Improving palliative care provision for patients with heart failure

Abstract

In the last 14 years, research has identified that patients with heart failure suffer symptoms as severe as people with cancer and would greatly benefit from a palliative care approach. In spite of this fact, it is recognized within the National Service Framework for Heart Failure (Department of Health (DoH), 2000b) and the Cancer Plan (DoH, 2000a) that service provision from a palliative care perspective remains inadequate. In order to address the palliative care needs for patients with heart failure and their families a multidisciplinary team approach between primary and secondary care is needed. This article will review the literature relating to improvement of services from a palliative care perspective. It discusses the quality of life experienced by patients with heart failure and their families and the barriers to providing a palliative care approach from a multidisciplinary team perspective. Finally, it attempts to present future recommendations to develop a structured service provision.

Symptom Burden, Depression, and Spiritual Well-Being: A Comparison of Heart Failure and Advanced Cancer Patients

“…Little researchbased evidence exists to guide practitioners on which patients with heart failure might be appropriate to receive palliative care, and when it should be provided, especially given the association of palliative care with end of life care. 16,[37][38][39][40][41][42][43][44][45][46][47][48] The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult generally equates palliative care with hospice and primarily discusses it in the context of end of life care. 49 However, palliative care can be understood as care that should be provided from the time of diagnosis of a serious illness, which is often much earlier than when patients are eligible for hospice or at the end of life.…”

Review Article: A Model of Palliative Care for Heart Failure

“…(11, 22-25) This lack of knowledge is twofold: primary care providers and cardiologists are often unsure of how to integrate palliative care services into their practice(24, 25) and palliative care specialists often lack the specialty knowledge required for heart failure management. (22, 24) In addition, some physicians interpret the introduction of palliative care as a path to death that should be only implemented for those patients who are actively dying.…”

“…(22, 24) In addition, some physicians interpret the introduction of palliative care as a path to death that should be only implemented for those patients who are actively dying. (11, 26, 27)…”

Defining the role of palliative care in older adults with heart failure

“…A substantial literature calls for palliative care in patients with heart failure [34,[50][51][52][53][54][55][56][57][58][59][60][61]. However, it has been underutilized in clinical practice to date, and little research-based evidence exists to guide practitioners on how to provide palliative care to patients with heart failure and what kinds of improvements to expect.…”