A Trial of a CPR Video in Heart Failure Patients

This is a randomized controlled trial of a CPR video decision aid in patients with advanced congestive heart failure (CHF).

Aim 1: To compare the care preferences for CPR and intubation among subjects randomized to video and subjects randomized to the current standard of care without the video. Hypothesis 1: Subjects randomized to the video intervention will be significantly more likely to opt against CPR and intubation compared to those who do not see the video. Aim 2: To compare code-status documentation in the electronic medical records between subjects randomized to the video and those who are receiving the current standard of care without the video. Hypothesis 2: Subjects randomized to the video are more likely to have their code status correctly documented in the electronic medical records compared to those who do not see the video. Aim 3: To compare knowledge and decisional conflict of subjects randomized to video and subjects randomized to the current standard of care without the video. Hypothesis 3: When compared to subjects randomized to the current standard of care, subjects in the video intervention group will have higher knowledge and lower decisional conflict (lower decisional conflict scores) when asked to choose CPR and intubation preferences.

Inclusion Criteria: A diagnosis of advanced heart failure: New York Heart Association Class III or IV (III: marked limitation in activity due to symptoms, even during less-than-ordinary activity; IV: severe limitations, experiences symptoms while at rest). AND Two or more hospitalizations for heart failure in the last year. AND Either a systolic blood pressure ≤ 120 mm Hg OR Na ≤ 135 mEq/L. Ability to provide informed consent. Ability to communicate in English. Age 65 or older.