The complexity of prognosis communication in heart failure: Patient and cardiologists’ preferences in the outpatient clinical setting

Strachan, Patricia H.; Arthur, Heather M.; Demers, Catherine; Robson, Robert J.

doi:10.4236/wjcd.2013.31a017

Cited by 2 publications

(1 citation statement)

References 35 publications

(38 reference statements)

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“…12,17,54 Recent guidelines from the American Heart Association summarise the need for timely conversations: ‘difficult discussions now will simplify difficult decisions in the future’. 17 These conversations require time, training and an individualised approach 55 and may appear daunting to some clinicians 17 but enable patients, if they wish, to discuss their poor prognosis and be involved in decisions about their future care despite uncertain disease trajectories by ‘hoping for the best, and preparing for the worst’. 56…”

Section: Implications For Clinical Practicementioning

confidence: 99%

Palliative care for people with heart failure: Summary of current evidence and future direction

2013

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Heart failure patients have limited access to palliative care services. Barriers to palliative care include difficult prognostication due to the unpredictable disease trajectory and inadequate initiation of conversations about end-of-life care. WHAT IS NOT KNOWN: There are gaps in the evidence for symptom control, especially for symptoms other than pain or dyspnoea, but recommendations are becoming increasingly evidence based. IMPLICATIONS FOR RESEARCH, POLICY AND PRACTICE: There are challenges to research in this area although progress is being made with increasing numbers of trials and use of novel research methods. Integrated models of care based on symptom triggers rather than prognosis are recommended. At the centre is excellent communication both with the patient and between services to ensure the best possible care.

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