Objectives To explore the perceptions of palliative care (PC) needs in patients with idiopathic pulmonary fibrosis (IPF) and their caregivers. Background IPF carries a poor prognosis with most patients succumbing to their illness at a rate comparable to aggressive cancers. No prior studies have comprehensively explored perceptions of PC needs from those currently living with the disease, caring for someone living with the disease, and who cared for a deceased family member. Methods Thematic analysis of focus group content was obtained from thirteen participants. Results Four themes described frustration with the diagnostic process and education received, overwhelming symptom burden, hesitance to engage in advance care planning, and comfort in receiving care from pulmonary specialty center because of resources. Conclusions Findings support that patients and caregivers have informational needs and high symptom burden, but limited understanding of the potential benefits of PC. Future studies are needed to identify optimal ways to introduce early PC.

Patients with HF and their families experience stress and suffering from a variety of sources over the course of the HF experience. Palliative care is an interdisciplinary service and an overall approach to care that improves quality of life and alleviates suffering for those living with serious illness, regardless of prognosis. In this review, we synthesize the evidence from randomized clinical trials of palliative care interventions in HF. While the evidence base for palliative care in HF is promising, it is still in its infancy and requires additional high-quality, methodologically sound studies to clearly elucidate the role of palliative care for patients and families living with the burdens of HF. Yet, an increase in attention to primary palliative care (e.g., basic physical and emotional symptom management, advance care planning), provided by primary care and cardiology clinicians, may be a vehicle to address unmet palliative needs earlier and throughout the illness course.

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administration. This dynamic automatically establishes a hierarchy of importance for the different medication groups, assists with formulating a rational initial medication regimen tailored to each patient, and prevents drug administration when, because of either relative hypotension or bradycardia, the agent could be deleterious. It also aids prognostication, and the eventual transitioning of patients off GDMT to only comfort medications (opioids and benzodiazepines) at the immediate end of life.Methods. Comparing statistics drawn from a 12month chart review of heart failure patients admitted to our in-patient hospice facility prior to implementation of this algorithm, to an ongoing data analysis of current patients with the same primary diagnosis. tom burden, may reveal underlying unmet supportive needs, and therefore be a patient-centered trigger for palliative care referral.