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Supportive Cardiology: Moving Palliative Care Upstream for Patients Living with Advanced Heart Failure

Warren Harris Lewin1, Wendy Cheung2, A Nina Horvath3,4

  • 11 Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai , New York, New York.

Journal of Palliative Medicine
|May 5, 2017
PubMed

Insights

Integrating palliative care (PC) into heart failure (HF) teams improved patient and family experiences. This model offers timely advance care planning and supports individuals with advanced HF nearing end of life (EOL).

Area of Science:

  • Cardiology
  • Palliative Care
  • Health Services Research

Background:

  • Heart failure (HF) is a chronic, life-limiting illness affecting many Canadians, often leading to distressing symptoms and emergency department visits.
  • Patients with advanced HF face challenges accessing palliative care (PC) and end-of-life (EOL) resources due to unpredictable illness trajectories and limited research on identifying EOL.
  • Palliative care optimizes quality of life through symptom management and ensures care aligns with patient and family preferences.

Purpose of the Study:

  • To evaluate the impact of embedding a palliative care team within an existing heart failure team.
  • To assess patient and family feedback on integrated PC delivery for advanced HF.
  • To explore potential patient, family, and system outcomes of this integrated model.

Main Methods:

  • An embedded model of palliative care delivery was integrated into a heart failure team.
  • Patient and family feedback was collected regarding the integrated care experience.
  • Potential patient, family, and system outcomes were analyzed.

Main Results:

  • The integrated model of PC delivery for advanced HF patients received overwhelmingly positive feedback from patients and families.
  • Timely advance care planning discussions were facilitated through the integrated PC team.
  • The model showed potential for beneficial patient, family, and system outcomes.

Conclusions:

  • Embedding PC within HF teams is a patient and family-centered approach for advanced HF care.
  • This model can inform public policy and offers a cost-effective strategy for managing advanced HF and EOL needs.
  • Improved access to PC supports timely advance care planning and enhances quality of life for individuals with advanced HF.

Keywords:
heart failurepalliative caresupportive cardiology

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