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Current Heart Failure Reports
Published in: Current Heart Failure Reports 5/2017

01-10-2017 | Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise (A Hasan, Section Editor)

Cardiac Palliative Medicine

Author: Todd Barrett

Published in: Current Heart Failure Reports | Issue 5/2017

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Abstract

Purpose of Review

Heart failure is an illness with high morbidity and mortality that affects 5.7 million Americans. As advanced heart therapies become more prevalent care for patients and families is becoming more complex. The American Heart Association has released a policy statement recommending continuous, high-quality access to palliative care for all patients with heart failure, and the Center for Medicare Services requires palliative care involvement in mechanical circulatory support teams.

Recent Findings

The National Quality Forum developed eight domains of palliative care that are required for high-quality delivery of comprehensive palliative care. This article assesses each domain and how it pertains to evolving care of patients with advanced heart failure.

Summary

Leadership from heart failure teams should review the domains of palliative care to ensure they are improving primary palliative care skills as well as identifying areas needed to improve funding so that patients have access to comprehensive specialty level palliative care.
Literature
1.
2.
•• Solano JP, Gomes B, Higgson IJ. A comparison of symptom prevalence in far advaced cancer AIDS, heart disease, chronic obstructive pulmonary disease, and renal disease. J Pain Symptom Manag. 2006;31:58–69. Summary of heart failure symptoms as it relates to other terminal illnesses. CrossRef
3.
• Braun LT, et al. Palliative care and cardiovascular disease and stroke: a policy statement from the American Heart Association/American Stroke Association. Circulation. 2016;134(11):e198–225. New policy statement by the American Heart Association that all heart failure programs should be familiar with. CrossRefPubMed
4.
•• National Consensus Project for Quality Palliative Care. Clinical practice guideline for quality palliative care. Pittsburgh PA: National Consensus Project for Quality Palliative Care; 2013. Pivotal paper in palliative care. This sets out the domains of palliative care that are used in measuring high-quality palliative care and providing palliative care education
5.
• Nipp RD, et al. Coping and prognostic awareness in patients with advanced cancer. J Clin Oncol. 2017;35(22):2551–7. doi:10.​1200/​JCO.​2016.​71.​3404. Fear of taking away hope is a barrier to advance care planning. This paper explores the role of prognostic awareness in quality of life and that it can be improved with active coping. CrossRefPubMed
6.
• Pizzo PA, Walker DM, et al. In: Briere R, editor. Dying in America. Washington D.C.: Institute of Medicine; 2015. Pivitol report by the Institute of Medicine on Dying in America. It addresses some of the major barriers to high-quality end of life care in America and summarizes the current landscape of end of life in modern medicine.
7.
•• Lund S, Richardson A, May C. Barriers to advance care planning at the end of life: an explanatory systematic review of implementation studies. PLoS One. 2015;10(2):e0116629. There are many percieved barriers to advance care planning. This review article is an excellent summary fo the barriers. CrossRefPubMedPubMedCentral
8.
• Ho KK, et al. Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation. 1993;88(1):107–15. Early important study for prognosis in heart failure. CrossRefPubMed
9.
• McMurray JJ, et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371(11):993–1004. Recent important paper for survival in heart failure stating recent mortality data and improvement with Entresto. CrossRefPubMed
10.
• Akoudad S, et al. Comparison of multivariate risk estimation models to predict prognosis in patients with implantable cardioverter defibrillators with or without cardiac resynchronization therapy. Am J Cardiol. 2017;119(9):1414–20. This paper is a key article discussing survival benefit with cardiac resynchronization therapy. CrossRefPubMed
11.
Rose EA, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001;345(20):1435–43.CrossRefPubMed
12.
•• Goodlin SJ. Palliative care in congestive heart failure. J Am Coll Cardiol. 2009;54(5):386–96. Pivotal review article for palliative care in heart failure The graph of trajectory of illness is widely used and replicated. CrossRefPubMed
13.
• Levy WC, et al. The Seattle heart failure model. Prediction Surviv Heart Fail. 2006;113(11):1424–33. Important article for heart failure prognostication. Seattle Heart Failure model is widely used, and this is the key paper summarizing it’s development.
14.
• Lanfear DE, et al. Accuracy of Seattle heart failure model and HeartMate II risk score in non-inotrope-dependent advanced heart failure patients: insights from the ROADMAP study (risk assessment and comparative effectiveness of left ventricular assist device and medical management in ambulatory heart failure patients). Circ Heart Fail. 2017;10(5):1747–61. This is an update looking at the use of the Seattle Heart Failure model showing that in non-inotrope dependent patients in underestimates clinical worsening CrossRef
15.
•• Sudore RL, et al. Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. J Pain Symptom Manag. 2017;53(5):821–832.e1. There has been a lack of common definition of advance care planning, and this consensus project helped crease a definition for the process and will be widely used in research. CrossRef
16.
17.
• Swetz KM, et al. Preparedness planning before mechanical circulatory support: a “how-to” guide for palliative medicine clinicians. J Pain Symptom Manag. 2014;47(5):926–935.e6. Pivital article in cardiac palliative care discussing the method of advance care planning prior to LVAD placment. CrossRef
18.
• Mahler DA. Opioids for refractory dyspnea. Expert Rev Respir Med. 2013;7(2):123–34. quiz 135.Paper outlines the mechanism of action of opioids for dyspnea CrossRefPubMed
19.
•• Dawson NL, et al. Opioid use in patients with congestive heart failure. Pain Med. 2017;0:1–6. The use of opioids are often avoided in patients with heart failure due to fear of worsening their condition. This paper shows no increased mortality or 30-day readmission which is important in current payment bundles in heart failure
20.
• Schwartzstein RM, et al. Cold facial stimulation reduces breathlessness induced in normal subjects. Am Rev Respir Dis. 1987;136(1):58–61. Many providers continue to use oxygen for dyspnea, but this dated article shows that cool air flow stimulation of the trigeminal nerve is an essential tool for dyspnea treatment. CrossRefPubMed
21.
•• Goodlin SJ, et al. How painful is advanced heart failure? Results from PAIN-HF. J Card Fail. 14(6):S106. Pain is a severe comorbid condition in heart failure. This is one of the only articles looking at its incidence
22.
• Papathanasiou J, et al. The effect of group-based cardiac rehabilitation models on the quality of life and exercise capacity of patients with chronic heart failure. Hell J Cardiol. 2017;1–4. Many articles exist looking at the role of cardiac rehab. This is a recent article that shows group-based cardiac rehab models are effective at improving quality of life in heart failure.
23.
• Kerrigan DJ, et al. Cardiac rehabilitation improves functional capacity and patient-reported health status in patients with continuous-flow left ventricular assist devices: the rehab-VAD randomized controlled trial. JACC Heart Fail. 2014;2(6):653–9. It has been long established that cardaic rehab is effective in heart failure, and this paper extends its benefit into mechanical circulatory support. CrossRefPubMed
24.
• Rutledge T, et al. Depression in heart failure. J Am Coll Cardiol. 2006;48(8):1527–37. Pivotal paper in the discussion of depression and heart failure. CrossRefPubMed
25.
• Sommerfeld A, et al. Obstructive sleep apnea is associated with increased readmission in heart failure patients. Clin Cardiol. 2017;1–6. Important paper discussing the recognition of sleep apnea as an important factor related to readmission in heart failure.
26.
• Lyons OD, et al. Design of the effect of adaptive servo-ventilation on survival and cardiovascular hospital admissions in patients with heart failure and sleep apnoea: the ADVENT-HF trial. Eur J Heart Fail. 2017;19(4):579–87. Paper discussing a large multi-center, multi-national trial for treament of sleep-disordered breathing in heart failure. Its results may have significant impact on how we care for patients with heart failure. CrossRefPubMed
27.
• Chung ML, et al. Predictors of depressive symptoms in caregivers of patients with heart failure. J Cardiovasc Nurs. 2010;25(5):411–9. Key article looking at morbidity in care givers specific to heart failure. CrossRefPubMedPubMedCentral
28.
• Wingham J, et al. Needs of caregivers in heart failure management: a qualitative study. Chronic Illness. 2015;11(4):304–19. Excellent qualitative assessment of caregiver need and illustrates the need to invovle caregivers in all aspect of self-care education in patients. CrossRefPubMedPubMedCentral
29.
• Clark AM, et al. Determinants of effective heart failure self-care: a systematic review of patients’ and caregivers’ perceptions. Heart. 2014;100(9):716–21. Linked with article 28 as evidence for need for inclusion of caregivers in eduction and advance care planning. CrossRefPubMed
30.
31.
• Robinson MR, et al. Efficacy of training interprofessional spiritual care generalists. J Palliat Med. 2016;19(8):814–21. Trial showing that spiritual generalist training is effective and has a lasting effect. CrossRefPubMed
32.
•• Medicine, A.A.o.H.a.P., Measuring what matters. American Academy of Hospice and Palliative Medicine. Web. 2017. Key recommendation statement from the American Academy of Hospice and Palliative Medicine stating the 10 evidence based quality guidelines in palliative medicine.
33.
• Yim CK, et al. Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization clinical perspective. Circ Heart Fail. 2017;10(3):e003335. This article is a recent assessment of hospice utilization in heart failure and shows the potential need for improved models of care to improve access to hospice care for patients with heart failure CrossRefPubMed
34.
A definition of irreversible coma. Report of the ad hoc committee of the harvard medical school to examine the definition of brain death. JAMA. 1968;205(6):337–340.
Metadata
Title
Cardiac Palliative Medicine
Author
Todd Barrett
Publication date
01-10-2017
Publisher
Springer US
Published in
Current Heart Failure Reports / Issue 5/2017
Print ISSN: 1546-9530
Electronic ISSN: 1546-9549
DOI
https://doi.org/10.1007/s11897-017-0357-5

Other articles of this Issue 5/2017

Current Heart Failure Reports 5/2017 Go to the issue

Decompensated Heart Failure (P Banerjee, Section Editor)

Inpatient Monitoring of Decompensated Heart Failure: What Is Needed?

Management of Heart Failure (T Meyer, Section Editor)

Diagnosis and Management of Heart Failure in Long-Term Dialysis Patients

Erratum

Erratum to: Updates in Cardiac Resynchronization Therapy for Chronic Heart Failure: Review of Multisite Pacing

Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise (A Hasan, Section Editor)

Updates in Cardiac Resynchronization Therapy for Chronic Heart Failure: Review of Multisite Pacing

Decompensated Heart Failure (P Banerjee, Section Editor)

Acute Heart Failure: Definition, Classification and Epidemiology

Management of Heart Failure (T Meyer, Section Editor)

Vitamin D and Heart Failure
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