Final published version
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - What palliative care clinicians need to know about heart failure?
AU - Gadoud, Amy
AU - Johnson, Miriam
PY - 2014/2
Y1 - 2014/2
N2 - Heart failure (HF) is a common chronic condition, increasing in prevalence in line with an ageing population. Patients have a significant symptom burden, and a palliative care approach may be appropriate in advanced disease. Barriers to a palliative care approach exist, but can be overcome by an integrated model of care. Palliative care of patients with advanced HF has many similarities to palliative care of cancer patients. It is important to assess the psychosocial and spiritual domains of symptoms such as breathlessness, as well as physical. Individually tailored medical management has transformed the care of HF, but in advanced disease management the cardiac medication should be regularly reviewed to ensure optimal tolerated doses are prescribed. Breathlessness is a common and distressing symptom for patients with HF and their families. Specific non-pharmacological interventions such as exercise and psychological interventions should be considered. Pharmacological strategies, particularly low-dose opioids may also be useful. Use of oxygen remains a clinical uncertainty. Usefulness of cardiac devices, particularly implantable cardioverter-defibrillators decreases in advanced disease. Deactivation requires excellent communication between teams and with patients and families.
AB - Heart failure (HF) is a common chronic condition, increasing in prevalence in line with an ageing population. Patients have a significant symptom burden, and a palliative care approach may be appropriate in advanced disease. Barriers to a palliative care approach exist, but can be overcome by an integrated model of care. Palliative care of patients with advanced HF has many similarities to palliative care of cancer patients. It is important to assess the psychosocial and spiritual domains of symptoms such as breathlessness, as well as physical. Individually tailored medical management has transformed the care of HF, but in advanced disease management the cardiac medication should be regularly reviewed to ensure optimal tolerated doses are prescribed. Breathlessness is a common and distressing symptom for patients with HF and their families. Specific non-pharmacological interventions such as exercise and psychological interventions should be considered. Pharmacological strategies, particularly low-dose opioids may also be useful. Use of oxygen remains a clinical uncertainty. Usefulness of cardiac devices, particularly implantable cardioverter-defibrillators decreases in advanced disease. Deactivation requires excellent communication between teams and with patients and families.
KW - Communication
KW - Dyspnoea
KW - Heart failure
KW - Integrated service
KW - Palliative
U2 - 10.1179/1743291X13Y.0000000061
DO - 10.1179/1743291X13Y.0000000061
M3 - Journal article
AN - SCOPUS:84896726873
VL - 22
SP - 26
EP - 31
JO - Progress in Palliative Care
JF - Progress in Palliative Care
SN - 0969-9260
IS - 1
ER -