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Current Heart Failure Reports

Erschienen in:

02.09.2020 | Ethics / Palliative Care (S Fedson, Section Editor)

Rethinking the Meaning of Palliation in Heart Failure

verfasst von: Savitri Fedson

Erschienen in: Current Heart Failure Reports | Ausgabe 5/2020

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Abstract

Purpose of Review

Palliative care follows a philosophy of care that focuses upon the quality of life in patients with chronic or life-threatening illness. It also focuses upon the needs of their families which is a wider scope of care. Cardiovascular disease, and specifically heart failure, affects millions of patients and family members who have a symptom burden that exceeds that of many cancers and other chronic diseases.

Recently Findings

Historically palliative care has been viewed as an alternative to curative therapies, but over time, it is now recognized that it should be implemented earlier in the course of chronic diseases. Although non-oncologic patients now comprise over half of the patient seen by palliative care, patients with cardiovascular disease are still not being referred to palliative care.

Summary

Palliative care goes beyond advance directives and end of life planning. There is a need to continue to expand the view of palliative care to encompass interventions that help improve the overall health of these patients, including their psychosocial well-being and quality of life. The collection of papers in this journal provides insight into the breadth of palliative care for patients with heart failure and other cardiovascular diseases.

Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics-2019 update: a report from the American Heart Association. Circulation. 2019;139(10):e56–e528. https://doi.org/10.1161/CIR.0000000000000659.CrossRefPubMed

Ladwig KH, Baumert J, Marten-Mittag B, Kolb C, Zrenner B, Schmitt C. Posttraumatic stress symptoms and predicted mortality in patients with implantable cardioverter-defibrillators: results from the prospective living with an implanted cardioverter-defibrillator study. Arch Gen Psychiatry. 2008;65(11):1324–30. https://doi.org/10.1001/archpsyc.65.11.1324.CrossRefPubMed

Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol. 2006;48(8):1527–37. https://doi.org/10.1016/j.jacc.2006.06.055.CrossRefPubMed

Organization WH. WHO Palliative care. https://www.who.int/cancer/palliative/definition/en/. Accessed 1 Mar 2020.

Sullivan MF, Kirkpatrick JN. Palliative cardiovascular care: the right patient at the right time. Clin Cardiol. 2019. https://doi.org/10.1002/clc.23307.

Xie K, Gelfman L, Horton JR, Goldstein NE. State of research on palliative care in heart failure as evidenced by published literature, Conference Proceedings, and NIH Funding. J Card Fail. 2017;23(2):197–200. https://doi.org/10.1016/j.cardfail.2016.10.013.CrossRefPubMed

Rogers JG, Patel CB, Mentz RJ, Granger BB, Steinhauser KE, Fiuzat M, et al. Palliative care in heart failure: the PAL-HF randomized, controlled clinical trial. J Am Coll Cardiol. 2017;70(3):331–41. https://doi.org/10.1016/j.jacc.2017.05.030.CrossRefPubMedPubMedCentral

Bekelman DB, Allen LA, McBryde CF, Hattler B, Fairclough DL, Havranek EP, et al. Effect of a collaborative care intervention vs usual care on health status of patients with chronic heart failure: the CASA randomized clinical trial. JAMA Intern Med. 2018;178(4):511–9. https://doi.org/10.1001/jamainternmed.2017.8667.CrossRefPubMedPubMedCentral

Hopp FP, Zalenski RJ, Waselewsky D, Burn J, Camp J, Welch RD, et al. Results of a hospital-based palliative care intervention for patients with an acute exacerbation of chronic heart failure. J Card Fail. 2016;22(12):1033–6. https://doi.org/10.1016/j.cardfail.2016.04.004.CrossRefPubMed

10.

Sidebottom AC, Jorgenson A, Richards H, Kirven J, Sillah A. Inpatient palliative care for patients with acute heart failure: outcomes from a randomized trial. J Palliat Med. 2015;18(2):134–42. https://doi.org/10.1089/jpm.2014.0192.CrossRefPubMed

11.

Brannstrom M, Boman K. Effects of person-centred and integrated chronic heart failure and palliative home care. PREFER: a randomized controlled study. Eur J Heart Fail. 2014;16(10):1142–51. https://doi.org/10.1002/ejhf.151.CrossRefPubMed

12.

Wong FK, Ng AY, Lee PH, Lam PT, Ng JS, Ng NH, et al. Effects of a transitional palliative care model on patients with end-stage heart failure: a randomised controlled trial. Heart. 2016;102(14):1100–8. https://doi.org/10.1136/heartjnl-2015-308638.CrossRefPubMed

13.

Bakitas M, Dionne-Odom JN, Pamboukian SV, Tallaj J, Kvale E, Swetz KM, et al. Engaging patients and families to create a feasible clinical trial integrating palliative and heart failure care: results of the ENABLE CHF-PC pilot clinical trial. BMC Palliat Care. 2017;16(1):45. https://doi.org/10.1186/s12904-017-0226-8.CrossRefPubMedPubMedCentral

14.

• Lewin WH, Cheung W, Horvath AN, Haberman S, Patel A, Sullivan D. Supportive cardiology: moving palliative care upstream for patients living with advanced heart failure. J Palliat Med. 2017;20(10):1112–9. https://doi.org/10.1089/jpm.2016.0317. This study describes how the integration of palliative care with inpatient heart failure rounds can improve patient centered care and normalize the end of life discussion.

15.

Allen LA, Stevenson LW, Grady KL, Goldstein NE, Matlock DD, Arnold RM, et al. Decision making in advanced heart failure: a scientific statement from the American Heart Association. Circulation. 2012;125(15):1928–52. https://doi.org/10.1161/CIR.0b013e31824f2173.CrossRefPubMedPubMedCentral

16.

Braun LT, Grady KL, Kutner JS, Adler E, Berlinger N, Boss R, et al. Palliative care and cardiovascular disease and stroke: a policy statement from the American Heart Association/American Stroke Association. Circulation. 2016;134(11):e198–225. https://doi.org/10.1161/CIR.0000000000000438.CrossRefPubMed

17.

Jaarsma T, Beattie JM, Ryder M, Rutten FH, McDonagh T, Mohacsi P, et al. Palliative care in heart failure: a position statement from the palliative care workshop of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2009;11(5):433–43. https://doi.org/10.1093/eurjhf/hfp041.CrossRefPubMed

18.

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Colvin MM, et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Am Coll Cardiol. 2017;70(6):776–803. https://doi.org/10.1016/j.jacc.2017.04.025.CrossRefPubMed

19.

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18(8):891–975. https://doi.org/10.1002/ejhf.592.CrossRefPubMed

20.

Crespo-Leiro MG, Metra M, Lund LH, Milicic D, Costanzo MR, Filippatos G, et al. Advanced heart failure: a position statement of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2018;20(11):1505–35. https://doi.org/10.1002/ejhf.1236.CrossRefPubMed

21.

Lampert R, Hayes DL, Annas GJ, Farley MA, Goldstein NE, Hamilton RM, et al. HRS expert consensus statement on the management of cardiovascular implantable electronic devices (CIEDs) in patients nearing end of life or requesting withdrawal of therapy. Heart Rhythm. 2010;7(7):1008–26. https://doi.org/10.1016/j.hrthm.2010.04.033.CrossRefPubMed

22.

Cagle JG, Bunting M, Kelemen A, Lee J, Terry D, Harris R. Psychosocial needs and interventions for heart failure patients and families receiving palliative care support: a systematic review. Heart Fail Rev. 2017;22(5):565–80. https://doi.org/10.1007/s10741-017-9596-5.CrossRefPubMed

23.

Riley JP, Beattie JM. Palliative care in heart failure: facts and numbers. ESC Heart Fail. 2017;4(2):81–7. https://doi.org/10.1002/ehf2.12125.CrossRefPubMed

24.

Singh GK, Davidson PM, Macdonald PS, Newton PJ. The use of hospital-based services by heart failure patients in the last year of life: a discussion paper. Heart Fail Rev. 2019;24(2):199–207. https://doi.org/10.1007/s10741-018-9751-7.CrossRefPubMed

25.

Gadoud A, Kane E, Macleod U, Ansell P, Oliver S, Johnson M. Palliative care among heart failure patients in primary care: a comparison to cancer patients using English family practice data. PLoS One. 2014;9(11):e113188. https://doi.org/10.1371/journal.pone.0113188.CrossRefPubMedPubMedCentral

26.

Feder SL, Redeker NS, Jeon S, Schulman-Green D, Womack JA, Tate JP, et al. Validation of the ICD-9 diagnostic code for palliative care in patients hospitalized with heart failure within the Veterans Health Administration. Am J Hosp Palliat Care. 2018;35(7):959–65. https://doi.org/10.1177/1049909117747519.CrossRefPubMed

27.

• Kavalieratos D, Gelfman LP, Tycon LE, Riegel B, Bekelman DB, Ikejiani DZ, et al. Palliative care in heart failure: rationale, evidence, and future priorities. J Am Coll Cardiol. 2017;70(15):1919–30. https://doi.org/10.1016/j.jacc.2017.08.036. This provides a comprehensive review of palliative care studies, and provides useful examples of the differences between primary and specialty palliative care.

28.

Kostick KM, Minard CG, Wilhelms LA, Delgado E, Abraham M, Bruce CR, et al. Development and validation of a patient-centered knowledge scale for left ventricular assist device placement. J Heart Lung Transplant. 2016;35(6):768–76. https://doi.org/10.1016/j.healun.2016.01.015.CrossRefPubMedPubMedCentral

29.

Allen LA, McIlvennan CK, Thompson JS, Dunlay SM, LaRue SJ, Lewis EF, et al. Effectiveness of an intervention supporting shared decision making for destination therapy left ventricular assist device: the DECIDE-LVAD randomized clinical trial. JAMA Intern Med. 2018;178(4):520–9. https://doi.org/10.1001/jamainternmed.2017.8713.CrossRefPubMedPubMedCentral

30.

Blumenthal-Barby JS, Cantor SB, Russell HV, Naik AD, Volk RJ. Decision aids: when ‘nudging’ patients to make a particular choice is more ethical than balanced, nondirective content. Health Aff (Millwood). 2013;32(2):303–10. https://doi.org/10.1377/hlthaff.2012.0761.CrossRef

31.

Talk V. https://www.vitaltalk.org. Accessed 1 Mar 2020.

32.

Project C. https://theconversationproject.org. Accessed 1 Mar 2020.

33.

Wishes. https://fivewishes.org. Accessed 1 Mar 2020.

34.

Ghashghaei R, Yousefzai R, Adler E. Palliative care in heart failure. Prog Cardiovasc Dis. 2016;58(4):455–60. https://doi.org/10.1016/j.pcad.2016.01.002.CrossRefPubMed

35.

Gelfman LP, Kavalieratos D, Teuteberg WG, Lala A, Goldstein NE. Primary palliative care for heart failure: what is it? How do we implement it? Heart Fail Rev. 2017;22(5):611–20. https://doi.org/10.1007/s10741-017-9604-9.CrossRefPubMedPubMedCentral

36.

Gryschek G, Machado DA, Otuyama LJ, Goodwin C, Lima MCP. Spiritual coping and psychological symptoms as the end approaches: a closer look on ambulatory palliative care patients. Psychol Health Med. 2019:1–8. https://doi.org/10.1080/13548506.2019.1640887.

37.

•• Straw S, Byrom R, Gierula J, Paton MF, Koshy A, Cubbon R, et al. Predicting one-year mortality in heart failure using the ‘Surprise Question’: a prospective pilot study. Eur J Heart Fail. 2019;21(2):227–34. https://doi.org/10.1002/ejhf.1353. This study shows how adoption of a simple question about prognosis can be useful in predicting patients nearing end of life, and how this can help guide decision making and patient preference centered care.

38.

McIlfatrick S, Doherty LC, Murphy M, Dixon L, Donnelly P, McDonald K, et al. ‘The importance of planning for the future’: Burden and unmet needs of caregivers’ in advanced heart failure: a mixed methods study. Palliat Med. 2018;32(4):881–90. https://doi.org/10.1177/0269216317743958.CrossRefPubMed

39.

Heidenreich PA, Spertus JA, Jones PG, Weintraub WS, Rumsfeld JS, Rathore SS, et al. Health status identifies heart failure outpatients at risk for hospitalization or death. J Am Coll Cardiol. 2006;47(4):752–6. https://doi.org/10.1016/j.jacc.2005.11.021.CrossRefPubMed

40.

Flint KM, Schmiege SJ, Allen LA, Fendler TJ, Rumsfeld J, Bekelman D. Health status trajectories among outpatients with heart failure. J Pain Symptom Manag. 2017;53(2):224–31. https://doi.org/10.1016/j.jpainsymman.2016.08.018.CrossRef

41.

Flint KM, Matlock DD, Lindenfeld J, Allen LA. Frailty and the selection of patients for destination therapy left ventricular assist device. Circ Heart Fail. 2012;5(2):286–93. https://doi.org/10.1161/CIRCHEARTFAILURE.111.963215.CrossRefPubMed

42.

Graffagnino JP, Avant LC, Calkins BC, Swetz KM. Home Therapies in Advanced Heart Failure: Inotropes and Diuretics. Curr Heart Fail Rep. 2020;17. https://doi.org/10.1007/s11897-020-00482-y.

43.

Pak ES, Jones CA, Mather PJ. Ethical Challenges in Care of Patients on Mechanical Circulatory Support at End-of-Life. Curr Heart Fail Rep. 2020;17:153–160. https://doi.org/10.1007/s11897-020-00460-4.

44.

Epstein E, Rosander A, Pazargadi A. et al. Cardiac Rehab for Functional Improvement. Curr Heart Fail Rep. 2020;17:161–170. https://doi.org/10.1007/s11897-020-00462-2.

Titel: Rethinking the Meaning of Palliation in Heart Failure
verfasst von: Savitri Fedson
Publikationsdatum: 02.09.2020
Verlag: Springer US
Erschienen in: Current Heart Failure Reports / Ausgabe 5/2020
Print ISSN: 1546-9530
Elektronische ISSN: 1546-9549
DOI: https://doi.org/10.1007/s11897-020-00483-x

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Rethinking the Meaning of Palliation in Heart Failure

Abstract

Purpose of Review

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Summary

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