Palliative care: Essential support for patients with heart failure in the COVID-19 pandemic

Hill, Loreena; Beattie, James; Geller, Tal Prager; Baruah, Resham; Boyne, Josiane; Stolfo, Giuseppe Di; Jaarsma, Tiny

doi:10.1177/1474515120932814

Cited by 7 publications

(9 citation statements)

References 20 publications

(20 reference statements)

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“…Health care professionals should be prepared for future virus outbreaks by becoming efficient and utilizing remote and virtual technology with HF patients 59 . The current use of PPE makes a person‐centred approach between clinician and patient difficult, but reassurance and verbal encouragement from the clinician are vital 72 . Resources and toolkits for health care professionals to guide palliative and end‐of‐life care options for HF patients are emerging 59,72 …”

Section: Transitioning To a Telehealth Frameworkmentioning

confidence: 99%

“…59 The current use of PPE makes a person-centred approach between clinician and patient difficult, but reassurance and verbal encouragement from the clinician are vital. 72 Resources and toolkits for health care professionals to guide palliative and end-oflife care options for HF patients are emerging. 59,72 Interestingly, in Italy, Salzano et al described the successful implementation of a telemedicine service (using phone technology) for HF patients, which was provided throughout lockdown with 58% of patients accessing the service.…”

Section: Transitioning To a Telehealth Frameworkmentioning

confidence: 99%

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Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

et al. 2020

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Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2. The clinical presentation of this virus mainly manifests in the respiratory system but may also lead to severe complications in the cardiovascular system. The global burden of COVID-19 has led to an unprecedented need to gain further insight into patient outcomes, management, and clinical practice. This review aims to provide an overview of the current literature on heart failure (HF) hospitalizations, management, and care pathways for supporting patients during and beyond this pandemic. A literature review of five areas of interest was conducted and included: (i) HF hospitalization; (ii) recognizing the needs and supporting HF patients during COVID-19; (iii) supporting rehabilitation services; (iv) transitioning to a telehealth framework; and (v) the need for evidence. Patients with new-onset or existing HF are particularly vulnerable, but a significant reduction in HF hospital admissions has been reported. During these periods of uncertainty, the current care pathways for acute and elective cardiac patients have had to change with the relocation of HF services to protect the vulnerable and reduce transmission of COVID-19. Optimizing community HF services has the potential to reduce the pressures on secondary care during the recovery from this pandemic. Telemedicine and virtual health care are emerging technologies and overcome the risk of in-person exposure. Successful remote delivery of cardiac rehabilitation services has been reported during the pandemic. Delivery of a robust telehealth framework for HF patients will improve communication between clinician and patient. The reduction in HF admissions is a concern for the future and may result in unintended mortality. New-onset and current HF patients must understand their diagnosis and future prognosis and seek help and support using the appropriate platform when needed. Realigning HF services and the use of telemedicine and virtual health care has great potential but needs to be carefully understood to ensure engagement and approval in this population to overcome barriers and challenges.

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Section: Transitioning To a Telehealth Frameworkmentioning

confidence: 99%

Section: Transitioning To a Telehealth Frameworkmentioning

confidence: 99%

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

et al. 2020

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“…Healthcare workers themselves may be faced with different dilemmas in these unprecedented situations such as COVID-19 pandemic. Some healthcare workers currently caring for COVID-19 patients may be redeployed from their customary clinical environments, including those normally assigned to cardiac, cancer and renal disease care, to support heavily burdened clinical services 18 . Some staff may feel conflicted, being aware that their reassignment to support the obvious needs of COVID-19 patients might undermine the care of those whom they are normally responsible for.…”

Section: Addressing the Role Of Healthcare Workers In Psychosocial Support In The Period Of Covid-19mentioning

confidence: 99%

“…In difficult situations like these, healthcare workers may give subjective considerations to younger patients, infected healthcare workers with COVID-19 over older end-of-life care patients requiring ventilator support. Such decisions through unethical is based predominantly on the concept of distributive justice and this can as well cause moral distress to the healthcare workers 18 . Reallocation of ventilator support from critically ill patients will be distressing for healthcare workers, patients and their family/caregivers because, in regular conditions, the removal of ventilator support is only done when a family member approves 22 .…”

Section: Addressing the Need For Improved Covid-19 Life Support Medical Equipment And Diagnostic Capacitymentioning

confidence: 99%

Covid-19 and Palliative Care Delivery in Resource-Limited Settings: Healthcare Workers’ Involvement

et al. 2021

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As the global surge of the COVID-19 pandemic continues to rise, attention has been drawn to health implications and damaging effects caused by COVID-19 in patients with chronic conditions. Palliative care delivery in diseased patients and those with chronic conditions is imperative in mitigating unprecedented health outcomes. Though many health care workers in developed countries are implementing new strategies to address palliative care challenges in patients at risk of COVID-19, preventive measures and strategies are crucial in resource-limited settings, where palliative care is seen as a new concept. This report addresses the approach to palliative care delivery and changes that may arise from the coronavirus pandemic. It also looks at possible socio-behavioural entities, education, preventive measures and upscaling diagnostic capacity for COVID-19 in resource-limited settings. Harnessing these factors as guidance and delivery tools for healthcare workers in resource-limited settings could help to manage risks and benefits associated with providing optimal palliative care in this pandemic period.

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“…COVID-19 has destabilised even highly developed healthcare systems that have had to flex in attempting to care for surges of seriously ill and dying patients. In the third review of this section, we draw attention to the challenges this virulent disease poses to the provision of palliative and supportive care, a clinical imperative for those with heart failure and other cardiovascular conditions who are at substantial risk from this novel coronavirus [ 14 ]. The necessary prioritisation of resources in response to the direct effects of COVID-19 has required reconfiguration of both cardiology and palliative care services, with the redeployment of personnel to support the treatment of those infected.…”

mentioning

confidence: 99%

Palliative care: Essential support for patients with heart failure in the COVID-19 pandemic

Cited by 7 publications

References 20 publications

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

Covid-19 and Palliative Care Delivery in Resource-Limited Settings: Healthcare Workers’ Involvement

Editorial: Cardiovascular service innovation, intersectionality, and the challenges of COVID-19

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