Timely recognition of palliative care needs of patients with advanced chronic heart failure:
Translation, adaptation and feasibility testing of the Dutch version of the ‘Needs Assessment Tool: Progressive Disease – Heart Failure (NAT: PD-HF)’

Rationale: In patients with advanced Chronic Heart Failure (CHF), palliative care needs remain frequently unrecognized and palliative care consultations are not routinely incorporated in clinical care, despite their potential benefit. Recently, the ‘Needs Assessment Tool: Progressive Disease – Heart Failure (NAT:PD-HF)’ has been developed with the potential to be used as part of a strategy to identify and triage the management of palliative care needs experienced by people with CHF.[1] To date, a Dutch version of the NAT: PD-HF is not available and the feasibility, acceptability and impact of this tool is unknown.


Objective: To study the feasibility and acceptability of the use of the NAT: PD-HF among outpatients with advanced CHF and to gain preliminary data regarding the effect of the NAT: PD-HF on patient and caregiver palliative care needs.


Study design: a single centre feasibility study.


Study population: 30 consecutive outpatients with a diagnosis of advanced CHF (New York Heart Association class III or IV) who receive a home visit by a heart failure nurse specialist of the Maastricht UMC+, Maastricht, the Netherlands and their family caregivers.


Intervention: The heart failure nurse specialist will complete the translated and adapted NAT: PD-HF during a usual clinical care home visit with the patient.


Main study parameters/endpoints: acceptability of the NAT: PD-HF according to nurses; recruitment rate of patients and their carers; completeness of nurses completion of the NAT: PD-HF; and time to complete the NAT: PD-HF.


Nature and extent of the burden and risks associated with participation and benefit: The study includes two home visits of about one hour during which participants are asked to complete questionnaires and/or interviews. Burden for patients will be low, because all interviews are done using home visits and questionnaires have been kept to a minimum and short-forms used where possible. Participation might be beneficial because palliative care needs will be assessed and addressed if present.

We hypothesize a priori that the Dutch NAT: PD-HF will be a feasible and acceptable tool to identify palliative care needs in patients with CHF and will initiate appropriate management.

baseline and 4 months

Heart failure nurse specialists will complete the NAT: PD-HF during a regular home visit. The NAT: PD-HF is a one-page assessment tool that can be completed by healthcare professionals across a range of disciplines.(Waller et al. 2013)