Role of Palliative Care in the Outpatient Management of the Chronic Heart Failure Patient
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Purpose of Review
Patients with heart failure (HF) have an increased symptom burden and complex psychosocial and decision-making needs that necessitate the integration of palliative care. However, in the current era, palliative care is frequently evoked for these patients only at the end-of-life or in the inpatient setting; rarely is palliative care proactively utilized in outpatients with HF. The purpose of this review is to evaluate the current state of palliative care and heart failure and to provide a roadmap for the integration of palliative care into outpatient HF care.
Recent studies, including PAL-HF, CASA, and SWAP-HF, have demonstrated that structured palliative care interventions may improve quality of life, depression, anxiety, understanding of prognosis, and well-being in HF.
HF is associated with high mortality risk, significant symptom burden, and impaired quality of life. Palliative care can meet many of these needs; however, in the current era, palliative care consultations in HF occur late in the disease course and too often in the inpatient setting. Primary palliative care should be provided to all outpatients with heart failure based on their needs, with referral to secondary palliative care provided based on certain triggers and milestones.
KeywordsHeart failure Palliative care Outpatient Clinic Symptoms
Compliance with Ethical Standards
Conflicts of Interest
Dr. Desai reports personal fees from Abbott, grants and personal fees from Alnylam, grants and personal fees from AstraZeneca, personal fees from Boston Scientific, personal fees from Boehringer Ingelheim, grants and personal fees from Biofourmis, personal fees from DalCor Pharma, grants and personal fees from Novartis, personal fees from Relypsa, and personal fees from Regeneron, outside the submitted work.
Human and Animal rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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