summary scores ≥50 are considered "fairly good" quality of life; and the Functional Assessment of Chronic Illness Therapy-Palliative-14 [FACIT-Pal-14]: score range, 0-56; higher scores indicate better quality of life) and mood (as measured by the Hospital Anxiety and Depression Scale [HADS]) over 16 weeks. Secondary outcomes were global health (Patient Reported Outcome Measurement System Global Health), pain (Patient Reported Outcome Measurement System Pain Intensity and Interference), and resource use (hospital days and emergency department visits). Results: Of 415 participants (221 men; baseline mean [SD] age, 63.8 [8.5] years) randomized to ENABLE CHF-PC (n = 208) or usual care (n = 207), 226 (54.5%) were African American, 108 (26.0%) lived in a rural area, and 190 (45.8%) had a high-school education or less, and a mean (SD) baseline KCCQ score of 52.6 (21.0). At week 16, the mean (SE) KCCQ score improved 3.9 (1.3) points in the intervention group vs 2.3 (1.2) in the usual care group (difference, 1.6; SE, 1.7; d = 0.07 [95% CI, -0.09 to 0.24]) and the mean (SE) FACIT-Pal-14 score improved 1.4 (0.6) points in the intervention group vs 0.2 (0.5) points in the usual care group (difference, 1.2; SE, 0.8; d = 0.12 [95% CI, -0.03 to 0.28]). There were no relevant between-group differences in mood (HADS-anxiety, d = -0.02 [95% CI, -0.20 to 0.16]; HADS-depression, d = -0.09 [95% CI, -0.24 to 0.06]). Conclusions and Relevance: This randomized clinical trial with a majority African American sample and baseline good quality of life did not demonstrate improved quality of life or mood with a 16-week early palliative care telehealth intervention. However, pain intensity and interference (secondary outcomes) demonstrated a clinically important improvement. Trial Registration: ClinicalTrials.gov Identifier: NCT02505425.

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Employing nurse-led ENABLE model to guide patients and caregivers problem-solving, coping, decision-making, advance care planning, symptom management, self-care, and communication reduces the burden on family caregivers.
“Employing nurse-led ENABLE model to gudie patients and caregivers problem-solving, coping, decision-making, advance care planning, symptom management, self-care, and communication, in turn reduce the burden on family caregivers [31, 32].”
From Experiences of family caregivers of patients with end-of-life cancer during the transition from hospital to home palliative care: a qualitative study (2024) · cites this paper as [32]
The introduction (page unavailable) describes ENABLE CHF-PC as nurse-led and says it teaches patients and family caregivers problem-solving, symptom and self-care management, communication, and care decision-making. It says caregiver intervention outcomes were reported separately; this paper does not establish the claimed reduction in family caregiver burden. (LLM, conf=0.86)
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2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., et al. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.12.012 · Cited by 2,862 · see citing works
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001063 · Cited by 4,922 · see citing works
AASLD Practice Guidance: Palliative care and symptom‐based management in decompensated cirrhosis
Rogal, S. S., Hansen, L., Patel, A., Ufere, N. N., Verma, M., Woodrell, C. D., & Kanwal, F. (2022) · Hepatology · doi:10.1002/hep.32378 · Cited by 226 · see citing works
The Role of Palliative Care in COPD
Iyer, A. S., Sullivan, D. R., Lindell, K. O., & Reinke, L. F. (2021) · CHEST Journal · doi:10.1016/j.chest.2021.10.032 · Cited by 96 · see citing works
Nurse and Social Worker Palliative Telecare Team and Quality of Life in Patients With COPD, Heart Failure, or Interstitial Lung Disease
Bekelman, D. B., Feser, W. J., Morgan, B. R., Welsh, C. H., Parsons, E. C., Paden, G., Barón, A. E., Hattler, B. G. J., McBryde, C. F., Cheng, A. M., et al. (2024) · JAMA · doi:10.1001/jama.2023.24035 · Cited by 102 · see citing works
Family Meetings in Palliative Care: Benefits and Barriers
Glajchen, M., Goehring, A., Johns, H., & Portenoy, R. K. (2022) · Current Treatment Options in Oncology · doi:10.1007/s11864-022-00957-1 · Cited by 86 · see citing works
Criteria for Referral of Patients With Advanced Heart Failure for Specialized Palliative Care
Chang, Y. K., Allen, L. A., McClung, J. A., Denvir, M. A., Philip, J. A. M., Mori, M., Perez‐Cruz, P. E., Cheng, S., Collins, A., & Hui, D. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2022.04.057 · Cited by 78 · see citing works
Effectiveness of eHealth Self-management Interventions in Patients With Heart Failure: Systematic Review and Meta-analysis
Liu, S., Li, J., Wan, D., Li, R., Qu, Z., Hu, Y., & Liu, J. (2022) · Journal of Medical Internet Research · doi:10.2196/38697 · Cited by 76 · see citing works
Can you hear me now?: Improving palliative care access through telehealth
Allen-Watts, K., Malone, E. B., Dionne-Odom, J. N., McCammon, S. D., Currie, E. R., Hicks, J. A., Tucker, R. O., Wallace, E. L., Elk, R. A., & Bakitas, M. A. (2021) · Research in Nursing & Health · doi:10.1002/nur.22105 · Cited by 71 · see citing works
Self-citation
Palliative Care in Heart Failure Guidelines: A Comparison of the 2021 ESC and the 2022 AHA/ACC/HFSA Guidelines on Heart Failure
Blum, M., Goldstein, N. E., Jaarsma, T., Allen, L. A., & Gelfman, L. P. (2023) · European Journal of Heart Failure · doi:10.1002/ejhf.2981 · Cited by 57 · see citing works
Impact of Telehealth and Process Virtualization on Healthcare Utilization
Ayabakan, S., Bardhan, I. R., & Zheng, Z. (2023) · Information Systems Research · doi:10.1287/isre.2023.1220 · Cited by 49 · see citing works
Palliative Care Across the Spectrum of Heart Failure
Gelfman, L. P., Blum, M., Ogunniyi, M. O., McIlvennan, C. K., Kavalieratos, D., & Allen, L. A. (2024) · JACC Heart Failure · doi:10.1016/j.jchf.2024.01.010 · Cited by 45 · see citing works
Spirituality in Patients With Heart Failure
Tobin, R. S., Cosiano, M. F., O’Connor, C. M., Fiuzat, M., Granger, B. B., Rogers, J. G., Tulsky, J. A., Steinhauser, K. E., & Mentz, R. J. (2022) · JACC Heart Failure · doi:10.1016/j.jchf.2022.01.014 · Cited by 54 · see citing works
Self-citation
Experiences of family caregivers of patients with end-of-life cancer during the transition from hospital to home palliative care: a qualitative study
Xu, Y., Liu, Y., Kang, Y., Wang, D., Zhou, Y., Wu, L., & Yuan, L. (2024) · BMC Palliative Care · doi:10.1186/s12904-024-01559-4 · Cited by 41 · see citing works
“Employing nurse-led ENABLE model to gudie patients and caregivers problem-solving, coping, decision-making, advance care planning, symptom management, self-care, and communication, in turn reduce the burden on family caregivers [31, 32].”
Method
The impact of an integrated early palliative care telehealth intervention on the quality of life of heart failure patients: a randomized controlled feasibility study
Mirshahi, A., Bakitas, M. A., Khoshavi, M., Khanipour-Kencha, A., Riahi, S. M., Wells, R. D., Dionne-Odom, J. N., Ghiyasvandian, S., & Zakerimoghadam, M. (2024) · BMC Palliative Care · doi:10.1186/s12904-024-01348-z · Cited by 39 · see citing works
Self-citation
Virtual care in end of life and palliative care: A rapid evidence check
Dolan, H., Eggett, C., Holliday, L., Delves, S., Parkes, D., & Sutherland, K. (2021) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x211046118 · Cited by 40 · see citing works
Benefits of specialist palliative care by identifying active ingredients of service composition, structure, and delivery model: A systematic review with meta-analysis and meta-regression
Johnson, M. J., Rutterford, L., Sunny, A., Pask, S., de Wolf‐Linder, S., Murtagh, F. E., & Ramsenthaler, C. (2024) · PLoS Medicine · doi:10.1371/journal.pmed.1004436 · Cited by 38 · see citing works
Experiences with Telehealth for Outpatient Palliative Care: Findings from a Mixed-Methods Study of Patients and Providers across the United States
Bandini, J. I., Scherling, A., Farmer, C. M., Fratkin, M. D., Mistler, B. J., Ast, K., & Ahluwalia, S. C. (2022) · Journal of Palliative Medicine · doi:10.1089/jpm.2021.0545 · Cited by 36 · see citing works
Hospital-based acute care in the last 30 days of life among patients with chronic disease that received early, late or no specialist palliative care: a retrospective cohort study of eight chronic disease groups
Earp, M. A., Cai, P., Fong, A., Blacklaws, K., Pham, T., Shack, L., & Sinnarajah, A. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-044196 · Cited by 35 · see citing works
Effectiveness of nurse-led electronic health interventions on illness management in patients with chronic heart failure: A systematic review and meta-analysis
Zhang, N., Li, Q., Chen, S., Wu, Y., Xin, B., Wan, Q., Shi, P., He, Y., Yang, S., & Jiang, W. (2023) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2023.104630 · Cited by 33 · see citing works
Integration of Palliative Care into Heart Failure Care: Consensus-Based Recommendations from the Heart Failure Society of America
Chuzi, S. E., Saylor, M. A., Allen, L. A., Desai, A. S., Feder, S. L., Goldstein, N. E., Groninger, H., Kirkpatrick, J. N., Tulsky, J. A., Steiner, J. M., et al. (2024) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2024.10.435 · Cited by 32 · see citing works
Palliative Care Interventions Effects on Psychological Distress: A Systematic Review & Meta-Analysis
Nowels, M., Kalra, S., Duberstein, P. R., Coakley, E., Saraiya, B., George, L. S., & Kozlov, E. (2023) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2023.02.001 · Cited by 29 · see citing works
Palliative and End-of-Life Care in Stroke: A Scientific Statement From the American Heart Association
Creutzfeldt, C. J., Bu, J., Comer, A. R., Enguidanos, S. M., Lutz, B. J., Robinson, M. T., Zahuranec, D. B., & Holloway, R. G. (2024) · Stroke · doi:10.1161/str.0000000000000479 · Cited by 28 · see citing works
Multicomponent Integrated Care for Patients with Chronic Heart Failure: Systematic Review and Meta-Analysis
Yang, Y., Hoo, J., Tan, J., & Lim, L. (2022) · ESC Heart Failure · doi:10.1002/ehf2.14207 · Cited by 27 · see citing works
Rural Palliative Care Telemedicine for Advanced Cancer Patients: A Systematic Review
Sánchez-Cárdenas, M. A., Iriarte‐Aristizábal, M. F., León, M., Rodríguez-Campos, L. F., Correa‐Morales, J. E., Piñeros, Á. M. C., & Parra, S. L. (2022) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/10499091221130329 · Cited by 27 · see citing works
Palliative Care and Advanced Cardiovascular Disease in Adults: Not Just End-of-Life Care: A Scientific Statement From the American Heart Association
Graven, L. J., Kitko, L. A., Saylor, M. A., Allen, L. A., Durante, Á., Evangelista, L. S., Fiedler, A. G., Kirkpatrick, J. N., Mixon, L. M., & Wells, R. D. (2025) · Circulation · doi:10.1161/cir.0000000000001323 · Cited by 25 · see citing works
Self-citation
Telemedicine Utilization in the Ambulatory Palliative Care Setting: Are There Disparities?
Frydman, J. L., Berkalieva, A., Liu, B., Scarborough, B. M., Mazumdar, M., & Smith, C. B. (2021) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2021.09.019 · Cited by 25 · see citing works
Primary palliative care for heart failure provided within ambulatory cardiology: A randomized pilot trial
Kavalieratos, D., Harinstein, M. E., Rose, B. A., Lowers, J., Hoydich, Z., Bekelman, D. B., Allen, L. A., Rollman, B. L., Ernecoff, N. C., Moreines, L. T., et al. (2022) · Heart & Lung · doi:10.1016/j.hrtlng.2022.07.002 · Cited by 25 · see citing works
Self-citation
Needs-based triggers for timely referral to palliative care for older adults severely affected by noncancer conditions: a systematic review and narrative synthesis
Kawashima, A., & Evans, C. (2023) · BMC Palliative Care · doi:10.1186/s12904-023-01131-6 · Cited by 25 · see citing works
Early Integration of Palliative Care in Nononcological Patients: A Systematic Review
Mós, J. R., & Reis-Pina, P. (2025) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2024.12.023 · Cited by 28 · see citing works
How is Telehealth Used to Increase Access to Specialty Palliative Care? A Systematic Review
Hutchinson, R. N., Chiu, E. J., Belin, S. C., Klein‐Fedyshin, M., Impagliazzo, C., Costanza, L., Passarelli, J., Patel, P. P., Sahay, S., Shen, A. E., et al. (2025) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2024.12.017 · Cited by 22 · see citing works
Heart Failure Nurses within the Primary Care Setting
Hill, L., McNulty, A., McMahon, J., Mitchell, G., Farrell, C., Uchmanowicz, I., & Castiello, T. (2024) · Cardiac failure review · doi:10.15420/cfr.2023.15 · Cited by 21 · see citing works
Effectiveness of telenursing in improving quality of life in patients with heart failure: A systematic review and meta-analysis
Ariyanto, H., & Rosa, E. M. (2024) · Journal of Taibah University Medical Sciences · doi:10.1016/j.jtumed.2024.04.009 · Cited by 21 · see citing works
Palliative Care for Patients With Heart Failure
Kim, C., Kim, S., Lee, K., Choi, J., & Kim, S. (2022) · Journal of Hospice and Palliative Nursing · doi:10.1097/njh.0000000000000869 · Cited by 20 · see citing works
Project EPIC (Early Palliative Care In COPD): A Formative and Summative Evaluation of the EPIC Telehealth Intervention
Iyer, A. S., Wells, R. D., Dionne-Odom, J. N., Bechthold, A. C., Armstrong, M., Byun, J. Y., O’Hare, L., Taylor, R. A., Ford, S., Coffee‐Dunning, J., et al. (2022) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2022.11.024 · Cited by 20 · see citing works
Self-citation
Palliative Care for Patients on Extracorporeal Membrane Oxygenation for COVID-19 Infection
Rao, A., Zaaqoq, A. M., Kang, I. G., Vaughan, E. M., Flores, J. M., Avila-Quintero, V. J., Alnababteh, M. H., Kelemen, A. M., & Groninger, H. (2021) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/10499091211001009 · Cited by 19 · see citing works
Assessing Telehealth in Palliative Care: A Systematic Review of the Effectiveness and Challenges in Rural and Underserved Areas
Ghazal, K. Y., Beniwal, S. S., & Dhingra, A. (2024) · Cureus · doi:10.7759/cureus.68275 · Cited by 19 · see citing works
Comprehensive care for people living with heart failure and chronic obstructive pulmonary disease—Integration of palliative care with disease-specific care: From guidelines to practice
Kowalczys, A., Bohdan, M., Wilkowska, A., Pawłowska, I., Pawłowski, L., Janowiak, P., Jassem, E., Lelonek, M., Gruchała, M., & Sobański, P. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.895495 · Cited by 18 · see citing works
Community Informed Recruitment: A Promising Method to Enhance Clinical Trial Participation
Gazaway, S. B., Bakitas, M. A., Underwood, F., Ekelem, C., Duffie, M., McCormick, S., Heard, V. T., Colvin, A., & Elk, R. A. (2023) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2023.02.319 · Cited by 18 · see citing works
Self-citation
Role of Telemedicine Intervention in the Treatment of Patients with Chronic Heart Failure: A Systematic Review and Meta-analysis
Wang, C. (2024) · The Anatolian Journal of Cardiology · doi:10.14744/anatoljcardiol.2023.3873 · Cited by 18 · see citing works
Nurse-Delivered Telehealth in Home-Based Palliative Care: Integrative Systematic Review
Ma, C., Fang, Y., Zhang, H., Zheng, Y., Zhang, Y., Zhao, W., Yan, G., Zeng, Y., Zhang, Y., Ning, X.-H., et al. (2025) · Journal of Medical Internet Research · doi:10.2196/73024 · Cited by 21 · see citing works
Electronic symptom monitoring for home-based palliative care: A systematic review
Mao, S., Liu, L., Miao, C., Wang, T., Chen, Y., Jiang, Z., Hua, C., Li, C., & Cao, Y. (2024) · Palliative Medicine · doi:10.1177/02692163241257578 · Cited by 16 · see citing works
Chronic Intravenous Inotropic Support as Palliative Therapy and Bridge Therapy for Patients With Advanced Heart Failure: A Single-Center Experience
Rao, A., Anderson, K. M., Mohammed, S. F., Hofmeyer, M. R., Gholami, S. S., Sheikh, F. H., Rodrigo, M. E., Crowell, N. A., Javed, H., Gupta, S., et al. (2021) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2021.06.006 · Cited by 16 · see citing works
Effectiveness of integrated palliative care telehealth intervention in patients with chronic heart failure: A systematic review and meta-analysis of randomized controlled trials
Sebastian, S. A., Shah, Y., & Arsene, C. (2024) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2024.102685 · Cited by 16 · see citing works
Integrating Palliative Care and Hematologic Malignancies: Bridging the Gaps for Our Patients and Their Caregivers
El-Jawahri, A. R., Webb, J. A., Hannon, B. L., & Zimmermann, C. (2024) · American Society of Clinical Oncology Educational Book · doi:10.1200/edbk_432196 · Cited by 14 · see citing works
Early integration of palliative care versus standard cardiac care for patients with heart failure (EPCHF): a multicentre, parallel, two-arm, open-label, randomised controlled trial
Balata, M., Radbruch, L., Hesse, M., Westenfeld, R., Neukirchen, M., Pfister, R., Batzler, Y.-N., Öztürk, C., Kavsur, R., Tiyerili, V., et al. (2024) · The Lancet Healthy Longevity · doi:10.1016/j.lanhl.2024.08.006 · Cited by 14 · see citing works
Defining “early palliative care” for adults diagnosed with a life-limiting illness: a scoping review
Kircher, C., Hanna, T. P., Tranmer, J. E., Goldie, C. E., Ross‐White, A., Moulton, E., Flegal, J., & Goldie, C. (2025) · BMC Palliative Care · doi:10.1186/s12904-025-01712-7 · Cited by 14 · see citing works
Implementation and Effectiveness of a Learning Collaborative to Improve Palliative Care for Seriously Ill Hemodialysis Patients
Tamura, M. K., Holdsworth, L. M., Stedman, M. R., Aldous, A. M., Asch, S. M., Han, J., Harbert, G., Lorenz, K., Malcolm, E. J., Nicklas, A. C., et al. (2022) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.00090122 · Cited by 14 · see citing works
Enhancing palliative care for advanced cancer patients: evaluating implementation and impact of a virtual nurse-led symptom monitoring and telehealth initiative
Neo, S. H.-S., Mok, N., Ng, X.-H., & Zhu, X. (2024) · BMC Palliative Care · doi:10.1186/s12904-024-01541-0 · Cited by 13 · see citing works
The Effect of Tele-palliative Care on Patient and Caregiver Outcomes: A Systematic Review
Chen, Y., Qiao, C., Zhang, X., Li, W., & Yang, H. L. (2022) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/10499091221123566 · Cited by 13 · see citing works
Telehealth in Palliative Care: Communication Strategies From the COVID-19 Pandemic
Stockdill, M., Barnett, M. D., Taylor, R. A., Dionne-Odom, J. N., & Bakitas, M. A. (2021) · Clinical journal of oncology nursing · doi:10.1188/21.cjon.17-22 · Cited by 13 · see citing works
Self-citation
Leveraging Artificial Intelligence/Machine Learning Models to Identify Potential Palliative Care Beneficiaries: A Systematic Review
Bressler, T., Song, J., Kamalumpundi, V., Chae, S., Song, H., & Tark, A. (2024) · Journal of Gerontological Nursing · doi:10.3928/00989134-20241210-01 · Cited by 12 · see citing works
Research Priorities in Neuropalliative Care
Lau, W. K., Fehnel, C. R., Macchi, Z. A., Mehta, A. K., Auffret, M., Bogetz, J. F., Fleisher, J. E., Graber, J. J., Leeper, H. E., Manglani, H. R., et al. (2025) · JAMA Neurology · doi:10.1001/jamaneurol.2024.4932 · Cited by 12 · see citing works
Use of Theoretical Frameworks in the Development and Testing of Palliative Care Interventions
Ingle, M. P., Check, D. K., Slack, D. H., Cross, S. H., Ernecoff, N. C., Matlock, D. D., & Kavalieratos, D. (2021) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2021.10.011 · Cited by 12 · see citing works
Using Latent Class Analysis to Identify Different Clinical Profiles Among Patients With Advanced Heart Failure
Blum, M., McKendrick, K., Gelfman, L. P., Pinney, S., & Goldstein, N. E. (2022) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2022.10.011 · Cited by 14 · see citing works
Effectiveness of palliative care interventions on patient-reported outcomes and all-cause mortality in community-dwelling adults with heart failure: A systematic review and meta-analysis
Li, Y., Li, J., Fu, M. R., Martín‐Payo, R., Tian, X., Sun, Y., Sun, L., & Fang, J. (2024) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2024.104887 · Cited by 11 · see citing works
The role of telemedicine in enhancing palliative care for older adults: opportunities and challenges
Mukamal, R. C., Dias, L. M., Sarti, T. D., Nunes, R., & Rêgo, G. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-06041-1 · Cited by 11 · see citing works
Exploring Culturally Responsive Religious and Spirituality Health Care Communications among African Americans with Advanced Heart Failure, Their Family Caregivers, and Clinicians
Ejem, D., Steinhauser, K., Dionne-Odom, J., Wells, R. D., Durant, R. W., Clay, O., & Bakitas, M. (2021) · Journal of Palliative Medicine · doi:10.1089/jpm.2021.0044 · Cited by 12 · see citing works
Self-citation
Telehealth-facilitated palliative care enables more people to die at home: An analysis of clinical outcomes and service activity data
Haydon, H. M., Lotfaliany, M., Broadbent, A. M., Snoswell, C. L., Smith, A. C., Brydon, J.-A., Caffery, L. J., & Thomas, E. E. (2025) · BMC Palliative Care · doi:10.1186/s12904-024-01622-0 · Cited by 10 · see citing works
Elements of Effective Palliative Care Interventions in Advanced Heart Failure: A Narrative Review
Allcroft, P., Pasquale, C. G. D., LIM, D. J., Amgarth‐Duff, I., & Agar, M. R. (2025) · ESC Heart Failure · doi:10.1002/ehf2.15243 · Cited by 10 · see citing works
Examining Adherence and Dose Effect of an Early Palliative Care Intervention for Advanced Heart Failure Patients
Wells, R. D., Dionne-Odom, J. N., Azuero, A., Buck, H. G., Ejem, D., Burgio, K. L., Stockdill, M., Tucker, R. O., Pamboukian, S. V., Tallaj, J. A., et al. (2021) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2021.01.136 · Cited by 10 · see citing works
Self-citation
Palliative Care in Chronic Heart Failure: A Systematic Review of Its Impact on Symptoms, Quality of Life, and Decision-Making Process
Dramba, T., Popa, A. E., Poroch, M., Bacoanu, G., Esanu, I. M., Popa, E., & Poroch, V. (2025) · Diseases · doi:10.3390/diseases13120389 · Cited by 9 · see citing works
Palliative Care in Heart Failure: An Integrative Review of Nurse Practice
Nunciaroni, A. T., Neves, I. F., Marques, C. S. G., dos Santos, N. D., Corrêa, V. D. A. F., & da Silva, R. F. A. (2022) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/10499091221085276 · Cited by 9 · see citing works
Building a Cardiac Palliative Care Program: A Qualitative Study of the Experiences of Ten Program Leaders From Across the United States
Blum, M., Beasley, A. M., Ikejiani, D. Z., Goldstein, N. E., Bakitas, M. A., Kavalieratos, D., & Gelfman, L. P. (2023) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2023.03.009 · Cited by 9 · see citing works
Self-citation
Integration of palliative care across the spectrum of heart failure care and therapies: considerations, contemporary data, and challenges
Chuzi, S. E., & Manning, K. (2024) · Current Opinion in Cardiology · doi:10.1097/hco.0000000000001120 · Cited by 8 · see citing works
A Rapid Review of Uses and Outcomes of Telehealth Care in Rural and Remote Regions in the United States
Fasolino, T. K., Koci, A., Huggins, J., & Lindell, K. O. (2023) · Journal of Hospice and Palliative Nursing · doi:10.1097/njh.0000000000000964 · Cited by 8 · see citing works
What should we report? Lessons learnt from the development and implementation of serious adverse event reporting procedures in non-pharmacological trials in palliative care
Dunleavy, L., Moore, D. C., Korfage, I. J., Payne, S. A., Walshe, C., & Preston, N. J. (2021) · BMC Palliative Care · doi:10.1186/s12904-021-00714-5 · Cited by 8 · see citing works
The Association Between Hospital End-of-Life Care Quality and the Care Received Among Patients With Heart Failure
Feder, S. L., Tate, J., Ersek, M. T., Krishnan, S., Chaudhry, S. I., Bastian, L. A., Rolnick, J. A., Kutney-Lee, A. M., & Akgün, K. M. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2020.09.006 · Cited by 7 · see citing works
Hospice delivery models and survival differences in the terminally ill: a large cohort study
Lai, W., Liu, I.-T., Tsai, J.-H., Su, P., Chiu, P.-H., Huang, Y.-T., Chiu, G., Chen, Y., & Lin, P. (2021) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2021-003262 · Cited by 7 · see citing works
Palliative Care for Patients With Heart Failure With Preserved Ejection Fraction
Godfrey, S., Peng, Y., Lorusso, N., Sulistio, M. S., Mentz, R. J., Pandey, A., & Warraich, H. J. (2023) · Circulation Heart Failure · doi:10.1161/circheartfailure.123.010802 · Cited by 7 · see citing works
Testing the Recruitment Frequency, Implementation Fidelity, and Feasibility of Outcomes of the Heart Failure Activity Coach Study (HEALTHY): Pilot Randomized Controlled Trial
Blomqvist, A., Bäck, M., Klompstra, L. V., Strömberg, A., & Jaarsma, T. (2024) · JMIR Formative Research · doi:10.2196/62910 · Cited by 6 · see citing works
Telemonitoring in Chronic Heart Failure Among the Elderly: A Rapid Review of Literature
Roaquin, L., Apsay, K. L. G., Pangan, C. R., Hangdaan, L., & Lin, Y. (2025) · SAGE Open Nursing · doi:10.1177/23779608251316823 · Cited by 6 · see citing works
Challenges for palliative care in times of COVID-19: a scoping review
Lourenço, M. D. C. G., Gomes, T., Araujo, F., Ventura, F. I. Q. S., & da Silva, R. C. G. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1330370 · Cited by 7 · see citing works
Palliative Care Education in Cardiovascular Disease Fellowships: A National Survey of Program Directors
Godfrey, S., Steiner, J. M., Damluji, A. A., Sampath, R., Chuzi, S. E., Warraich, H. J., Krishnaswami, A., Bernacki, G. M., Goodlin, S. J., Josephson, R., et al. (2024) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2024.03.008 · Cited by 7 · see citing works
Improving the Integration of Palliative Care in Heart Failure—It’s Hard to Hit a Moving Target
Goldstein, N. E. (2020) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2020.2855 · Cited by 6 · see citing works
The feasibility and acceptability of an early tele-palliative care intervention to improve quality of life in heart failure patients in Iran: A protocol for a randomized controlled trial
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Bakitas, M. A., Ejem, D., Dionne-Odom, J. N., Wells, R. D., Azuero, A., Stockdill, M., Keebler, K., Sockwell, E., Tims, S., Engler, S., et al. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2020.04.033
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Bakitas, M. A., Dionne-Odom, J. N., Ejem, D., Wells, R. D., Azuero, A., Stockdill, M., Keebler, K., Sockwell, E., Tims, T., Engler, S., et al. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2019.12.149 · Cited by 2 · see citing works
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Effects of a Telehealth Early Palliative Care Intervention for Family Caregivers of Persons With Advanced Heart Failure: The ENABLE CHF-PC Randomized Clinical Trial
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The impact of an integrated early palliative care telehealth intervention on the quality of life of heart failure patients: a randomized controlled feasibility study
Mirshahi, A., Bakitas, M. A., Khoshavi, M., Khanipour-Kencha, A., Riahi, S. M., Wells, R. D., Dionne-Odom, J. N., Ghiyasvandian, S., & Zakerimoghadam, M. (2024) · BMC Palliative Care · doi:10.1186/s12904-024-01348-z · Cited by 39 · see citing works
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The feasibility and acceptability of an early tele-palliative care intervention to improve quality of life in heart failure patients in Iran: A protocol for a randomized controlled trial
Mirshahi, A., Ghiasvandian, S., Khoshavi, M., Riahi, S. M., Khanipour-Kencha, A., Bakitas, M. A., Dionne-Odom, J. N., Wells, R. D., & Zakerimoghadam, M. (2023) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2023.101114 · Cited by 6 · see citing works
Self-citation

Authors: Bakitas, M. A., Dionne-Odom, J. N., Ejem, D. B., Wells, R., Azuero, A., Stockdill, M. L., Keebler, K., Sockwell, E., Tims, S., Engler, S., Steinhauser, K., Kvale, E., Durant, R. W., Tucker, R. O., Burgio, K. L., Tallaj, J., Swetz, K. M., & Pamboukian, S. V.
Affiliations: University of Alabama at Birmingham (US)
School of Nursing, University of Alabama at Birmingham, Birmingham
Duke University (US)
The University of Texas at Austin (US)
Corresponding author: Bakitas, Marie A.
ORCID: Bakitas, Marie A.
Dionne-Odom, J. Nicholas
Ejem, Deborah B.
Wells, Rachel
Stockdill, Macy L.
Engler, Sally
Steinhauser, Karen
Kvale, Elizabeth
Durant, Raegan W.
Burgio, Kathryn L.
Tallaj, Jose
Swetz, Keith M.
Pamboukian, Salpy V.
Venue: JAMA Internal Medicine
Publisher: American Medical Association (AMA)
Published: 2020-09-01
Volume: 180
Issue: 9
Pages: 1203
ISSN: 2168-6106 (ISSN-L)
DOI: 10.1001/jamainternmed.2020.2861
PMC: PMC7385678
OpenAlex: W3044975541
Cited by: 170
References: 63
Citations by year: 2026: 29 · 2025: 38 · 2024: 35 · 2023: 22 · 2022: 26 · 2021: 16 · 2020: 4
FWCI: 12.75
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: JAMA Internal Medicine (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (TL1TR003106)
National Institute of Nursing Research (R01NR013665, F31NR018782)
National Center for Advancing Translational Sciences
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Keywords: early palliative care, advanced heart failure, telemedicine, nurse coaching, quality of life, mood, anxiety and depression, pain, resource utilization (health care), rural population, African American patients, palliative care consultation, Kansas City Cardiomyopathy Questionnaire, Hospital Anxiety and Depression Scale, Department of Veterans Affairs
MeSH terms: Affect, Aged, Female, Heart Failure, Humans, Male, Middle Aged, Pain Measurement, Palliative Care, Quality of Life, Single-Blind Method, Treatment Outcome, Telemedicine

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Effect of an Early Palliative Care Telehealth Intervention vs Usual Care on Patients With Heart Failure: The ENABLE CHF-PC Randomized Clinical Trial

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