Comparison of Palliative Care Interventions for Cancer versus Heart Failure Patients: A Secondary Analysis of a Systematic Review

Bannon, Megan; Ernecoff, Natalie C.; Dionne‐Odom, J. Nicholas; Zimmermann, Camilla; Corbelli, Jennifer; Klein‐Fedyshin, Michele; Arnold, Robert M.; Schenker, Yael; Kavalieratos, Dio

doi:10.1089/jpm.2018.0513

Cited by 11 publications

(4 citation statements)

References 10 publications

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“…It focuses on the prevention, early identification, assessment, and management of physical issues, including pain and other distressing symptoms, psychological distress, spiritual distress, and social needs. 7 However, studies 1 , 4 , 8 , 9 , 10 , 11 contrasting palliative care for patients with cancer and those with terminal noncancer illness report disparities in access and differences in the magnitude of its associated benefits.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Palliative Care Delivery in the Last Year of Life Between Adults With Terminal Noncancer Illness or Cancer

et al. 2021

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Section: Introductionmentioning

confidence: 99%

Comparison of Palliative Care Delivery in the Last Year of Life Between Adults With Terminal Noncancer Illness or Cancer

et al. 2021

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“…The question of whether cancer patients require a different palliative care approach than non-cancer patients is an important issue in current palliative care research. 15 , 16 , 36 – 38 As there might be little to no difference in the severity of symptoms, end-of-life care seems to be more influenced by the severity of the life-limiting disease, by the attitudes toward the disease, and by the social support the patient receives than by the category cancer versus non-cancer. 38 We therefore derive that presumably effective elements of specialized palliative homecare (such as keeping a team on standby 24/7, training in palliative care, and coordination of care) 39 also display effect in the complex care of non-cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of two types of palliative home care in cancer and non-cancer patients: A retrospective population-based study using claims data

et al. 2021

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Background: Comparative effectiveness of different types of palliative homecare is sparsely researched internationally—despite its potential to inform necessary decisions in palliative care infrastructure development. In Germany, specialized palliative homecare delivered by multi-professional teams has increased in recent years and factors beyond medical need seem to drive its involvement and affect the application of primary palliative care, delivered by general practitioners who are supported by nursing services. Aim: To compare effectiveness of primary palliative care and specialized palliative homecare in reducing potentially aggressive interventions at the end-of-life in cancer and non-cancer. Design: Retrospective population-based study with claims data from 95,962 deceased adults in Germany in 2016 using multivariable regression analyses. Settings/participants: Patients having received primary palliative care or specialized palliative homecare (alone or in addition to primary palliative care), for at least 14 days before death, differentiating between cancer and non-cancer patients. Results: Rates of potentially aggressive interventions in most indicators were higher in primary palliative care than in specialized palliative homecare ( p < 0.01), in both cancer and non-cancer patients: death in hospital (odds ratio (OR) 4.541), hospital care (OR 2.720), intensive care treatment (OR 6.749), chemotherapy (OR 2.173), and application of a percutaneous endoscopic gastrostomy (OR 4.476), but not for parenteral nutrition (OR 0.477). Conclusion: Specialized palliative homecare is more strongly associated with reduction of potentially aggressive interventions than primary palliative care in the last days of life. Future research should identify elements of specialized palliative homecare applicable for more effective primary palliative care, too. German Clinical Trials Register (DRKS00014730).

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“…45 Additionally, systematic reviews show that psychosocial support of HF patients is as important an element as that of cancer patients. 46…”

Section: Psychological Support and Spiritual Carementioning

confidence: 99%

“…45 Additionally, systematic reviews show that psychosocial support of HF patients is as important an element as that of cancer patients. 46 Spiritual care is a core domain of EOL care that encompasses the following: beliefs and values, meaning and connections, self-transcendence, forgiveness, coping, and practices. 47 As frontline caregivers who immediately recognize the patient's suffering and pain, training nurses and caregivers is crucial in providing acceptance, understanding, and compassion.…”

Section: Psychological Support and Spiritual Carementioning

confidence: 99%

End-Of-Life Care for Patients With End-Stage Heart Failure, Comparisons of International Guidelines

Rivera

Choi²,

Carado

et al. 2023

Am J Hosp Palliat Care

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Heart failure (HF) is a chronic, debilitating condition associated with significant morbidity, mortality, and socioeconomic burden. Patients with end-stage HF (ESHF) who are not a candidate for advanced therapies will continue to progress despite standard medical therapy. Thus, the focus of care shifts from prolonging life to controlling symptoms and improving quality of life through palliative care ( PC). Because the condition and prognosis of HF patients evolve and can rapidly deteriorate, it is imperative to begin the discussion on end-of-life (EOL) issues early during HF management. These include the completion of an advance directive, do-not-resuscitate orders, and policies on device therapy and discontinuation as part of advance care planning (ACP). ESHF patients who do not have indications for advanced therapies or those who wish not to have a left ventricular assist device (LVAD) or heart transplant (HT) often experience high symptom burden despite adequate medical management. The proper identification and assessment of symptoms such as pain, dyspnea, nausea, depression, and anxiety are essential to the management of ESHF and may be underdiagnosed and undertreated. Psychological support and spiritual care are also crucial to improving the quality of life during EOL. Caregivers of ESHF patients must also be provided supportive care to prevent compassion fatigue and improve resilience in patient care. In this narrative review, we compare the international guidelines and provide an overview of end-of-life and palliative care for patients with ESHF.

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Comparison of Palliative Care Interventions for Cancer versus Heart Failure Patients: A Secondary Analysis of a Systematic Review

Cited by 11 publications

References 10 publications

Comparison of Palliative Care Delivery in the Last Year of Life Between Adults With Terminal Noncancer Illness or Cancer

Comparison of Palliative Care Delivery in the Last Year of Life Between Adults With Terminal Noncancer Illness or Cancer

Effectiveness of two types of palliative home care in cancer and non-cancer patients: A retrospective population-based study using claims data

End-Of-Life Care for Patients With End-Stage Heart Failure, Comparisons of International Guidelines

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