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Editorial| Volume 31, ISSUE 6, P755-756, June 2022

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Integrating Heart Failure Palliative Care Delivery in an Uncertain Disease Trajectory

DOI:https://doi.org/10.1016/j.hlc.2022.04.001
Integrating Heart Failure Palliative Care Delivery in an Uncertain Disease Trajectory
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      Dying with end stage heart failure can be like a roller-coaster: a process punctuated by unpredictable episodes of acute deterioration, recovery, and often seemingly unexpected decline [
      • Rogers J.G.
      • Patel C.B.
      • Mentz R.J.
      • Granger B.B.
      • Steinhauser K.E.
      • Fiuzat M.
      • et al.
      Palliative care in heart failure: the PAL-HF randomized, controlled clinical trial.
      J Am Coll Cardiol. 2017; 70: 331-341
      ,
      • Jha S.R.
      • Ha H.S.
      • Hickman L.D.
      • Hannu M.
      • Davidson P.M.
      • Macdonald P.S.
      • Newton P.J.
      Frailty in advanced heart failure: a systematic review.
      Heart Fail Rev. 2015; 20: 553-560
      ,
      • Liu L.
      • Eisen H.J.
      Epidemiology of heart failure and scope of the problem.
      Cardiol Clin. 2014; 32 (1-8, vii)
      ]. This not-so-predictable disease trajectory often results in referral to palliative care in only the terminal, or ‘end of life’ phase. Yet, late engagement with palliative care can result in increased hospitalisations, length of stays, depression [
      • Rao A.
      • Zecchin R.
      • Newton P.J.
      • Phillips J.L.
      • DiGiacomo M.
      • Denniss A.R.
      • Hickman L.D.
      The prevalence and impact of depression and anxiety in cardiac rehabilitation: a longitudinal cohort study.
      Eur J Prev Cardiol. 2020; 27: 478-489
      ], poor symptom management, and decreased quality of life, and most importantly, fewer days for patients and family members in their preferred place of care before they die [
      • Atherton J.J.
      • Sindone A.
      • De Pasquale C.G.
      • Driscoll A.
      • MacDonald P.S.
      • Hopper I.
      • et al.
      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 Circ. 2018; 27: 1123-1208
      ,
      • Kavalieratos D.
      • Gelfman L.P.
      • Tycon L.E.
      • Riegel B.
      • Bekelman D.B.
      • Ikejani D.Z.
      • et al.
      Palliative care in heart failure: rationale, evidence, and future priorities.
      J Am Coll Cardiol. 2017; 70: 1919-1930
      ,
      • Liu A.Y.
      • O’Riordan D.L.
      • Marks A.K.
      • Bischoff K.E.
      • Pantilat S.Z.
      A comparison of hospitalized patients with heart failure and cancer referred to palliative care.
      JAMA Netw Open. 2020; 3e200020
      ].
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        • Fiuzat M.
        • et al.
        Palliative care in heart failure: the PAL-HF randomized, controlled clinical trial.
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        View in Article
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        • Ha H.S.
        • Hickman L.D.
        • Hannu M.
        • Davidson P.M.
        • Macdonald P.S.
        • Newton P.J.
        Frailty in advanced heart failure: a systematic review.
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        View in Article
        • Liu L.
        • Eisen H.J.
        Epidemiology of heart failure and scope of the problem.
        Cardiol Clin. 2014; 32 (1-8, vii)
        View in Article
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        • Newton P.J.
        • Phillips J.L.
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        The prevalence and impact of depression and anxiety in cardiac rehabilitation: a longitudinal cohort study.
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        View in Article
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        • MacDonald P.S.
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      Article info

      Identification

      DOI: https://doi.org/10.1016/j.hlc.2022.04.001

      Copyright

      © 2022 Published by Elsevier B.V. on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).

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