{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:40:38Z","timestamp":1792489238507,"version":"4.5.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Older adults with advanced heart failure experience significant morbidity and mortality and face higher complication rates from advanced therapies. Ensuring these therapies match patients\u2019 values is essential for patient-centered care, and palliative care can be instrumental in clarifying patients\u2019 goals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To examine the relationship between advanced heart failure patients\u2019 expressed goals of care and their subsequent clinical outcomes and circumstances of death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>In this retrospective cohort study, electronic medical records were reviewed for demographic information, advanced therapy evaluation outcomes, and quality-of-death metrics. Goals of care were identified from palliative consult notes and compared with outcomes to assess goal-concordance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Participants:<\/jats:title>\n                    <jats:p>This single-center study included adults who were referred to both advanced heart failure and palliative care specialists from 2012 to 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 212 patients, 91 (42.9%) underwent evaluation for advanced therapies, though few received a heart transplant (16, 7.5%) or left ventricular assist device (32, 15.1%). Most (148, 69.8%) had only one palliative physician visit. One hundred thirty-nine (65.6%) died, often in the hospital (55, 40%) and with life-sustaining therapy in the last 24\u2009h (73, 52.5%). Most (167, 78.8%) received goal-concordant care, with the main reasons for discordance being the desire for advanced therapy (33, 15.6%) and complications post-implantation affecting quality of life (9, 4.2%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Few older adults received advanced therapies, and palliative care was underutilized, with many patients seeing palliative care only once. Most received goal-concordant care, but decisions were often made late, highlighting the need for earlier, longitudinal palliative care for these vulnerable patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163261464366","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T10:31:12Z","timestamp":1784025072000},"page":"1388-1393","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Goal-concordant care for older adults with advanced heart failure: A retrospective cohort study"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2896-2124","authenticated-orcid":false,"given":"Sarah","family":"Godfrey","sequence":"first","affiliation":[{"name":"Divisions of Comprehensive Cardiology and Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryjane","family":"Farr","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Pennsylvania Medical Center, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Martin SS Aday AW Allen NB et al. 2025 Heart disease and stroke statistics: a report of US and global data from the American Heart Association. 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J Am Coll Cardiol 2022; 79(17): e263\u2013e421. https:\/\/doi.org\/10.1016\/j.jacc.2021.12.012","DOI":"10.1016\/j.jacc.2021.12.012"},{"key":"e_1_3_2_11_2","doi-asserted-by":"crossref","unstructured":"Evangelista LS Lombardo D Malik S et al. Examining the effects of an outpatient palliative care consultation on symptom burden depression and quality of life in patients with symptomatic heart failure. J Card Fail 2012; 18(12): 894\u2013899. https:\/\/doi.org\/10.1016\/j.cardfail.2012.10.019","DOI":"10.1016\/j.cardfail.2012.10.019"},{"key":"e_1_3_2_12_2","doi-asserted-by":"crossref","unstructured":"Br\u00e4nnstr\u00f6m M Boman K. Effects of person-centred and integrated chronic heart failure and palliative home care. PREFER: a randomized controlled study. Eur J Heart Fail 2014; 16: 1142\u20131151. https:\/\/doi.org\/10.1002\/ejhf.151","DOI":"10.1002\/ejhf.151"},{"key":"e_1_3_2_13_2","doi-asserted-by":"crossref","unstructured":"Wong FKY Ng AYM Lee PH et al. 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