Palliative Care in Heart Failure: Rationale, Evidence, and Future Priorities

J Am Coll Cardiol. 2017 Oct 10;70(15):1919-1930. doi: 10.1016/j.jacc.2017.08.036.

Abstract

Patients with heart failure (HF) and their families experience stress and suffering from a variety of sources over the course of the HF experience. Palliative care is an interdisciplinary service and an overall approach to care that improves quality of life and alleviates suffering for those living with serious illness, regardless of prognosis. In this review, we synthesize the evidence from randomized clinical trials of palliative care interventions in HF. While the evidence base for palliative care in HF is promising, it is still in its infancy and requires additional high-quality, methodologically sound studies to clearly elucidate the role of palliative care for patients and families living with the burdens of HF. Yet, an increase in attention to primary palliative care (e.g., basic physical and emotional symptom management, advance care planning), provided by primary care and cardiology clinicians, may be a vehicle to address unmet palliative needs earlier and throughout the illness course.

Keywords: heart failure; hospice; palliative care; quality of care; quality of life.

Publication types

  • Review

MeSH terms

  • Disease Progression
  • Family Health*
  • Heart Failure* / physiopathology
  • Heart Failure* / psychology
  • Heart Failure* / therapy
  • Humans
  • Palliative Care* / methods
  • Palliative Care* / organization & administration
  • Palliative Care* / psychology
  • Palliative Care* / trends
  • Patient Care Team / organization & administration
  • Patient Comfort*
  • Quality of Life*
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index