Home Is Where the Heart Is: The Impact of Home-Based Palliative Care on Patients with Advanced Heart Failure

There is growing interest in the effect that specialty palliative care (PC) has on outcomes for patients with advanced heart failure (HF). Some evidence suggests that PC may improve quality of life, understanding of prognosis, and documentation of treatment preferences but that it does not affect hospitalization or mortality.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 317 Source Type: research

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Balloon aortic valvuloplasty (BAV) is indicated in patients with acute decompensated heart failure or cardiogenic shock secondary to severe aortic stenosis,1 either as palliative therapy for patients who are not candidates for valve replacement,2 or as a bridge to transcatheter (TAVR) or surgical aortic valve replacement (SAVR).1,3 Given the high morbidity and mortality associated with BAV, especially because it is performed not infrequently in critically ill patients, it is important to understand the effect of hospital procedural volume on outcomes following BAV.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Congestive heart failure is a leading cause of readmissions in the United States. Although treatment has come a long away, palliative care (PC) is often not appropriately offered in advanced heart failure. The purpose of this study was to use a large database of national in-patient sample to find out the penetrance of PC in acute heart failure admissions.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 140 Source Type: research
: Symptom burden, psychological morbidity and advance care planning needs remain high and often unmet among patients with heart failure (HF). Despite recommendations for the utilization of palliative care to address these burdens, palliative care remains greatly underutilized. Insufficient data exists regarding these patients ’ preferences and the perceived need for palliative care in patients with HF.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 378 Source Type: research
Introduction: Persons with heart failure (HF) suffer from distressing symptoms and quality of life (QOL) challenges that can be addressed by an individualized palliative care (PC) approach early and throughout the disease trajectory. However, of the 6.5 million Americans with HF,
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 350 Source Type: research
Palliative care can improve heart failure (HF) symptoms, however many HF patients lack access. Likewise, standard exercise programs can improve symptoms in HF patients, however participation rates are low due to poor access and patient-specific barriers, such as high symptom burden. Further, measurement of physical function at home is uncommon. It is unknown whether gentle exercise via remote live-video conferencing is feasible in patients with HF.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 255 Source Type: research
CONCLUSIONS: Very low- to low-quality evidence suggests that when compared to usual care, HSPC may offer small benefits for several person-centred outcomes including patient HRQoL, symptom burden and patient satisfaction with care, while also increasing the chances of patients dying in their preferred place (measured by home death). While we found no evidence that HSPC causes serious harms, the evidence was insufficient to draw strong conclusions. Although these are only small effect sizes, they may be clinically relevant at an advanced stage of disease with limited prognosis, and are person-centred outcomes important to m...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
AbstractIntravenous inotropic therapy can be used in patients with advanced heart failure, as palliative therapy or as a bridge to cardiac transplantation or mechanical circulatory support, as well as in cardiogenic shock. Their use is limited to increasing cardiac output in low cardiac output states and reducing ventricular filling pressures to alleviate patient symptoms and improve functional class. Many advanced heart failure patients have sinus tachycardia as a compensatory mechanism to maintain cardiac output. However, excessive sinus tachycardia caused by intravenous inotropes can increase myocardial oxygen consumpti...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
CONCLUSIONS: This qualitative study about the experiences and perceptions of family carers of people with a chronic life-limiting illness living at home regarding the collaboration with different healthcare providers in the last phase life, showed that family carers experience a lot of possibilities, but perceive missed opportunities as well, for healthcare professionals to effectively collaborate with them for palliative care. PMID: 32928056 [PubMed - as supplied by publisher]
Source: Palliative Medicine - Category: Palliative Care Authors: Tags: Palliat Med Source Type: research
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Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Position Paper Source Type: research
Hospice agencies serve an expanding population of patients with varying disease conditions and sociodemographic characteristics. Patients with heart failure represent a growing share of hospice deaths in the United States. However, limited research has explored the perspectives of hospice interdisciplinary team members regarding how patients with heart failure and their families navigate hospice care. We sought to address this research gap by conducting qualitative interviews with hospice interdisciplinary team members at a large, not-for-profit hospice agency in New York City (N = 32). Five overarching themes from these i...
Source: Journal of Hospice and Palliative Nursing - Category: Nursing Tags: Feature Articles Source Type: research
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