Spiritual Support in Advanced Heart Failure: A Randomized Controlled Feasibility Study

Abstract

Heart failure is a complex, progressive disease with an uncertain trajectory.  Those with advanced heart failure (AHF) experience substantial spiritual needs.  Spiritual interventions may enhance quality of life and reduce anxiety and depression,  but studies are limited and none have focused exclusively on the AHF patient population.  This is the first feasibility randomized controlled trial (RCT) to ascertain the clinical and cost effectiveness of a spiritual intervention (spiritual support) in AHF  patients. A total of 47 AHF patients were randomized to control (standard care, n = 25)  or intervention (standard care plus spiritual support, n = 22) groups. Spiritual support  consisted of a one-hour discussion facilitated by trained volunteers using a “Spiritual  Enquiry Tool” at two-monthly intervals over six months. Participants completed validated  measures of spiritual well-being, depression/anxiety, and health-related quality  of life (QoL). Purpose-designed questionnaires gathered information on demographics,  NHS resource use, confounding factors, and satisfaction with spiritual support. The  new information was to help researchers design an RCT to determine the clinical and  cost effectiveness of spiritual support within a holistic model of care for AHF patients.  Future trends worthy of further investigation include (i) the possible positive effect of  spiritual support on QoL and anxiety, and (ii) possible lower NHS resource use and cost  savings in patients receiving spiritual support. Overall, the key message of this study is  that researchers must evaluate whether the cost of running a well-designed trial of this  nature is justified in the current economic climate, where funding bodies are looking  for value for money.