Table 3 Summary of trial eligibility criteria by disease type
Diagnostic criteria | HF | NYHA II-IV [43, 44], NYHA III-IV [50, 60, 61], NYHA IIIB or IV [51], NYHA III [59] |
COPD | Oxygen saturations of less than 88%, or baseline pO2 less than 55, and to be on continuous oxygen [48] GOLD stage III or IV [40, 58, 59] Oxygen dependent [59] | |
IPF, ILD | End stage IPF as judged by either high resolution CT or composite physiologic index scores > 50, clinical status, oxygen requirements, severe PH for too unwell patients [49] IPF diagnosed by chest CT or lung biopsy [41] ILD defined by a HRCT (with traction bronchiectasis and/or honeycombing) [37] | |
Dementia | FAST 6d or greater [35] GDS stage 5, 6 or 7 [39] | |
Neurological conditions | MS (EDSS score ≥ 7.5), MND (All stages), IPD (Hoehn and Yahr stages 4–5), Progressive supranuclear palsy / Multiple system atrophy (Hoehn and Yahr stages 3–5) [56] | |
Other (no criteria) | Hospitalized with life-limiting diagnosis [38], End-stage organ failure [40] Non-malignant disease [55], Non-malignant chronic conditions [53] Advanced disease: cancer, COPD, CHF, ILD, MND [57], COPD/COAD (no criteria) [54] Acute HF (reports from the electronic health record) [47] HF as primary diagnosis [44], Parkinson’s disease (no criteria) [36] Probable PD or another PDRD (multiple system atrophy, corticobasal degeneration, progressive supranuclear palsy, or Lewy body dementia) [42] | |
Prognostic criteria | General | Surprise Question: Life expectancy of 12 months or less.“Would I be surprised if this patient died in the next 12 months?” [38, 51, 60, 61] Age ≥ 80 years, APACHE II ≥ 14, SOFA ≥ 9 [40] |
HF | ESCAPE risk score ≥ 4 (indicating > 50% predicted 6-month mortality) [45] | |
ESHF by the Prognostic Indicator Guidance (Hospitalization with at least one of the following high-risk features) [60, 61] 1. Prior hospitalization for HF within 1 year, 2. Age ≥ 80 years, 3. CKD (estimated GFR ≥ ≤ 45 mL/min/m2 177), 4. Systolic Blood Pressure ≤ 100 mm Hg 5. Serum sodium ≤ 130 mEq/L, 6. Cardiogenic Shock (Cardiac Index ≤ 2.0) 7. Serious Non-Cardiovascular Illness (e.g. advanced stage cancer, COPD, or the like) | ||
ILD | GAP index at least 3, PaO2 ≤ 60 mmHg at room air, a decline in FVC ≥ 10% in the previous 6 months [37] | |
Other (no criteria) | Live for up to 2 years, based on expert judgment that drew on available prognostic data [48] Life expectancy of < 1 year [55] | |
Symptoms (physical /psycho social) | General | MRC dyspnoea scale score (refractory breathlessness) [57] ≥ 2 symptoms or concerns including end-of-life issues, like advance care planning and/or complex needs (i.e. multiple psychosocial or physical symptoms or concerns) [53] Breathlessness due to life-limiting disease despite treatment of the underlying condition [46] |
HF | Symptoms (fatigue, palpitation, dyspnoea, or angina) due with any activity [48, 62] Cardiac cachexia (involuntary non-oedematous weight loss ≥ 6% of total body weight within the preceding 6–12 months) [50] Existence of physical/psychological symptoms despite optimal tolerated therapy [60, 61] Dyspnoea at rest or minimal exertion plus at least 1 sign of volume overload (JVP > 10 cm, peripheral oedema, congestion on chest x-ray) [60] At least one symptom (fatigue, shortness of breath, pain, and/or depression) [36] | |
COPD | Breathlessness in spite of optimisation of underlying illness [54, 55] CAT scale ≥ 25, MRC Scale Dyspnoea 4, NYHA III, BMI ≤ 18 [59] | |
Neurological conditions | An unresolved symptom which had not responded to standard care, an unresolved other symptom, cognitive problems or complex psychological issues, communication or information problems or complex social need [56] Moderate to high PC needs based on the PC-NAT modified for PD [42] | |
Functional status | General | PPS 70% or less [51] Clinical Frailty Scale sore of ≥ 4 [53] Capable to participate physiotherapy and self-management programs [46] Pre-existing functional dependency (admitted from an acute living facility, skilled nursing facility, or long-term acute care facility) [40] |
HF | HF–specific health status (KCCQ score of ≤ 70) [36] | |
COPD | CAT scale ≥ 25 [59] | |
Dementia | FAST of 6d or greater [34, 35] Late-stage dementia (bed-bound, nonverbal, incontinent, or unable to self-nourish) [40] | |
PD | Moderate to high PC needs based on the PC-NAT modified for PD [42] | |
QOL | General | QOL (VAS < 50) [50] |
HF | HF–specific health status (KCCQ score of ≤ 70) [36] | |
Medical history /treatment | General | Consideration to place a permanent feeding tube or tracheostomy, recurrent ICU admissions in the past year, post-cardiac arrest [40] Increasing health service use [53] |
HF | Repeated hospital admissions with symptoms of HF (three within 1 year [49]/ > 2 in last 6 months [60]) Symptomatic/active HF in current hospitalization or within prior six months [44] A hospitalized episode of worsening HF that resolved with the injection/infusion of diuretics or the addition of other HF treatment in the preceding 6 months despite being optimally treated [50] Need for frequent or continual IV support [50] Required diuretic dosing (furosemide ≥ 80 mg/d or equivalent), LVEF of 40% or less, BNP levels of 250 pg/mL or more, or NT-pro BNP of 1000 pg/mL or more [36] Hospitalization for acute HF [45], Hospitalization with high-risk features [43] | |
HF/COPD | Recent exacerbation (treatment in an ED, urgent care facility, or hospital within the 3 months prior to enrolment) [48] Visited ED or hospital at least once within the previous year of enrolment [51] | |
COPD | LTOT, home NIV, hospital admissions in the previous year for an acute exacerbation. [58] Three or more hospitalizations for COPD in the past three years, intubation in the past year, non-invasive ventilation in the past year [59] | |
Dementia | ||
Others | General | Patients who might benefit from a self-management programme [54, 55] Willing to engage with willing to engage with short-term home physiotherapy and occupational therapy [57] MICU perceived need [40] |