Hospice Use Among Patients with Heart Failure

Cross, Sarah H.; Kamal, Arif H.; Taylor, Donald H.; Warraich, Haider J.

doi:10.15420/cfr.2019.2.2

Cited by 28 publications

(7 citation statements)

References 105 publications

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“…6,37,[44][45][46][47][48][49][50][51][52][53] There are no standardized "transition points" in heart failure that may suggest the initiation of SPC referral. However, qualification for SPC services should be needs-based and not prognosis-based, [54][55][56][57] a recommendation made by guidelines. 1 A total of 42% and 46.8% of respondents believed that SPC prioritizes and is designed to meet the needs of patients with cancer, respectively.…”

Section: Discussionmentioning

confidence: 99%

Referral Practices of Cardiologists to Specialist Palliative Care in Canada

et al. 2021

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Background: Patients with heart failure have palliative care needs that can be effectively addressed by specialist palliative care (SPC). Despite this, SPC utilization by this patient population is low, suggesting barriers to SPC referral. We sought to determine the referral practices of cardiologists to SPC. Methods: Cardiologists across Canada were invited to participate in a survey about their referral practices to SPC. Associations between R ESUM EContexte : Les services de soins palliatifs sp ecialis es (SPS) peuvent r epondre efficacement aux besoins des patients pr esentant une insuffisance cardiaque. Malgr e tout, les patients de cette population n'ont pas beaucoup recours aux SPS, ce qui semble indiquer la pr esence d'obstacles à l'orientation vers les SPS. Nous avons entrepris de d eterminer les pratiques des cardiologues en matière d'orientation des patients vers les SPS.

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Section: Discussionmentioning

confidence: 99%

Referral Practices of Cardiologists to Specialist Palliative Care in Canada

et al. 2021

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“…In the US, “hospice” care is available at home through the Medicare Hospice Benefit Program for patients certified as having a likely life expectancy of ≤6 months, and who choose to forgo curative therapy. It has been estimated that close to one-third of American HF patients have subscribed to this scheme by the time of death [ 111 ]. Enrolment tends to occur late in the course of the disease but is associated with reduced use of acute medical services.…”

Section: Care Near the End Of Lifementioning

confidence: 99%

Palliative Care in Acute Heart Failure

Beattie

Higginson

McDonagh

2020

Curr Heart Fail Rep

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Purpose of Review Palliative care is increasingly acknowledged as beneficial in supporting patients and families affected by heart failure, but policy documents have generally focused on the chronic form of this disease. We examined palliative care provision for those with acute heart failure, based on the recently updated National Consensus Project Clinical Practice Guidelines for Quality Palliative Care. Recent Findings The commonest reason for hospitalization in those > 65 years, acute heart failure admissions delineate crisis points on the unpredictable disease trajectory. Palliative care is underutilized, often perceived as limited to end-of-life care rather than determined by regular systematic needs assessment. No dominant paradigm of palliative care provision has emerged from the nascent evidence base related to this clinical cohort, underscoring the need for further research. Summary Embedding palliative support as mainstream to heart failure care from the point of diagnosis may better ensure treatment strategies for those admitted with acute heart failure remain consistent with patients’ preferences and values.

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“…5,6 The vast majority of patients with HF either do not meet eligibility criteria for hospice which, in turn, leads to less timely referrals or opt for alternative palliative care alongside disease-directed treatment. 7 Hospice enrollment in patients with HF has resulted in reduced utilization of acute medical services. 8 After enrolling in hospice, many patients with HF are not prepared to manage distressing symptoms and return to acute-care settings more frequently than patients with cancer.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Development and Implementation of a Cardiac Home Hospice Program: Results of a RE-AIM Analysis

Jordan

Russell

Baik

et al. 2020

Am J Hosp Palliat Care

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Background: Use of hospice has grown among patients with heart failure; however, gaps remain in the ability of agencies to tailor services to meet their needs. Aim: This study describes the implementation of a cardiac home hospice program and insights for dissemination to other hospice programs. Design: We conducted a multimethod analysis structured around the Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) framework. Settings/Participants: We used electronic medical records for our quantitative data source and interviews with hospice clinicians from a not-for-profit hospice agency (N = 32) for our qualitative data source. Results: Reach—A total of 1273 participants were enrolled in the cardiac home hospice program, of which 57% were female and 42% were black or Hispanic with a mean age was 86 years. Effectiveness—The cardiac home hospice program increased hospice enrollment among patients with heart failure from 7.9% to 9.5% over 1 year (2016-2017). Adoption—Institutional factors that supported the program included the acute need to support medically complex patients at the end of life and an engaged clinical champion. Implementation—Program implementation was supported by interdisciplinary teams who engaged in care coordination. Maintenance—The program has been maintained for over 3 years. Conclusion: The cardiac home hospice program strengthened hospice clinicians’ ability to confidently provide care for patients with heart failure, expanded awareness of their symptoms among clinicians, and was associated with increased enrollment of patients with heart failure over the study period. This RE-AIM evaluation provides lessons learned and strategies for future adoption, implementation, and maintenance of a cardiac home hospice program.

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Hospice Use Among Patients with Heart Failure

Cited by 28 publications

References 105 publications

Referral Practices of Cardiologists to Specialist Palliative Care in Canada

Referral Practices of Cardiologists to Specialist Palliative Care in Canada

Palliative Care in Acute Heart Failure

The Development and Implementation of a Cardiac Home Hospice Program: Results of a RE-AIM Analysis

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