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Deaths from heart failure in general practice: implications for palliative care
A Seamark David1, Ryan Mary, Smallwood Neil
1Honiton Group Practice, Honiton, Devon, UK. d.seamark@gp-183002.nhs.uk
Palliative Medicine
|December 6, 2002
Summary
This study found that symptomatic heart failure patients in general practice had lower mortality than expected. Specialist palliative care may be limited by prognosis prediction difficulties.
Area of Science:
- Cardiology
- Palliative Care
- General Practice Research
Background:
- Observational studies suggest high mortality and potential for specialist palliative care in heart failure patients.
- General practice data is crucial for understanding heart failure patient outcomes and care needs.
Purpose of the Study:
- To determine the prevalence of symptomatic heart failure in a general practice population.
- To document mortality rates at 6 and 12 months within this cohort.
- To identify the subset of patients receiving a palliative care approach.
Main Methods:
- Community-based observational study conducted in two general practices (21,000 population).
- Computerized medical record review to identify patients with symptomatic heart failure.
- Analysis of mortality data and recorded palliative care interventions over 6 and 12 months.
Main Results:
- Identified 548 patients (2.6%) with symptomatic heart failure.
- Recorded 6% mortality at 6 months and 12% at 12 months.
- Palliative care was documented in 33% of deaths, excluding sudden deaths or those from malignancy.
Conclusions:
- Symptomatic heart failure in general practice does not appear to have a universally high mortality rate.
- Prognostic uncertainty limits the role of specialist palliative care for many heart failure patients.
- General practitioners demonstrate awareness of palliative care needs for heart failure patients nearing end-of-life.