Skip to main content
Top
Published in: Heart Failure Reviews 2/2019

01-03-2019

The use of hospital-based services by heart failure patients in the last year of life: a discussion paper

Authors: Gursharan K. Singh, Patricia M. Davidson, Peter S. Macdonald, Phillip J. Newton

Published in: Heart Failure Reviews | Issue 2/2019

Login to get access

Abstract

Individuals with chronic heart failure have high utilisation of hospital-related services towards the end of life and receive treatments that provide symptom relief without improving life expectancy. The aim of this discussion paper is to determine chronic heart failure patients’ use of acute hospital-based services in their last year of life and to discuss the potential for palliative care to reduce service utilisation. A systematic search of the literature was conducted. Medline, Cumulative Index for Nursing and Allied Health (CINAHL) and SCOPUS databases were used to systematically search for literature from database commencement to September 2016. Specific inclusion criteria and search terms were used to identify relevant studies on heart failure patients’ use of hospital services in their last year of life. There were 12 studies that evaluated the use of hospital-based services by chronic heart failure patients at the end of life. In all studies, it was found that chronic heart failure patients used acute hospital-based services as death approached. However, only two studies examined if palliative care consultations were obtained by patients, and neither study assessed the impact that these consultations had on service utilisation in the last year of life. Heart failure negatively impacts health status, and this is a predictor of service utilisation. Further research is needed to determine the efficacy of both primary and secondary palliative care in reducing resource use towards the end of life and improving the quality of end of life care.
Literature
10.
go back to reference Davidson PM, Paull G, Introna K, Cockburn J, Davis JM, Rees D, Gorman D, Magann L, Lafferty M, Dracup K (2004) Integrated, collaborative palliative care in heart failure: the St. George Heart Failure Service experience 1999-2002. J Cardiovasc Nurs 19(1):68–75CrossRefPubMed Davidson PM, Paull G, Introna K, Cockburn J, Davis JM, Rees D, Gorman D, Magann L, Lafferty M, Dracup K (2004) Integrated, collaborative palliative care in heart failure: the St. George Heart Failure Service experience 1999-2002. J Cardiovasc Nurs 19(1):68–75CrossRefPubMed
11.
go back to reference Rosenwax LK, McNamara BA, Murray K, McCabe RJ, Aoun SM, Currow DC (2011) Hospital and emergency department use in the last year of life: a baseline for future modifications to end-of-life care. Med J Aust 194(11):570–573PubMed Rosenwax LK, McNamara BA, Murray K, McCabe RJ, Aoun SM, Currow DC (2011) Hospital and emergency department use in the last year of life: a baseline for future modifications to end-of-life care. Med J Aust 194(11):570–573PubMed
12.
go back to reference Xie K, Gelfman L, Horton J, Goldstein N (2015) Current state of research on palliative care in heart failure as evidenced by published literature, conference proceedings and NIH funding. J Am Geriatr Soc 63:S131–S132 Xie K, Gelfman L, Horton J, Goldstein N (2015) Current state of research on palliative care in heart failure as evidenced by published literature, conference proceedings and NIH funding. J Am Geriatr Soc 63:S131–S132
24.
27.
go back to reference Van den Block L, Deschepper R, Drieskens K, Bauwens S, Bilsen J, Bossuyt N, Deliens L (2007) Hospitalisations at the end of life: using a sentinel surveillance network to study hospital use and associated patient, disease and healthcare factors. BMC Health Serv Res 7:9. https://doi.org/10.1186/1472-6963-7-69 CrossRef Van den Block L, Deschepper R, Drieskens K, Bauwens S, Bilsen J, Bossuyt N, Deliens L (2007) Hospitalisations at the end of life: using a sentinel surveillance network to study hospital use and associated patient, disease and healthcare factors. BMC Health Serv Res 7:9. https://​doi.​org/​10.​1186/​1472-6963-7-69 CrossRef
30.
go back to reference Levenson JW, McCarthy EP, Lynn J, Davis RB, Phillips RS (2000) The last six months of life for patients with congestive heart failure. J Am Geriatr Soc 48(5):S101–S109CrossRefPubMed Levenson JW, McCarthy EP, Lynn J, Davis RB, Phillips RS (2000) The last six months of life for patients with congestive heart failure. J Am Geriatr Soc 48(5):S101–S109CrossRefPubMed
31.
go back to reference Krumholz HM, Phillips RS, Hamel MB, Teno JM, Bellamy P, Broste SK, Califf RM, Vidaillet H, Davis RB, Muhlbaier LH, Connors AF, Lynn J, Goldman L, Investigators S (1998) Resuscitation preferences among patients with severe congestive heart failure—results from the SUPPORT project. Circulation 98(7):648–655CrossRefPubMed Krumholz HM, Phillips RS, Hamel MB, Teno JM, Bellamy P, Broste SK, Califf RM, Vidaillet H, Davis RB, Muhlbaier LH, Connors AF, Lynn J, Goldman L, Investigators S (1998) Resuscitation preferences among patients with severe congestive heart failure—results from the SUPPORT project. Circulation 98(7):648–655CrossRefPubMed
34.
go back to reference Hui D, De La Cruz M, Mori M, Parsons HA, Kwon JH, Torres-Vigil I, Kim SH, Dev R, Hutchins R, Liem C, Kang DH, Bruera E (2013) Concepts and definitions for “supportive care,” “best supportive care,” “palliative care,” and “hospice care” in the published literature, dictionaries, and textbooks. Support Care Cancer 21(3):659–685. https://doi.org/10.1007/s00520-012-1564-y CrossRefPubMed Hui D, De La Cruz M, Mori M, Parsons HA, Kwon JH, Torres-Vigil I, Kim SH, Dev R, Hutchins R, Liem C, Kang DH, Bruera E (2013) Concepts and definitions for “supportive care,” “best supportive care,” “palliative care,” and “hospice care” in the published literature, dictionaries, and textbooks. Support Care Cancer 21(3):659–685. https://​doi.​org/​10.​1007/​s00520-012-1564-y CrossRefPubMed
39.
go back to reference Welfare AIoHa (2012) Palliative care services in Australia Welfare AIoHa (2012) Palliative care services in Australia
40.
go back to reference Zhang BH, Wright AA, Huskamp HA, Nilsson ME, Maciejewski ML, Earle CC, Block SD, Maciejewski PK, Prigerson HG (2009) Health care costs in the last week of life: associations with end-of-life conversations. Arch Intern Med 169(5):480–488CrossRefPubMedPubMedCentral Zhang BH, Wright AA, Huskamp HA, Nilsson ME, Maciejewski ML, Earle CC, Block SD, Maciejewski PK, Prigerson HG (2009) Health care costs in the last week of life: associations with end-of-life conversations. Arch Intern Med 169(5):480–488CrossRefPubMedPubMedCentral
46.
go back to reference Seow H, Brazil K, Sussman J, Pereira J, Marshall D, Austin PC, Husain A, Rangrej J, Barbera L (2014) Impact of community based, specialist palliative care teams on hospitalisations and emergency department visits late in life and hospital deaths: a pooled analysis. BMJ-Br Med J 348:10. https://doi.org/10.1136/bmj.g3496 CrossRef Seow H, Brazil K, Sussman J, Pereira J, Marshall D, Austin PC, Husain A, Rangrej J, Barbera L (2014) Impact of community based, specialist palliative care teams on hospitalisations and emergency department visits late in life and hospital deaths: a pooled analysis. BMJ-Br Med J 348:10. https://​doi.​org/​10.​1136/​bmj.​g3496 CrossRef
47.
53.
go back to reference Johnson MJ, Gadoud A (2011) Palliative care for people with chronic heart failure: when is it time? J Palliat Care 27(1):37–42CrossRefPubMed Johnson MJ, Gadoud A (2011) Palliative care for people with chronic heart failure: when is it time? J Palliat Care 27(1):37–42CrossRefPubMed
56.
go back to reference Wong RCC, Tan PT, Seow YH, Aziz S, Oo N, Seow SC, Seah A, Chai P (2013) Home-based advance care programme is effective in reducing hospitalisations of advanced heart failure patients: a clinical and healthcare cost study. Ann Acad Med Singap 42(9):466–471PubMed Wong RCC, Tan PT, Seow YH, Aziz S, Oo N, Seow SC, Seah A, Chai P (2013) Home-based advance care programme is effective in reducing hospitalisations of advanced heart failure patients: a clinical and healthcare cost study. Ann Acad Med Singap 42(9):466–471PubMed
62.
go back to reference Wotton K, Borbasi S, Redden M (2005) When all else has failed: nurses’ perceptions of factors influencing palliative care for patients with end-stage heart failure. J Cardiovasc Nurs 20(1):18–25CrossRefPubMed Wotton K, Borbasi S, Redden M (2005) When all else has failed: nurses’ perceptions of factors influencing palliative care for patients with end-stage heart failure. J Cardiovasc Nurs 20(1):18–25CrossRefPubMed
64.
go back to reference Allen LA, Stevenson LW, Grady KL, Goldstein NE, Matlock DD, Arnold RM, Cook NR, Felker GM, Francis GS, Hauptman PJ, Havranek EP, Krumholz HM, Mancini D, Riegel B, Spertus JA, Amer Heart Assoc Council Q, Council Cardiovasc N, Council Clinical C, Council Cardiovasc R, Council Cardiovasc Surg A (2012) Decision making in advanced heart failure: a scientific statement from the American Heart Association. Circulation 125(15):1928–1952. https://doi.org/10.1161/CIR.0b013e31824f2173 CrossRefPubMedPubMedCentral Allen LA, Stevenson LW, Grady KL, Goldstein NE, Matlock DD, Arnold RM, Cook NR, Felker GM, Francis GS, Hauptman PJ, Havranek EP, Krumholz HM, Mancini D, Riegel B, Spertus JA, Amer Heart Assoc Council Q, Council Cardiovasc N, Council Clinical C, Council Cardiovasc R, Council Cardiovasc Surg A (2012) Decision making in advanced heart failure: a scientific statement from the American Heart Association. Circulation 125(15):1928–1952. https://​doi.​org/​10.​1161/​CIR.​0b013e31824f2173​ CrossRefPubMedPubMedCentral
66.
go back to reference Fitzsimons D, Mullan D, Wilson JS, Conway B, Corcoran B, Dempster M, Gamble J, Stewart C, Rafferty S, McMahon M, MacMahon J, Mulholland P, Stockdalle P, Chew E, Hanna L, Brown J, Ferguson G, Fogarty D (2007) The challenge of patients’ unmet palliative care needs in the final stages of chronic illness. Palliat Med 21(4):313–322. https://doi.org/10.1177/0269216307077711 CrossRefPubMed Fitzsimons D, Mullan D, Wilson JS, Conway B, Corcoran B, Dempster M, Gamble J, Stewart C, Rafferty S, McMahon M, MacMahon J, Mulholland P, Stockdalle P, Chew E, Hanna L, Brown J, Ferguson G, Fogarty D (2007) The challenge of patients’ unmet palliative care needs in the final stages of chronic illness. Palliat Med 21(4):313–322. https://​doi.​org/​10.​1177/​0269216307077711​ CrossRefPubMed
70.
go back to reference Siouta N, van Beek K, Preston N, Hasselaar J, Hughes S, Payne S, Garralda E, Centeno C, van der Eerden M, Groot M, Hodiamont F, Radbruch L, Busa C, Csikos A, Menten J (2016) Towards integration of palliative care in patients with chronic heart failure and chronic obstructive pulmonary disease: a systematic literature review of European guidelines and pathways. Bmc Palliative Care 15:12:18. https://doi.org/10.1186/s12904-016-0089-4 CrossRefPubMedPubMedCentral Siouta N, van Beek K, Preston N, Hasselaar J, Hughes S, Payne S, Garralda E, Centeno C, van der Eerden M, Groot M, Hodiamont F, Radbruch L, Busa C, Csikos A, Menten J (2016) Towards integration of palliative care in patients with chronic heart failure and chronic obstructive pulmonary disease: a systematic literature review of European guidelines and pathways. Bmc Palliative Care 15:12:18. https://​doi.​org/​10.​1186/​s12904-016-0089-4 CrossRefPubMedPubMedCentral
71.
go back to reference Atherton JJ, Sindone A, De Pasquale CG, Driscoll A, MacDonald PS, Hopper I, Kistler PM, Briffa T, Wong J, Abhayaratna W, Thomas L, Audehm R, Newton P, O'Loughlin J, Branagan M, Connell C (2018) National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: guidelines for the prevention, detection, and management of heart failure in Australia 2018. Heart Lung and Circulation 27(10):1123–1208. https://doi.org/10.1016/j.hlc.2018.06.1042 CrossRef Atherton JJ, Sindone A, De Pasquale CG, Driscoll A, MacDonald PS, Hopper I, Kistler PM, Briffa T, Wong J, Abhayaratna W, Thomas L, Audehm R, Newton P, O'Loughlin J, Branagan M, Connell C (2018) National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: guidelines for the prevention, detection, and management of heart failure in Australia 2018. Heart Lung and Circulation 27(10):1123–1208. https://​doi.​org/​10.​1016/​j.​hlc.​2018.​06.​1042 CrossRef
Metadata
Title
The use of hospital-based services by heart failure patients in the last year of life: a discussion paper
Authors
Gursharan K. Singh
Patricia M. Davidson
Peter S. Macdonald
Phillip J. Newton
Publication date
01-03-2019
Publisher
Springer US
Published in
Heart Failure Reviews / Issue 2/2019
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI
https://doi.org/10.1007/s10741-018-9751-7

Other articles of this Issue 2/2019

Heart Failure Reviews 2/2019 Go to the issue