Michael J Diamant1, Hesam Keshmiri2, Mustafa Toma1. 1. Division of Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 2. Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
PURPOSE OF REVIEW: With an aging population with heart failure, there is a growing need for end-of-life care in this population, including a focus on symptom management and quality-of-life considerations. RECENT FINDINGS: Targeted therapies focusing on symptom control and improving quality of life is the cornerstone of providing care in patients with heart failure near the end of life. Such therapies, including the use of inotropes for palliative purposes, have been shown to improve symptoms without an increase in mortality. In addition, recent evidence shows that implementing certain strategies in planning for end of life, including advance care planning and palliative care involvement, can significantly improve symptoms and quality of life, reduce hospitalizations, and ensure care respects patient values and preferences. SUMMARY: Shifting focus from prolonging life to enhancing quality of life in heart failure patients approaching the end of life can be achieved by recognizing and managing end-stage heart failure-related symptoms, advanced care planning, and a multidisciplinary care approach.
PURPOSE OF REVIEW: With an aging population with heart failure, there is a growing need for end-of-life care in this population, including a focus on symptom management and quality-of-life considerations. RECENT FINDINGS: Targeted therapies focusing on symptom control and improving quality of life is the cornerstone of providing care in patients with heart failure near the end of life. Such therapies, including the use of inotropes for palliative purposes, have been shown to improve symptoms without an increase in mortality. In addition, recent evidence shows that implementing certain strategies in planning for end of life, including advance care planning and palliative care involvement, can significantly improve symptoms and quality of life, reduce hospitalizations, and ensure care respects patient values and preferences. SUMMARY: Shifting focus from prolonging life to enhancing quality of life in heart failurepatients approaching the end of life can be achieved by recognizing and managing end-stage heart failure-related symptoms, advanced care planning, and a multidisciplinary care approach.
Authors: Marie A Bakitas; J Nicholas Dionne-Odom; Deborah B Ejem; Rachel Wells; Andres Azuero; Macy L Stockdill; Konda Keebler; Elizabeth Sockwell; Sheri Tims; Sally Engler; Karen Steinhauser; Elizabeth Kvale; Raegan W Durant; Rodney O Tucker; Kathryn L Burgio; Jose Tallaj; Keith M Swetz; Salpy V Pamboukian Journal: JAMA Intern Med Date: 2020-09-01 Impact factor: 21.873