Palliative care in cardiopulmonary transplantation

McKenna, Maria K.; Clark, Stephen

doi:10.1136/bmjspcare-2014-000769

Cited by 14 publications

(6 citation statements)

References 36 publications

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“…92,93 Palliative care is relevant for patients being considered for HT because these patients have needs for advance care planning and are likely to have needs for symptom palliation and family support.…”

Section: Ht and Palliative Carementioning

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

199

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: Ht and Palliative Carementioning

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

199

143

View full text Add to dashboard Cite

show abstract

“…Patients requiring transplant have advanced illness and may have unmet palliative care needs [99][100][101] . While specific data sources for many of the diseases listed in Table 1 are not available in Ireland, data from the national transplant services (cardiopulmonary, liver and renal diseases) has been linked to cancer registry data 60 and could be used to identify cohorts of patients with palliative care needs.…”

Section: Discussionmentioning

confidence: 99%

Using administrative health data for palliative and end of life care research in Ireland: potential and challenges

2021

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Background: This study aims to examine the potential of currently available administrative health and social care data for palliative and end-of-life care (PEoLC) research in Ireland. Objectives include to i) identify data sources for PEoLC research ii) describe the challenges and opportunities of using these and iii) evaluate the impact of recent health system reforms and changes to data protection laws. Methods: The 2017 Health Information and Quality Authority catalogue of health and social care datasets was cross-referenced with a recognised list of diseases with associated palliative care needs. Criteria to assess the datasets included population coverage, data collected, data dictionary and data model availability, and mechanisms for data access. Results: Nine datasets with potential for PEoLC research were identified, including death certificate data, hospital episode data, pharmacy claims data, one national survey, four disease registries (cancer, cystic fibrosis, motor neurone and interstitial lung disease) and a national renal transplant registry. The ad hoc development of the health system in Ireland has resulted in i) a fragmented information infrastructure resulting in gaps in data collections particularly in the primary and community care sector where much palliative care is delivered, ii) ill-defined data governance arrangements across service providers, many of whom are not part of the publically funded health service and iii) systemic and temporal issues that affect data quality. Initiatives to improve data collections include introduction of i) patient unique identifiers, ii) health entity identifiers and iii) integration of the Eircode postcodes. Recently enacted general data protection and health research regulations will clarify legal and ethical requirements for data use. Conclusions: Ongoing reform initiatives and recent changes to data privacy laws combined with detailed knowledge of the datasets, appropriate permissions, and good study design will facilitate future use of administrative health and social care data for PEoLC research in Ireland.

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“…Some authors have suggested that the point in the disease trajectory when providers are discussing lung transplant is an ideal time to also discuss palliative care integration. 31,32 Standards have been established in other groups of seriously ill patients who are referred for life-sustaining or curative therapies; for example, patients receiving ventricular assist devices for heart failure must be managed by a multidisciplinary team that includes a palliative care specialist. 33 Recent clinical practice guidelines by the American Society of Clinical Oncology also recommend that palliative care be provided concurrently with curative treatments for oncology patients.…”

Section: Discussionmentioning

confidence: 99%

An Integrative Review of the Role of Palliative Care in Lung Transplantation

et al. 2020

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Background: Lung transplant patients experience significant physical symptoms and psychological stress that affect their quality of life. Palliative care is an interdisciplinary specialty associated with improved symptom management and enhanced quality of life. Little, however, is known about the palliative care needs of lung transplant patients and the role it plays in their care. Aim: The aim of this integrative review was to synthesize the literature describing the palliative care needs, the current role, and factors influencing the integration of palliative care in the care of lung transplant patients. Design/Data Sources: We searched PubMed, Scopus, CINAHL, and Embase to identify English-language, primary studies focused on palliative care in adult lung transplantation. Study quality was evaluated using Strengthening the Report of Observational studies in Epidemiology and Consolidated Criteria for Reporting Qualitative Research criteria. Results: Seven articles were included in the review. Most were single-center, descriptive studies. Two studies used qualitative and 5 used quantitative methodologies. Collectively, these studies suggest that palliative care is typically consulted for physical and psychological symptom management, although consultation is uncommon and often occurs late in the lung transplant process. We found no studies that systematically assessed palliative needs. Misperceptions about palliative care, communication challenges, and unrealistic patient/family expectations are identified barriers to the integration. While limited, evidence suggests that palliative care can be successfully integrated into lung transplant patient management. Conclusions: Empirical literature about palliative care in lung transplantation is sparse. Further research is needed to define the needs and opportunities for integration into the care of these patients.

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Palliative care in cardiopulmonary transplantation

Cited by 14 publications

References 36 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

Using administrative health data for palliative and end of life care research in Ireland: potential and challenges

An Integrative Review of the Role of Palliative Care in Lung Transplantation

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