Talking about palliative care in heart failure

Optimizing of a question prompt list to improve communication about the heart failure trajectory in patients, families, and health care professionals

“…Health care professionals working in HF care should openly discuss any issue related to the illness trajectory, including prognosis, symptom management, options and preferences for palliation and end-of-life care as well as deactivation of devices with patients and their families. By doing so, the professionals help them to be prepared to live with a life-limiting illness and for the last phase of life [ 4 , 5 ]. However, this open approach to communication about the HF trajectory is not widely implemented in clinical practice.…”

Figures of the Heart Failure Association (HFA): Prof. Dr. Tiny Jaarsma, HFA Board Member (2018–2020), Coordinator Patient Care: Management and Delivery Committee and Co‐Chair HFA Task Force on Palliative Care

“…Currently she is the principal investigator of the ‘HF‐WII’ study, a randomized clinical trial on the effect of exergaming to increase physical activity in patients with heart failure. Her other research is aimed at improving communication between health care providers and patients regarding end‐of‐life issues (TALK‐HF) …”

“…Her other research is aimed at improving communication between health care providers and patients regarding end-of-life issues (TALK-HF). 6 Tiny is a fellow of the ESC and HFA and also of the American Heart Association (AHA), the American Academy of Nursing (AAN) and the European Academy of Nursing (EANS).…”

Guidelines: friend or foe? Opportunities for improvement of cardiovascular pharmacotherapy based on evidence from real-world observational data

“…It is therefore of utmost importance to diagnose and treat heart failure on the basis of all available evidence. In 1987 the Consensus trial 36 was published, which for the first time incontrovertibly demonstrated that the -at that time-poor outcome of patients with heart failure can be markedly improved with medical therapy. The first European guideline on the treatment of heart failure was published in 1997 37 , followed by revised guidelines in 2001 38 , 2005 39 , 2008 40 , 2012 41 and 2016.…”

“…However, despite this quite positive statement, there comes a time, when the palliative phase starts for a patient like John. In contrast to, for example oncology patients, patients with HF and their physician tend to maintain a too positive perspective on the nearby future [34][35][36]. The position statement of the Heart Failure Association onAdvanced Heart Failure focusses on what can and should be done for about 22 pages, while only the last short section is spent on palliative care and what should be refrained…”