SCOPAH: Singapore Cohort of Patients with Advanced Heart Failure


Principal Investigator:

Chetna Malhotra, Assistant Professor, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore

Study Team:

David Sim Kheng Leng, Than Aung, Yeo Khung Keong, Chetna Malhotra, Semra Özdemir, Irene Teo Eng Ai, Nivedita Nadkarni


Chronic heart failure (CHF) is one of the leading causes of death in Singapore. Although it is well established that CHF patients in Singapore are less likely to be referred to palliative care services than cancer patients, little data is available on end of life experience of advanced CHF patients in Singapore, including the inter-relationships between patient decision-making, quality of life trajectories, and health and cost consequences.


The objective of this cohort study is to better understand the relationship between patient preferences, health care access, utilization, costs, and quality of life, and to identify strategies to improve the EOL experience for these patients.


Prospective study of patients with advanced heart failure (New York Heart Association class III and IV). 250 patients and their primary informal caregivers are followed every 4 months for a period of two years or till they die, whichever is earlier. Treating physicians of the patients are invited to take part in the study.

Study sites:

National Heart Centre Singapore

Singapore General Hospital


The results of the cohort study with patients with advanced CHF will be useful to better understand the role that patient, family, and health system characteristic play in determining health outcomes, utilization and costs of care and for identifying inappropriate use of services, quality improvement initiatives, resource allocation, and budgeting.


Study Protocol for a Cohort Study of Patients with Advanced Heart Failure in Singapore.

Malhotra C, Foo R, Singh R, Ozdemir S, Teo I, Sim D, Jaufeerally FR, Aung T, Yeo KK, Nadkarni N, Finkelstein EA. BMJ Open.2018;8(9):e022248.

Role in Decision Making among Congestive Heart Failure Patients and its Association with Patient Outcomes: A Baseline Analysis of the SCOPAH study

Ozdemir S, Teo I, Bundoc FC, Malhotra C, Yeo KK, Sim DKL, Finkelstein EA. Patient Education and Counseling.2020; S0738-3991(20)30464-X.

Financial difficulties and patient-reported outcomes among patients with advanced heart failure

Malhotra, C., Bundoc, F., Ang, F., Ozdemir, S., Teo, I., Sim, D., Jaufeerally, F. R., Aung, T., & Finkelstein, E. (2021). Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 30(5), 1379–1387.

Project Start Date:

1 October 2016

Contact Person: