Pulmonary Hypertension
Specialty Palliative Care to Improve Quality of Life in PAH — RCT
- Authors: Single-center RCT
- Journal / date: Pulmonary Circulation, 2026
- DOI / URL: 10.1002/pul2.70321 | PMID 42164136 | PMC13183769
- Source basis: Full text (open access)
- Study type: Single-center RCT
- PH group: Group 1 (PAH)
- Population: N=62 PAH patients with impaired HRQOL (36 usual care, 26 SPC + usual care)
- Intervention: Specialty palliative care visits added to usual care
- Primary endpoint: Change in PAH-SYMPACT HRQOL across cardiopulmonary symptoms, CV symptoms, physical impact, and cognitive/emotional impact
- Findings:
- Only 58% of randomized SPC patients actually completed their visits.
- ITT: no improvement in total / symptom / physical impact scores; cognitive/emotional impact scores worsened (higher = worse HRQOL).
- Per-protocol: no significant change in any score.
- Most patients who attended SPC reported satisfaction and would recommend it.
- Why it matters (clinical takeaway):
- First RCT of specialty palliative care in PAH — does NOT support routine SPC referral for the primary purpose of improving disease-specific HRQOL.
- Acceptance (visit completion) was the main bottleneck — suggests the question isn't whether SPC works but who, when, and how to engage.
- Patient satisfaction was high — keep SPC available as an option for selected patients who want it (e.g., symptom-driven referral, advance care planning), but don't oversell HRQOL benefit.
- Caveats / limitations: Single center, small N (62), poor uptake, possible Hawthorne effects on usual care arm.
- Trial registry: NCT03905421
- Referenced trials pulled forward: None.