Palliative Care Training in Cardiology Fellowship: A National Survey of the Fellows

Abstract

Our survey results highlight a need for enhanced palliative care and end-of-life training experiences for cardiology fellows and also suggest underutilization of hospice and palliative care resources for patients with advanced cardiac diseases. These findings create a platform for future work that might: (1) confirm this training deficit, (2) lead to exploration of educational models that could reconcile this deficit, and (3) potentially help improve palliative care support for patients and families facing advanced heart disease.

Referral Practices of Cardiologists to Specialist Palliative Care in Canada

“…38 Our results demonstrate that palliative care is being inaccurately synonymized with end-of-life care, an issue highlighted by previous reviews on this topic. 6,[42][43][44][45] This attitude informed whether and how early cardiologists made referrals to SPC. Collectively, these findings suggest that barriers to timely SPC referral include an insufficiency of services for patients with nonmalignant disease especially in the outpatient setting, disqualification of patients because they may be pursuing acute care management or receiving continuous infusions, and a misperception that palliative care is equivalent to end-of-life care.…”

“…This finding is echoed in several previous studies that have identified the unpredictable course of heart failure as a barrier to referral. 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.…”

“…37 The present study has one of the highest number of respondents and a comparable response rate amongst similar studies; among previous surveys, the response rate ranged from 14% to 100%. 34,38,40,45,46,48,64,65 Previous studies have provided a qualitative analysis of the factors that inform SPC referral for patients with cardiac diseases; our study provides a quantitative analysis of factors associated with referral and its frequency.…”

The Role of Palliative Care in the Cardiac Intensive Care Unit

“…Therefore, Scientific Societies and above all university faculties should take on more responsibility for specific education. They should promote a program focusing on the patient’s needs rather than on the disease, including learning of communication with patients and family members [73,74,75].…”

Palliative care experience and perceived gaps in training among transplant hepatology fellows: A national survey

“…[ 7 , 8 , 9 , 10 , 11 , 12 ] In national surveys of trainees in oncology, cardiology, surgery, and obstetrics and gynecology, most trainees understand the value and importance of PC but few have received formalized PC instruction. [ 13 , 14 , 15 , 16 , 17 ]…”