Jane MacIver1, Kirsten Wentlandt, Heather J Ross. 1. aPeter Munk Cardiac Center bDepartment of Supportive Care, University Health Network cLawrence S. Bloomberg Faculty of Nursing dDepartment of Medicine eDepartment of Family and Community Medicine, University of Toronto, Toronto, Canada.
Abstract
PURPOSE OF REVIEW: Patients with Stage D heart failure can benefit from palliative care consultation to help them manage unpleasant symptoms and improve quality of life. Although guidelines describe how to manage symptoms, very little direction is provided on how to evaluate the effectiveness of those interventions. RECENT FINDINGS: Numerous studies have used the measurement of symptoms, emotional distress, functional capacity and quality of life to evaluate the effectiveness of interventions in heart failure. There is limited evidence on the use of these instruments in heart failure palliative care. Four studies were identified that evaluate the effectiveness of palliative care consultation for patients with advanced heart failure. All four studies measured symptom severity, emotional distress, and quality of life. The application of appropriate instruments is discussed. Suggestions for scores that should trigger palliative care consultation are identified. SUMMARY: The routine administration of standardized instruments to measure symptom severity and quality of life may improve the assessment and management of patients with Stage D heart failure. Ongoing discussion and research is needed to determine if these instruments are the best tools to use with heart failure palliative care patients.
PURPOSE OF REVIEW: Patients with Stage D heart failure can benefit from palliative care consultation to help them manage unpleasant symptoms and improve quality of life. Although guidelines describe how to manage symptoms, very little direction is provided on how to evaluate the effectiveness of those interventions. RECENT FINDINGS: Numerous studies have used the measurement of symptoms, emotional distress, functional capacity and quality of life to evaluate the effectiveness of interventions in heart failure. There is limited evidence on the use of these instruments in heart failure palliative care. Four studies were identified that evaluate the effectiveness of palliative care consultation for patients with advanced heart failure. All four studies measured symptom severity, emotional distress, and quality of life. The application of appropriate instruments is discussed. Suggestions for scores that should trigger palliative care consultation are identified. SUMMARY: The routine administration of standardized instruments to measure symptom severity and quality of life may improve the assessment and management of patients with Stage D heart failure. Ongoing discussion and research is needed to determine if these instruments are the best tools to use with heart failure palliative care patients.
Authors: Stephanie Mc Ament; Inge Me Couwenberg; Josiane Jj Boyne; Jos Kleijnen; Henri Ejh Stoffers; Marieke Hj van den Beuken; Yvonne Engels; Louise Bellersen; Daisy Ja Janssen Journal: Palliat Med Date: 2020-10-15 Impact factor: 4.762