LAUSR

Background While recent evidence demonstrates providing early palliative care (EPC) with routine heart failure (HF) care can improve quality of life (QOL) and reduce symptom burden and healthcare use, there is limited evidence examining EPC in a racially diverse HF population in the Southeastern US. Aims To describe and explore patient (PT) and caregiver (CG) participants’ baseline sociodemographics and outcome measures focusing on racial differences. Methods We compared sociodemographics and baseline PT/CG-reported outcome measures (Kansas City Cardiomyopathy Questionnaire [KCCQ], Hospital Anxiety/Depression Scale [HADS], religious coping style, & CG burden (Montgomery Borgatta Caregiver Burden [MCBC] Scale). We then calculated racial differences in these measures using T-tests adjusted with a False Discovery Rate. Results Of 487 participants, there were 357 PTs (nWhite(W)= 157; nBlack(B)= 200) and 130 CGs (nW= 55; nB= 75). Relative to race, Black PTs were younger (nW= 65.12; nB= 62.72; d= 0.29; p= 0.037), less likely to be married (nW= 90; nB= 78; d=0. 42, p= 0.0024), less likely to have private insurance coverage (nW= 103; nB= 83; d= 0.42, p= 0.0024), less likely to have a rural residence (nw= 55, nB= 39; d=0.35; p= 0.0086). Clinically, Black PTs had a lower ejection fraction (Mw= 44.99, MB= 38.9; d= 0.38, p= 0.0047) and fewer had a DNR order (nW= 37; nB = 22; d= 0.36, p= 0.0101). Black PTs also reported more negative religious coping (Mw= 3.8; MB=3.65; d=0.32, p= 0.473). Relative to race, more Black CGs were Protestant (nw= 48, nB= 74; d= 0.39). Black CGs reported lower HADS-depression scores (Mw= 5.36, MB= 4.15; d= 0.38) and lower CG burden scores (MBCB (Mw= 45.05; MB= 42.59; d= 0.43)). Conclusion There were relevant differences in RCT participants’ demographic and clinical characteristics at baseline. It will be important to consider these differences in analyzing trial outcomes and in intervention impact. Ultimately, if racial differences are identified this presents opportunities for tailoring the cultural aspects of the intervention to improve both access to and acceptability of EPC in all HF populations. ClinicalTrials.gov Identifier: NCT02505425.