Integration of a palliative approach into heart failure care: a European Society of Cardiology Heart Failure Association position paper

Abstract

The Heart Failure Association of the European Society of Cardiology has published a previous position paper and various guidelines over the past decade recognizing the value of palliative care for those affected by this burdensome condition. Integrating palliative care into evidence‐based heart failure management remains challenging for many professionals, as it includes the identification of palliative care needs, symptom control, adjustment of drug and device therapy, advance care planning, family and informal caregiver support, and trying to ensure a ‘good death’. This new position paper aims to provide day‐to‐day practical clinical guidance on these topics, supporting the coordinated provision of palliation strategies as goals of care fluctuate along the heart failure disease trajectory. The specific components of palliative care for symptom alleviation, spiritual and psychosocial support, and the appropriate modification of guideline‐directed treatment protocols, including drug deprescription and device deactivation, are described for the chronic, crisis and terminal phases of heart failure.

The year in cardiovascular medicine 2020: heart failure and cardiomyopathies

“…Praktični savjeti za ključne aktivnosti i prioritete opisani su u članku Europskog društva za zatajivanje srca (HFA). 149 Pri kraju kontinuuma bolesnika s HF-om, palijativnu bi brigu trebalo uvesti što prije, usredotočujući se na liječenje simptoma, 150 neovisno o prognozi, što se za sada u Europi malo primjenjuje. 151 Provođenje palijativne njege smanjuje broj hospitalizacija, no učinak na preživljenje nije toliko jasan.…”

Palliative key aspects are of importance for symptom relief during the last week of life in patients with heart failure

“…Palliative care knowledge also has to be adapted to the specific care needs of patients with HF. A recently published position paper from the Heart Failure Association of the European Society of Cardiology describes in detail the important role of symptom assessment and symptom management and an integrated approach of palliative and end‐of‐life care 22 . Thus, a palliative approach should both apply knowledge and adapt it to the uniqueness of disease profiles.…”

December 2020 at a glance: focus on COVID‐19, comorbidities and palliative care

“…Management of end‐stage HF needs to include palliative care 17,18 . A position paper provides day‐to‐day practical clinical guidance on palliation strategies 19 . Sahlollbey et al 20 .…”