Role of Palliative Care in the Outpatient Management of the Chronic Heart Failure Patient

Springer Science and Business Media LLC - Tập 16 - Trang 220-228 - 2019
Sarah Chuzi1, Esther S. Pak2, Akshay S. Desai3,4, Kristen G. Schaefer4,5,6, Haider J. Warraich3,4,7
1Division of Cardiology, Department of Medicine, Northwestern University at Feinberg School of Medicine, Chicago, USA
2Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, USA
3Center for Advanced Heart Disease, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, USA
4Harvard Medical School, Boston, USA;
5Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, USA
6Division of Palliative Medicine, Brigham and Women’s Hospital, Boston, USA
7Cardiology Section, Department of Medicine, Boston VA Healthcare System, Boston, USA

Tóm tắt

Patients with heart failure (HF) have an increased symptom burden and complex psychosocial and decision-making needs that necessitate the integration of palliative care. However, in the current era, palliative care is frequently evoked for these patients only at the end-of-life or in the inpatient setting; rarely is palliative care proactively utilized in outpatients with HF. The purpose of this review is to evaluate the current state of palliative care and heart failure and to provide a roadmap for the integration of palliative care into outpatient HF care. Recent studies, including PAL-HF, CASA, and SWAP-HF, have demonstrated that structured palliative care interventions may improve quality of life, depression, anxiety, understanding of prognosis, and well-being in HF. HF is associated with high mortality risk, significant symptom burden, and impaired quality of life. Palliative care can meet many of these needs; however, in the current era, palliative care consultations in HF occur late in the disease course and too often in the inpatient setting. Primary palliative care should be provided to all outpatients with heart failure based on their needs, with referral to secondary palliative care provided based on certain triggers and milestones.

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Springer Science and Business Media LLC

Tập 16

220-228

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