# Palliative Care Needs of Community-Dwelling Patients with Advanced Heart Failure and Physical Frailty

> **NIH NIH F31** · JOHNS HOPKINS UNIVERSITY · 2021 · $46,036

## Abstract

Project Summary
There are 6 million people with heart failure in the United States with an expected 40% increase in prevalence
in the next decade. Although advances in therapies allow for medical management of HF, patients often
experience fragmented care, severe physical symptoms, psychological sequelae, existential distress,
increased caregiving needs, complex end of life decision making, and financial concerns. Despite
overwhelming evidence that early integration of palliative care effectively addresses these complex needs
among HF patients, improves quality of life, and decreases hospitalizations, less than 10% of the six million
patients with HF receive palliative care. If they do, it is often incorporated late in their disease trajectory.
Palliative care should be integrated into traditional HF care based on patients’ perceived needs in any of the
eight domains of palliative care which include physical, psychological, social, spiritual, cultural, ethical/legal,
end of life, and care coordination needs. However, few studies have examined the unmet palliative care needs
of patients with HF, particularly those who are physically frail. Because approximately half of all patients with
HF are physically frail, there is a critical need to understand the unmet palliative care needs of physically frail
patients with advanced HF. Further, we need to understand how higher unmet palliative care needs and
physical frailty may interact to contribute to worse quality of life and increased odds of
hospitalizations/mortality. However, no studies have investigated this phenomenon, creating a gap in our
understanding of the potential impact of physical frailty and unmet palliative care needs on key HF outcomes.
Using a prospective design, this study aims to investigate the associations of unmet palliative care
needs and physical frailty with key HF outcomes among racially diverse, recently hospitalized,
community-dwelling people with advanced HF. This will be accomplished through the following specific
aims: Aim 1: Test the associations of unmet palliative care needs with key HF outcomes (health-related quality
of life and 6-month all-cause hospitalization/mortality). Aim 2: Test the associations of physical frailty with key
HF outcomes (health-related quality of life and 6-month all-cause hospitalization/mortality). Exploratory Aim:
Test the interaction of physical frailty and unmet palliative care needs on key heart failure outcomes.
Filling this gap in the science will provide foundational evidence to develop future interventions addressing the
palliative care needs of physically frail patients with heart failure. The conceptual model of this study
innovatively aligns with best-practice guidelines for palliative care and the National Institute for Nursing
Research’s goal to conduct research which develops the most effective ways to screen, assess, and monitor
the met and unmet palliative care needs of individuals with serious advanced illness and their fam...

## Key facts

- **NIH application ID:** 10314132
- **Project number:** 1F31NR019733-01A1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Lyndsay DeGroot
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $46,036
- **Award type:** 1
- **Project period:** 2021-09-01 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10314132

## Citation

> US National Institutes of Health, RePORTER application 10314132, Palliative Care Needs of Community-Dwelling Patients with Advanced Heart Failure and Physical Frailty (1F31NR019733-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10314132. Licensed CC0.

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