Consensus statement: palliative and supportive care in advanced heart failure
Abstract
Background
A
consensus conference was convened to define the current state and
important gaps in knowledge and needed research on “Palliative and
Supportive Care in Advanced Heart Failure.”
Evidence
Evidence
was drawn from expert opinion and from extensive review of the medical
literature, evidence-based guidelines, and reviews.
Conclusions
The
conference identified gaps in current knowledge, practice, and research
relating to prognostication, symptom management, and supportive care
for advanced heart failure (HF). Specific conclusions include: (1)
although supportive care should be integrated throughout treatment of
patients with advanced HF, data are needed to understand how to best
decrease physical and psychosocial burdens of advanced HF and to meet
patient and family needs; (2) prognostication in advanced HF is
difficult and data are needed to understand which patients will benefit
from which interventions and how best to counsel patients with advanced
HF; (3) research is needed to identify which interventions improve
quality of life and best achieve the outcomes desired by patients and
family members; (4) care should be coordinated between sites of care,
and barriers to evidence-based practice must be addressed
programmatically; and (5) more research is needed to identify the
content and technique of communicating prognosis and treatment options
with patients with advanced HF; physicians caring for patients with
advanced HF must develop skills to better integrate the patient's
preferences into the goals of care.
Keywords:
advanced heart failure,
palliative care
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