Primary palliative care for heart failure: what is it? How do we implement it?

Abstract

Heart Failure (HF) is a chronic and progressive illness, which affects a growing number of adults and is associated with a high morbidity and mortality, as well as significant physical and psychological symptom burden on both patients with HF and their families. Palliative care is the multidisciplinary specialty focused on optimizing quality of life and reducing suffering for patients and families facing serious illness, regardless of prognosis. Palliative care can be delivered as (1) specialist palliative care in which a palliative care specialist with subspecialty palliative care training consults or co-manages patients to address palliative needs alongside clinicians who manage the underlying illness or (2) as primary palliative care in which the primary clinician (such as the internist, cardiologist, cardiology nurse or HF specialist) caring for the patient with HF provides the essential palliative domains. In this paper, we describe the key domains of primary palliative care for patients with HF and offer some specific ways in which primary palliative care and specialist palliative care can be offered in this population. Although there is little research on HF primary palliative care, primary palliative care in HF offers a key opportunity to ensuring this population receives high quality palliative care in spite of the growing numbers of patients with HF as well as the limited number of specialist palliative care providers.

Palliative Care in a Death-Denying Culture: Exploring Barriers to Timely Palliative Efforts for Heart Failure Patients in the Primary Care Setting

“…Despite radical advances in cardiac therapy, heart failure (HF) remains a chronic, progressive, and incurable pandemic affecting an estimated 5.7 million people in the United States and 26 million people worldwide. [1][2][3][4] Troubling projections estimate that by 2030, over 8 million people in the United States will be diagnosed with HF, compounding its prevalence by an astounding 46% increase. 2 Throughout the course of illness, patients with HF will face dramatic functional limitations, physical and psychological high-symptom burden, and an uncertain clinical trajectory placing great demands on the patient, caregivers, clinicians, and health-care system at large.…”

Necesidad De Prácticas Cuidantes Culturalmente Congruentes: Personas Con Enfermedad Cardiovascular Al Final De La Vida

“…Están determinadas por la enfermedad que se sufre , son distintas si se está en la fase final de un cáncer, de una enfermedad neurodegenerativa o de un padecimiento cardiovascular (44). Actualmente las personas con enfermedad cardiovascular al final de la vida reciben menos cuidados paliativos, en relación a pacientes con enfermedad oncológica; sigue latente en el medio académico, científico y asistencial la necesidad de desarrollar conocimientos concretos para el cuidado de esta población específica, resultados similares a los de otros estudios abordados desde la medicina tales como el de Aguayo, Gelfman y Howlett et al (10,19,24).…”

Erythropoietin in the Evaluation of Treatment Outcomes in Patients with Polytrauma

“…It was observed that heart failure was the most common prior condition in our patients. Th is fact could be explained by heart failure being a complicated disease with high morbidity and mortality rates, affecting many physical and mental abilities of patients, thus making trauma common in this population 26 .…”