Team-based Palliative and End-of-life Care for Heart Failure

Fendler, Timothy J.; Swetz, Keith M.; Allen, Larry A.

doi:10.1016/j.hfc.2015.03.010

Cited by 68 publications

(46 citation statements)

References 83 publications

(97 reference statements)

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“…However, gaps in knowledge must be addressed about optimal palliative care for patients with CVD, long-term outcomes associated with early and iterative use of palliative care in CVD, and effectiveness of primary palliative care for patients with CVD. 109 Palliative care is an essential health benefit and central to high-quality overall care. In this policy statement on behalf of the AHA/ASA, we address the importance and benefits of integrating palliative care services in the care of seriously ill patients with CVD and stroke, and we provide policy recommendations based on the association's guiding principles of comprehensive and high-quality palliative care, individualized care that reflects patient and family values and preferences, a skilled and compassionate workforce, and continual assessment and quality measurement.…”

Section: Resultsmentioning

confidence: 99%

“…109 These documents are portable order sets that are written to ensure that care is provided according to patient wishes. These order sets are honored in all settings, including home, acute care, long-term care, and hospice settings, and may include actionable orders concerning patient preferences for cardiopulmonary resuscitation, artificial nutrition and hydration, antibiotic use, other life-sustaining therapies (eg, implantable cardioverter-defibrillators, assist devices), and comfort care.…”

Section: Patient-clinician Communicationmentioning

confidence: 99%

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Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association

Braun¹,

Grady²,

Kutner³

et al. 2016

Circulation

193

143

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AbstrAct:The mission of the American Heart Association/American Stroke Association includes increasing access to high-quality, evidencebased care that improves patient outcomes such as health-related quality of life and is consistent with the patients' values, preferences, and goals. Awareness of and access to palliative care interventions align with the American Heart Association/American Stroke Association mission. The purposes of this policy statement are to provide background on the importance of palliative care as it pertains to patients with advanced cardiovascular disease and stroke and their families and to make recommendations for policy decisions. Palliative care, defined as patient-and family-centered care that optimizes health-related quality of life by anticipating, preventing, and treating suffering, should be integrated into the care of all patients with advanced cardiovascular disease and stroke early in the disease trajectory. Palliative care focuses on communication, shared decision making about treatment options, advance care planning, and attention to physical, emotional, spiritual, and psychological distress with inclusion of the patient's family and care system. Our policy recommendations address the following: reimbursement for comprehensive delivery of palliative care services for patients with advanced cardiovascular disease and stroke; strong payerprovider relationships that involve data sharing to identify patients in need of palliative care, identification of better care and payment models, and establishment of quality standards and outcome measurements; healthcare system policies for the provision of comprehensive palliative care services during hospitalization, including goals of care, treatment decisions, needs of family caregivers, and transition to other care settings; and health professional education in palliative care as part of licensure requirements.

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Section: Resultsmentioning

confidence: 99%

Section: Patient-clinician Communicationmentioning

confidence: 99%

Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association

Braun¹,

Grady²,

Kutner³

et al. 2016

Circulation

193

143

View full text Add to dashboard Cite

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“…In the United States, patients with end-stage HF may be considered for hospice services. 374 Hospice care is frequently underused, but a referral to hospice may be appropriate for patients with a short life expectancy. …”

Section: Clinical Statements and Guidelinesmentioning

confidence: 99%

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Feingold¹,

Mahle²,

Auerbach³

et al. 2017

Circulation

211

195

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For many neuromuscular diseases (NMDs), cardiac disease represents a major cause of morbidity and mortality. The management of cardiac disease in NMDs is made challenging by the broad clinical heterogeneity that exists among many NMDs and by limited knowledge about disease-specific cardiovascular pathogenesis and course-modifying interventions. The overlay of compromise in peripheral muscle function and other organ systems, such as the lungs, also makes the simple application of endorsed adult or pediatric heart failure guidelines to the NMD population problematic. In this statement, we provide background on several NMDs in which there is cardiac involvement, highlighting unique features of NMD-associated myocardial disease that require clinicians to tailor their approach to prevention and treatment of heart failure. Undoubtedly, further investigations are required to best inform future guidelines on NMD-specific cardiovascular health risks, treatments, and outcomes. N euromuscular diseases (NMDs) encompass a broad spectrum of diagnoses with overlapping but distinct phenotypes. Common to many NMDs is cardiac involvement. Although the past 3 decades have seen marked advances in our understanding of many NMDs, significant gaps in knowledge remain on how best to approach cardiac care in these patients. For example, survival in Duchenne muscular dystrophy (DMD) has been extended through the use of glucocorticoid use and respiratory support, yet cardiac complications remain a significant cause of morbidity and mortality.1-3 To achieve further gains in care, we will need to improve our understanding of the pathophysiologies driving cardiac involvement in NMDs and advance treatments aimed at preventing the progression of heart failure (HF) and sudden death in NMDs. The recently published findings of an expert working group on cardiac involvement in DMD, which outlined key gaps in knowledge and made specific recommendations aimed at improving diagnosis and management, are a step toward this goal. 4 In this statement, we include a comprehensive overview of the major categories of NMDs with cardiac involvement. For each, a brief background of the gene defect(s), common clinical manifestations (particularly cardiac findings), and current therapies is summarized. Gaps in knowledge are highlighted, and where possible, clinical treatment suggestions are made by the expert writing group appointed by the American Heart Association to review the available literature. Selection of the writing group was performed in accordance with the American Heart Association's conflict-of-interest management policy. Participants volunteered to write sections relevant to their expertise and experience. CLINICAL STATEMENTS AND GUIDELINESconducted a general search of the literature, restricted to human subjects research published between 1980 and 2016. Drafts of each section were written and sent to the chair of the writing group for incorporation into a single document, which was then edited. The edited document was discussed electron...

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“…Moreover, there may be two types of treatment teams in Japan: a palliative care team (conventional palliative care focusing on cancer) and a heart failure care team. Although the role of multidisciplinary teams in the treatment of patients with heart failure has been described, the individual team members have been less clearly characterized and the members of these multidisciplinary teams vary by institutions [10,11]. Therefore, we collected basic information on hospital beds, certified heart failure care nurses, certified palliative care nurses, multidisciplinary teams, and collaboration with cancer palliative teams.…”

Section: Basic Information About the Facility And Multidisciplinary Teammentioning

confidence: 99%

Design of a nationwide survey on palliative care for end-stage heart failure in Japan

Kurozumi

Oishi

Sugano

et al. 2018

Journal of Cardiology

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Team-based Palliative and End-of-life Care for Heart Failure

Cited by 68 publications

References 83 publications

Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association

Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Design of a nationwide survey on palliative care for end-stage heart failure in Japan

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