Prevalence and characteristics of patients with heart failure needing palliative care

BMC Palliative Care

Xavier Gómez-Batiste¹  Clara Saldarriaga²  Mariantonia Lemos³  Valentina González-Jaramillo⁴  Nathalia Gonzalez-Jaramillo⁴  Alicia Krikorian⁵  Luisa Fernanda Arenas Ochoa⁶  John Jairo Vargas⁷  Steffen Eychmüller⁸ 

[1] Chair Qualy Palliative Care, Faculty Medicine, University of Vic/Central of Catalonia, Barcelona, Spain;Department of Cardiology, Clínica Cardio VID, Medellín, Colombia;Cardiology Department, Universidad de Antioquia, Medellín, Colombia;Department of Psychology, School of Humanities, Universidad EAFIT, Medellín, Colombia;Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland;Graduate School for Health Sciences, University of Bern, Bern, Switzerland;Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia;Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia;Department of Palliative Care, Clínica Cardio VID, Medellín, Colombia;Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia;Institute of Cancerology, Clínica Las Américas, Medellin, Colombia;University Center for Palliative Care, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland;

关键词: Heart failure;    Palliative care;    Needs assessment;    Prognosis;    Patient-centered care;    Health services needs and demands;   

DOI  :  10.1186/s12904-021-00850-y

来源: Springer

【 摘 要 】

BackgroundFew hospitals and heart failure (HF) clinics offer concurrent palliative care (PC) together with life-prolonging therapies. To know the prevalence of patients in HF clinics needing PC and useful tools to recognize them are the first steps to extending PC in those settings. However, it is still unknown whether tools commonly used to identify patients with HF needing PC can correctly distinguish them. Two systematic reviews found that the NECesidades PALiativas (NECPAL) tool was one of the two most commonly used tools to asses PC needs in HF patients. Therefore, we assessed 1) the prevalence of PC needs in HF clinics according to the NECPAL tool, and 2) the characteristics of the patients identified as having PC; mainly, their quality of life (QoL), symptom burden, and psychosocial problems.MethodsThis cross-sectional study was conducted at two HF clinics in Colombia. We assessed the prevalence of PC in the overall sample and in subgroups according to clinical and demographic variables. We assessed QoL, symptom burden, and psychosocial problems using the 12-Item Short-Form Health Survey (SF-12), the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Edmonton Symptom Assessment System (ESAS). We compared the results of these tools between patients identified as having PC needs (+NECPAL) and patients identified as not having PC needs (–NECPAL).ResultsAmong the 178 patients, 78 (44%) had PC needs. The prevalence of PC needs was twice as nigh in patients NYHA III/IV as in patients NYHA I/II and almost twice as high in patients older than 70 years as in patients younger than 70 years. Compared to –NECPAL patients, +NECPAL patients had worse QoL, more severe shortness of breath, tiredness, drowsiness, and pain, and more psychosocial problems.ConclusionThe prevalence of PC needs in outpatient HF clinics is high and is even higher in older patients and in patients at more advanced NYHA stages. Compared to patients identified as not having PC needs, patients identified as having PC needs have worse QoL, more severe symptoms, and greater psychosocial problems. Including a PC provider in the multidisciplinary team of HF clinics may help to assess and cover these needs.

【 授权许可】

CC BY